Jump to content
This site uses cookies. Continued use is acceptance of our Terms of Use and Privacy Policy. More Info... ×
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

Should I get a different gi doctor?


need7
Go to solution Solved by trents,

Recommended Posts

need7 Newbie

Just had my first followup after diagnosis (or rather bloodwork) for celiac disease and my doctor seemed rather dismissive of my concerns. I asked about the autoimmune aspect and if I need to do additional followup since according to data a diagnoses at my age is a 33% chance of a concurrent autoimmune issue.  To which the response was (well we dont really do that and only focus on it if you have symptoms). She also seemed a bit unconcerned with cross contamination and when I brought up how most restaurants have "we cannot recommend this for people with celiac disease as we used a shared kitchen" she pretty much said all of them have to say that legally but supposedly its been getting better and to not focus so much on the cross contamination and just focus on the removing gluten from my diet. Both of these and the way she went about it seem to me like she doesnt really understand the disease all too because based on the research I didO(which I basically got none from them after the diagnosis) those are serious concerns. I could also understand if im wrong about something but it seemed like they just didnt care or didnt know enough in general. Should I look for a new gastroenterologist? their only plan they ahd for me was to do bloodwork and check for any nutrient deficiencies in about 6 weeks. For anyone with mroe experience does that sound right or should I really look elsewhere?


Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):



Celiac.com Sponsor (A8-M):



knitty kitty Grand Master

Welcome to the forum!

Unfortunately, doctors are not as knowledgeable about Celiac Disease as we would like.  But your doctor is going to check for nutritional deficiencies, which is a point in her favor.  You might request a referral to a nutritionist.

Their dismissive attitude can be because they don't have a clue what it's really like to experience celiac disease.  But we do here, so we'll be glad to answer any questions.

  • Solution
trents Grand Master

Welcome to the forum, need7!

It is unfortunate that your GI doc projects this attitude but the fact is this is the norm. There is just a lot of ignorance in the medical community regarding celiac disease and the chances of finding another doc who is more in tune with your celiac disease may not be that good.

It would probably be a more fruitful approach to educate yourself and just be your own advocate. You don't need the GI doc to confirm your safety strategy as a celiac. Just do what you need to do. The doc isn't there at the restaurant with you anyway when you eat out. At least your current doc is willing to do follow-up testing which is really all you need.

Also, be aware that nutrient level serum testing has limitations in that it can't really measure how well the nutrients are getting into the cells. Nutrient deficiency symptoms may be a more reliable indicator of deficiencies. We routinely recommend taking the following gluten-free supplements: B-complex, B12, D3, and magnesium (citrate or gycinate forms since they are best assimilated). Nutrient deficiency is almost a given with celiac disease as it usually takes years to get diagnosed after onset.

 

need7 Newbie
20 minutes ago, trents said:

Welcome to the forum, need7!

It is unfortunate that your GI doc projects this attitude but the fact is this is the norm. There is just a lot of ignorance in the medical community regarding celiac disease and the chances of finding another doc who is more in tune with your celiac disease may not be that good.

It would probably be a more fruitful approach to educate yourself and just be your own advocate. You don't need the GI doc to confirm your safety strategy as a celiac. Just do what you need to do. The doc isn't there at the restaurant with you anyway when you eat out. At least your current doc is willing to do follow-up testing which is really all you need.

Also, be aware that nutrient level serum testing has limitations in that it can't really measure how well the nutrients are getting into the cells. Nutrient deficiency symptoms may be a more reliable indicator of deficiencies. We routinely recommend taking the following gluten-free supplements: B-complex, B12, D3, and magnesium (citrate or gycinate forms since they are best assimilated). Nutrient deficiency is almost a given with celiac disease as it usually takes years to get diagnosed after onset.

 

Thanks for the followup and advice. I am looking into my options for supplements and I sadly wasnt able to really get a understanding of how damaged my villi was or what marsh score as there wasnt much communication about that when asked only that "it looked normal during the procedure, but the biopsy itself was suggestive of celiac" whatever that exactly means the gi  I spoke to believes it might have been caught early. I just am trying to make the best decisions possible and gather what information I can really. ill be sure to make note of those supplements and see what my options are for getting them thank you again!

need7 Newbie
29 minutes ago, knitty kitty said:

Welcome to the forum!

Unfortunately, doctors are not as knowledgeable about Celiac Disease as we would like.  But your doctor is going to check for nutritional deficiencies, which is a point in her favor.  You might request a referral to a nutritionist.

Their dismissive attitude can be because they don't have a clue what it's really like to experience celiac disease.  But we do here, so we'll be glad to answer any questions.

Thanks for the response I havent really been to a gastroenterologist before but was just very disturbed by the lack of awareness about it so I figured it would be better safe then sorry to ask. It was very jarring to see my doctor offer rather conflicting advice to what I had seen when I did my own research on very reputable sites. 

plumbago Experienced
6 hours ago, need7 said:

wasnt able to really get a understanding of how damaged my villi was or what marsh score as there wasnt much communication about that when asked only that "it looked normal during the procedure, but the biopsy itself was suggestive of celiac" whatever that exactly means

Ok, so you've had an EGD and biopsy. You have every right to look at the pathologist's report - indeed that should have been handed to you, along with pictures. This is, in my experience, across the board standard. Get that report. It's yours.

need7 Newbie
1 hour ago, plumbago said:

Ok, so you've had an EGD and biopsy. You have every right to look at the pathologist's report - indeed that should have been handed to you, along with pictures. This is, in my experience, across the board standard. Get that report. It's yours.

I do actually have that report but my diagnosis wasnt what I was getting a EGD for so I believe that might be why its lacking that information. The most I have is villous blunting/partial atrophy is what is said. which isnt severe but the classification of differences is a bit complicated in terms of finding out the extent of the damage to my villi, but after a bit more checking and looking it seems that does give me the answer I was looking for just not as easily as I was hoping. Thank you for clarifying that so I am able to figure that out for myself I appreciate it!


Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):



Celiac.com Sponsor (A8-M):



Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      126,475
    • Most Online (within 30 mins)
      7,748

    Lilstorm
    Newest Member
    Lilstorm
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      120.9k
    • Total Posts
      69.4k

  • Celiac.com Sponsor (A22):





  • Celiac.com Sponsor (A21):



  • Upcoming Events

  • Posts

    • Mmar
      Hello! I have been on a strict gluten-free diet for 20 years after my initial diagnosis, but in July had an endoscopy that showed villous atrophy (but multiple ttgs have all been normal). I have gone through everything in my house to eliminate any gluten and have been eating almost no processed foods, and will be getting a second endoscopy in a month because my GI doctor thinks it could be refractory celiac. She told me that if it’s refractory, I would need to see a “specialist” because she doesn’t know enough.  I live in Philadelphia and the Celiac Center at Jefferson has 0 appointments with any doctors, I keep trying. Does anyone know of either a doctor in Philadelphia that treats refractory celiac or a doctor elsewhere that does virtual appointments to treat refractory? Thank you!
    • knitty kitty
      @GardeningForHealth, On my journey, I found following the Autoimmune Paleo Diet most helpful in reducing reactions to various foods.  It's very restrictive, but it really helps improve gut health.  It's worth the effort for a few weeks or months. Tea from any grocery store; Tea, organic; Tea, grown in USA, never-sprayed, loose leaf Tea contains TANNINS which can inactivate Thiamin resulting in Thiamin deficiency.  Tannins inhibit the absorption of other vitamins and minerals, especially iron. Tannins can inactivate digestive enzymes.  So drink tea between meals.  Choose a tea with lower levels of tannin, like green tea or Oolong tea.  Oolong tea contains amino acid Theanine which reduces inflammation in the digestive tract. Dairy; Rice, any brand, even after washing 3 times Many people develop Lactose intolerance because damaged villi in the intestinal lining of the digestive tract cannot produce the enzyme Lactase needed to digest the sugar in dairy, Lactose.   Many people with Celiac Disease react to the protein Casein the same as they react to the protein Gluten.  This is because both Casein and Gluten, as well as the protein in rice, carry a similar segment of a protein building block chain (33 mer peptide) that triggers the autoimmune response in Celiac Disease.  Basmati rice is less likely to carry this protein chain and may be better tolerated.  Don't wash rice before cooking.  The added vitamins get washed away.  Some of those grains of rice are extruded vitamins.  They dissolved into the cooking water and are reabsorbed into the grains as the rice cooks. Organic catchup, Potatoes; Tomatoes are a member of the Nightshade vegetables which have been shown to increase gastrointestinal permeability and "leaky gut syndrome."  Potatoes, Peppers and Eggplant also belong to the Nightshades, and should be avoided until healed.  Catsup usually is acidic which can be irritating to the digestive system. Any and all brands of gluten-free breads and dessert items; Cassava flour; Gluten-free flour Often these contain cross contamination with gluten.  @Scott Adams recently posted a new article about this.  Gluten free products are not enriched with vitamins and minerals needed to digest and process them.  They are high in insoluble fiber and saturated fats.  These may also contain microbial transglutaminase, see below. Sausage, Any processed meat These foods contain microbial transglutaminase, a flavor and texture enhancer, called "meat glue" in the food processing industry, which triggers and provokes anti-gluten antibodies to attack the microbial transglutaminase as well as the tissue transglutaminase produced by our own bodies as with Celiac Disease.  We have articles about microbial transglutaminase, too.  Cassava also contains Thiaminase, an enzyme which destroys Thiamin. Cucumbers from a grocery store, but not from my garden, Most apples, Zucchini, Plums Cucumbers, like these other fruits and veggies, contain lots of soluble fiber, pectin, which intestinal bacteria can ferment and then make short chain fatty acids, which are beneficial.  So that's a good thing.  However, commercially produced breeds of veggies and fruits may contain higher levels of pectins than historically home grown varieties.  Excess consumption of pectins can result in gas, bloating and diarrhea.   Bottled spices  There's an article (perhaps @Scott Adams can help us find, please) about how some spices can cause gastrointestinal symptoms. Gluten-free dairy-free ice cream These can cause reactions if one reacts to oats.  Products made from nuts or nut milks may contain high levels of lectins which are hard to digest and can cause all the usual symptoms.   Smoke from a fire; Strong cleaning chemical fumes These contain Sulfites.  Developing a hyperensitivity to Sulfites is possible in Celiac Disease.  We can be low in vitamins and minerals needed to process Sulfites.  I have Hypersensitivity Type Four where the immune system identifies Sulfites as something to be attacked.  Celiac Disease is another Hypersensitivity Type Four disorder. Packaged sweet potato chips; Packaged plantain chips;  Rice; Any and all brands of gluten-free breads and dessert items; Cassava flour; Gluten-free flour; Gluten-free dairy-free ice cream A High Carbohydrate diet can lead to Small Intestinal Bacterial Overgrowth (SIBO).  Adopting a Paleo diet like the AIP diet is a great way to change your gut biome without using antibiotics which kill off the bad with the good bacteria.  Taking probiotics may not be very effective as long as SIBO bacteria are entrenched in the digestive tract.  You change what you eat and you change what grows inside you.  You starve out the bad SIBO bacteria, repopulate and feed the good ones.  Supplementing with Benfotiamin helps because thiamine has antibacterial properties that keeps the bad bacteria in check and benefits the good bacteria.  Benfotiamin is needed to process all those carbs turning them into energy instead of them turning to fat.   I hope this has been helpful.
    • trents
      Welcome to the forum @Newhere19! Yes, we have had many forum members that for one reason or another cannot go forward with the confirmation step of the endoscopy with biopsy. Usually it is because they have already been gluten free for a significant period and react so severely to gluten ingestion that they cannot undertake the gluten challenge without endangering their health. But we also have had more than a few who have severe anxiety surrounding the endoscopy itself and cannot bring themselves to go forward with it. May I ask, what was your antibody score or scores, what was the name of the test or tests done and what were the ranges given for normal/negative vs. positive?  What symptoms do you have? What caused you to seek out celiac testing? And to answer your question, many on this forum have had to go forward with the gluten free diet without an official diagnosis for the reasons already stated. You should start seeing symptom improvement within weeks. But realize that achieving a truly free gluten lifestyle is more challenging than most of us realize at the outset. There is a real learning curve involved in order to achieve consistency. That is partly due to the many unexpected places gluten is tucked away in the food supply/supplements/medications and partly because of CC (Cross Contamination) issues. I will offer this primer to get you off to a good start:  
    • Newhere19
      I recently had bloodwork done with a GI specialist and was told that I have celiac.. .but they will not confirm the diagnosis without an endoscopy and biopsy. Due to severe trauma I cannot endure the endoscopy and they made it quite clear full sedation is not an option. So now I have to venture forward assuming this is in fact what is causing all of my symptoms. Has anyone else here had the same experience and started the gluten free diet to see if you're really suffering from celiac? If so, how long did you commit before safely saying the results are accurate? My thought was at least three months would be necessary. Much love to everyone ❤️ 
    • trents
×
×
  • Create New...