Stool test, do I need to look further?

[marko19]

5 years ago I ended up in the hospital with severe stomach issues and organ issues. After that, I struggled with my stomach, mostly bloating and bowel obstruction. Which might occur once every month and a few fiber pills would fix this within a day.
Now the last 3 months, the problems have become more frequent than normal. So I decided to start with a stool test for my microbiome. 
Keep in mind all these 5 years I have been consuming gluten products without a problem(that's what I think). The test results came in kinda vague, and my next appointment is only in 2 weeks. The test concluded: This may indicate gluten intolerance or possibly also gluten enteropathy (synonyms: celiac disease).

Test results: 
Anti-gliadin antibodies in feces >200,00 U/l (light red on diagram)

Anti-transglutaminase antibodies in feces <50,00 U/I (green on diagram)

My overall gut health isn't the best right now considering the other subjects tested. It also showed I might have lactose-intolerance for example

 

[Wheatwacked]

Welcome to the forum marko19.

"Sensitivity of faecal antibodies against human tissue transglutaminase was 10%, and specificity was 98% . For antibodies against gliadin, sensitivity was 6% (0% to 29%) and specificity was 97%."  Detection of secretory IgA antibodies against gliadin and human tissue transglutaminase in stool to screen for coeliac disease in children: validation study

Not a very accurate test, if you are looking for a lab based diagnosis.

If you are looking for an excuse to do a trial gluten free diet, why not? This test gives you a maybe yes, maybe no.

But you already know that from your symptoms.

If you need a positive test to prompt you, the biopsy is still the Gold Standard for a positive diagnosis, but many people have negative test, and are declare Not Celiac, only to suffer years more until one day the test is Positive.  So positive biopsy is a definate diagnosis, negative biopsy means either you are not Celiac or they didn't find it this time.  Even with negative biopsy and blood tests, there are no diagnostic tests for Non Celiac Gluten Sensitivity other than to rule out Celiac but respond well to Gluten Free Diet.

If you can this would be the time to get a full Celiac test panel and or biopsy done, before you start GFD.  Once you are gluten free you will test negative.  After being gluten-free many people with Celiac are even more sensitive to gluten, so it would be a defacto diagnosis in my mind.  Are Celiac and NCGS simply different variations of the same disease?  No one knows.  Does it matter?  Not really.  The only treatment in all cases of GS is avoidance of gluten and correcting the malnutrition they cause by malabsorption and food avoidance.

Close to one half the world population have one or more genes for Celiac, yet only 1 to 3 percent have a positive Celiac Disease diagnosis.  10% are diagnosed as NCGs.

If you have a rash, it may be Dermetitis Hepetiforumus which is only caused by Celiac Disease and a properly done biopsy, adjacent to the rash is a positive diagnosis.

How many more symptoms on this list do you have?

 

[Wheatwacked]

1 hour ago, marko19 said:

I struggled with my stomach, mostly bloating and bowel obstruction.

Many with these symptoms are deficient in vitamin D, Thiamine (subclinical Beriberi) and Choline deficient (gallbladder disease symptoms).

[marko19]

4 minutes ago, Wheatwacked said:

Welcome to the forum marko19.

"Sensitivity of faecal antibodies against human tissue transglutaminase was 10%, and specificity was 98% . For antibodies against gliadin, sensitivity was 6% (0% to 29%) and specificity was 97%."  Detection of secretory IgA antibodies against gliadin and human tissue transglutaminase in stool to screen for coeliac disease in children: validation study

Not a very accurate test, if you are looking for a lab based diagnosis.

If you are looking for an excuse to do a trial gluten free diet, why not? This test gives you a maybe yes, maybe no.

But you already know that from your symptoms.

If you need a positive test to prompt you, the biopsy is still the Gold Standard for a positive diagnosis, but many people have negative test, and are declare Not Celiac, only to suffer years more until one day the test is Positive.  So positive biopsy is a definate diagnosis, negative biopsy means either you are not Celiac or they didn't find it this time.  Even with negative biopsy and blood tests, there are no diagnostic tests for Non Celiac Gluten Sensitivity other than to rule out Celiac but respond well to Gluten Free Diet.

If you can this would be the time to get a full Celiac test panel and or biopsy done, before you start GFD.  Once you are gluten free you will test negative.  After being gluten-free many people with Celiac are even more sensitive to gluten, so it would be a defacto diagnosis in my mind.  Are Celiac and NCGS simply different variations of the same disease?  No one knows.  Does it matter?  Not really.  The only treatment in all cases of GS is avoidance of gluten and correcting the malnutrition they cause by malabsorption and food avoidance.

Close to one half the world population have one or more genes for Celiac, yet only 1 to 3 percent have a positive Celiac Disease diagnosis.  10% are diagnosed as NCGs.

If you have a rash, it may be Dermetitis Hepetiforumus which is only caused by Celiac Disease and a properly done biopsy, adjacent to the rash is a positive diagnosis.

How many more symptoms on this list do you have?

 

Thank you for the information.

From the symptom list I only have
- Abdominal cramps, gas and bloating
- Sometimes diarrhea, but only around the time I am bloating
- The test also showed lactose intolerance 

[trents]

If you really want to explore the possibility of celiac disease you need to have serum antibody testing, including "total serum IGA" in case your total IGA is low since this could skew the individual IGA tests down toward the negative range. The total serum IGA test is not in and of itself a celiac antibody test.

If the serum antibody tests are positive then you would likely be referred to a GI specialist for an endoscopy with biopsy to check for damage to the small bowel villous lining, the hallmark of celiac disease. If the antibody tests are negative then you many have NCGS (Non Celiac Gluten Sensitivity) for which there are no tests. Celiac disease must first be ruled out. But it's important to remember that if you start a gluten free diet ahead of either of these testing modes you will invalidate the test resutls.

[Wheatwacked]

Lactose intolerance is mostly a gut biome issue.  The lactobacillus that we host returns the favor by producing lactase.  Most mammals only produce enough lactase endogenously to support the infant.  Since they started making quick pickles instead of fermenting them in salt the world has experienced an increase in Lactose Intolerance complaints.

Fermented foods like Dill Pickles are a good source of lactobacillus.  Pickled foods with vinegar are not fermented so they have the taste but not the nutrition.  Another case of profit over nutrition.

[marko19]

I have kept eating gluten for the last few days, and have felt perfectly fine doing so.
Can it be a one-time thing that my anti-gliadin antibodies in my stool were with increased levels?

[Wheatwacked]

On 8/11/2023 at 1:26 PM, marko19 said:

5 years ago I ended up in the hospital with severe stomach issues and organ issues.

They'll be back.

Quote

Physical examination of the patient showed nothing remarkable, except for notable thinness. The patient showed no gastrointestinal symptoms, and had no family history of gastroenterological diseases.   
Diagnostic tests, including blood tests and duodenal biopsy, confirmed the diagnosis of celiac disease with grade 4 Marsh 3C classification, even though the patient lacked typical gastrointestinal symptoms.  Celiac Disease Masquerades

 

Edited August 15, 2023 by Wheatwacked