Endoscopy

[Hiawatha]

Hello,

I'm wondering if one exposure to gluten is enough to change biopsy results during an endoscopy. My recent endoscopy showed some indication of inflammation. I will receive details during my follow-up appointment tomorrow. But I'm wondering if the inflammation could have occurred as a result of a gluten exposure which occurred just a few weeks ago.

[Hiawatha]

4 minutes ago, Hiawatha said:

Hello,

I'm wondering if one exposure to gluten is enough to change biopsy results during an endoscopy. My recent endoscopy showed some indication of inflammation. I will receive details during my follow-up appointment tomorrow. But I'm wondering if the inflammation could have occurred as a result of a gluten exposure which occurred just a few weeks ago.

Just to be clear, I had been gluten free for multiple years prior to this endoscopy (with the exception of the recent exposure which occurred in one meal).

[knitty kitty]

Yes, once triggered by gluten, the immune response can last awhile.  Antigluten antibodies increase with exposure to gluten and may remain for months, but they should come down without repeated exposure.  The antigluten antibodies mistakenly attack our own cells. 

Keep us posted on your progress!

Edited February 2 by knitty kitty
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[Hiawatha]

Thank you!

[Hiawatha]

16 hours ago, knitty kitty said:

Yes, once triggered by gluten, the immune response can last awhile.  Antigluten antibodies increase with exposure to gluten and may remain for months, but they should come down without repeated exposure.  The antigluten antibodies mistakenly attack our own cells. 

Keep us posted on your progress!

I just finished my appointment with the GI doctor. He showed me pictures of my esophagus. He said the ridges indicate ongoing inflammation. He said gluten and dairy may not be the (only) cause. He said I could stop the proton pump inhibitor because I do not experience acid reflux. He recommended a swallowed oral steroid. I am more drawn to diet modifications but he said I'd have to have an endoscopy after every new food is introduced on an elimination diet.

I'm very interested in what I've read on-line related to vitamin D and Thiamin. I've had allergies my whole life and, for me, EoE seems very much connected to overall allergies. But I'm hesitant to just start supplementing without some guidance.

My inclination is to try the steroid short-term and check-in with the integrative doctor at my appointment in March. 

Any thoughts/recommendations?

[knitty kitty]

@Hiawatha,

Yes, I think you've made good decisions to try the steroids short term with check up in March, supplement with vitamins and minerals, and adjust your diet.

Steroids can be useful to rein in wildly galloping immune systems.  Supplementation and diet changes help provide a less inflammatory condition and promote healing.  

Steroids, Thiamine and Vitamin C have been used together to treat critically ill Covid patients, resulting in shorter times on respirators and lowered inflammation.  Lower Vitamin D levels are found in EoE.  A nutritionist might be able to give you guidance on eating a nutrient dense diet and supplementing with all the essential nutrients.  

A Low Histamine Paleo diet has been very helpful in reducing inflammation for many, including me.  I followed this diet for several weeks, and slowly introduced one food at a time.  I found The Autoimmune Protocol Diet by Dr. Sarah Ballantyne most helpful.  Not an advertisement.  Simply my opinion.  

Our body can make histamine.  It does a lot of beneficial things.  Histamine is a neurotransmitter that causes alertness.  That cup of coffee in the morning causes a release of histamine, helping us wake up.  We also get histamine from the foods we eat.  Our body can clear histamine, but can become overwhelmed if we're making lots of histamine because we're sick, and consuming foods containing high histamine levels.  Diamine Oxidase, an OTC digestive enzyme that can be low in people with celiac disease, helps us clear histamine from high histamine foods.  Following a low histamine diet gives our body time to clear histamine in our system.  Mast cells produce and release histamine when stimulated.  If mast cells do not have sufficient Thiamine to function properly, they release histamine at the slightest provocation.  Eosinophils, another kind of immune cells, talk to their neighboring mast cells, call in their friends, and release proinflammatory cytokines.  Thiamine in the form Fursaltiamine or Allithiamine (Tetrahydrofurfuryl disulfide - TTFD) reduces the secretion of these proinflammatory cytokines.  

Allergic reactions involve the release of histamine, too.  If allergic-type symptoms persist with exposure to certain foods after a course of steroids and following the low histamine diet and supplementation, then testing for allergies may be a good idea.  But while histamine levels are high, there's the potential to react to everything because the mast cells are so hypersensitive.  

Keep a journal of your diet and supplementation.  It's handy to show medical professionals documentation.  

Keep us posted on your progress!

Reference:

Fursultiamine Alleviates Choroidal Neovascularization by Suppressing Inflammation and Metabolic Reprogramming

https://pubmed.ncbi.nlm.nih.gov/33107903/