Can't figure this out

[Captain173]

My story, have had on/off issues with acid reflux, diarrhea, gas, and bloating for a few years.

Noticed when I got prescribed antibiotics (sinus infection etc.) my symptoms got a lot better. Diarrhea would go away, stools got a lot better. Then shortly after use symptoms would return.

Over the summer symptoms got worse, went to local urgent care hoping for some antibiotics, was tested for h pylori (negative) and told to see a GI specialist.

At GI appointment, told the doctor all my symptoms and how antibiotics seemed to always help she suspected sibo. Was prescribed xifaxan for 14 days along with blood work. Immediately following course of antibiotics had dental surgery and received 5 days of amoxicillin.

During all this got lab results back, high level for celiac, need biopsy for confirmation.

Thing is after all the antibiotics and watching my gluten intake..my symptoms went away, except for some gas. 

I've read where others have had same thing with antibiotics but never saw anyone follow up.

Any thoughts or ideas would be appreciated.

[Russ H]

The prevalence of SIBO is about 5x higher in people with coeliac disease than those without. In people with coeliac disease, it responds well to antibiotic therapy.  It can take several years to achieve full recovery of the digestive tract when following a strict gluten free diet.

Note that if you are having a biopsy to confirm coeliac disease, you must continue eating gluten prior to the test. Clinical guidance in the UK is to eat at least 2 gluten-containing meals every day for at at 6 weeks prior to testing. US guidance will be similar. In the UK, if your blood antibody levels are at least 10x standard range and you are under 55, you can be diagnosed on blood test results alone.

Links between celiac disease and small intestinal bacterial overgrowth: A systematic review and meta-analysis

[Captain173]

So most of my symptoms might be from the sibo, and asymptomatic of celiac?

Definitely need biopsy to prove celiac 

[Russ H]

Apart from the symptoms of SIBO there may be other symptoms that you are unaware of because they come on so slowly. It takes a long time to fully recover, especially when diagnosed as an adult. Apart from the classic signs and symptoms, I had all sorts of strange ones that have gradually resolved including: heart arrhythmia, tendonitis, chilblains, body odour, painful scalp, memory problems and thickened red skin on knees and elbows. It is definitely worth getting a diagnosis and following a strict gluten free diet.

[Captain173]

Thank you for your help. I will try and get biopsy scheduled soon

[Scott Adams]

Here is more info about how to do a gluten challenge for a celiac disease blood panel, or for an endoscopy:

Quote

"...in order to properly diagnose celiac disease based on serology and duodenal histology, doctors need patients to be on gluten-containing diets, even if they are causing symptoms, and this is called a "gluten challenge."

• Eat gluten prior to celiac disease blood tests: The amount and length of time can vary, but is somewhere between 2 slices of wheat bread daily for 6-8 weeks and 1/2 slice of wheat bread or 1 wheat cracker for 12 weeks 12 weeks;
• Eat gluten prior to the endoscopic biopsy procedure: 2 slices of wheat bread daily for at least 2 weeks;

and this recent study recommends 4-6 slices of wheat bread per day:

 

 

[trents]

What do you mean by "asymptomatic of celiac disease"? Many celiacs are asymptomatic. We call them "silent" celiacs. Are you asking if your symptoms all have to do with something other than celiac disease?

[Wheatwacked]

You might want to consider eating lots of yogurt to repopulate your intestines with benificial bacteria after all those antibiotics.  I've had good results with Stoneyfield Whole milk vanilla and add a couple handfuls of frozen berries. Potassium, magnesium, vitamins C and K, fiber, and prebiotics—carbohydrates that help promote a healthy gut.

The no fat brands have added  Guar gum, and Locust bean gum that causes some people with Celiac disease to have discomfort.  They take milk powder, add water, sugar and gums to give texture and add probiotics.  Altogether I would consider this a processed food.  Personally I think they taste like cardboard.  And the minimal fruit they add is a cruel joke.

• Cultured nonfat milk
• Water
• Natural flavors
• Cane sugar
• Fruit pectin
• Guar gum
• Locust bean gum

Ingredients in Stonyfield Whole milk vanilla:

Organic whole milk, organic cane sugar, organic natural vanilla flavor, pectin, lactase enzyme, vitamin D3. 6 live active probiotic cultures.  This brand even has lactase for those who are lactose intolerant.

Also get your vitamin D level checked.  Vitamin D keeps your immune system in check and low D may be a trigger for Celiac Disease.  Many, if not all Celiacs have low vitamin D and  42% of the US population have low vitamin D.  A new study shows 60% of the UK population have low D.

Possible Role of Vitamin D in Celiac Disease Onset

 

Edited November 20, 2024 by Wheatwacked

[Captain173]

Yes I was asking could the symptoms I listed be related to the sibo only.

 

 

[Scott Adams]

I don't think there is any way to be sure, as symptoms of SIBO and celiac disease can overlap each other. I was also treated with antibiotics around the time of my diagnosis, which also made me feel better, but in the end only a gluten-free diet did this for the long-term.

[Wheatwacked]

6 hours ago, Captain173 said:

During all this got lab results back, high level for celiac

More likely the Sibo was a symptom of the Celiac malabsorption syndrome.