Physician Recommendation And Timing Question

[Stagiary]

1) Can anyone recommend a family physician that I could see in the Virginia/West Virginia area that would provide a referral to a gastroenterologist?

2) How long do I need to be on a gluten filled diet in order to provoke measurable consequences?

I have been on a gluten free diet for two months. I did a food elimination diet to identify the foods that trigger my IBS. Somewhat ignorantly, I included gluten in the rotation of food substances that I eliminated. That was the first thing that made me feel better. I have been gluten free ever since.

After going gluten free, I immediately consulted my family physician, who believes based on the diet evidence that I have celiac disease. However, the doctor has been ineffective in getting an appointment with a gastroenterologist even though she agrees that such a referral is the right course of treatment.

Based on recommendations from this site, I contacted Sheila Crowe of UVA hospital, and her office indicated that they would accept me with a referral. Now, I am leaning on my family doctor's office to make that referral. Because my family physician doctor's office is dragging its feet, I may need to see another family doctor with greater motivation or resources. I live in Charleston, WV. I move to Washington, DC on August 5, 2006. I am happy to drive as far as Roanoke, Richmond, Louisville, Columbus, or Charlotte to get to a family doctor who will follow through on making referrals.

If I am able to get an appointment with a gastroenterologist, I want to be tested for celiac disease and receive accurate results as soon as possible. If I don't have celiac disease, I need to move on in my pursuit of feeling better. I want to be in testable condition on the day of my visit. So, for how may days/weeks prior to the visit should I eat gluten containing foods?

[penguin]

3 months, eating the equivalent of 4 slices of bread a day to have a chance at getting reliable results. If the diet makes you feel better and your tests come back negative, however, be gluten-free!

[eKatherine]

1) Can anyone recommend a family physician that I could see in the Virginia/West Virginia area that would provide a referral to a gastroenterologist?

2) How long do I need to be on a gluten filled diet in order to provoke measurable consequences?

I have been on a gluten free diet for two months. I did a food elimination diet to identify the foods that trigger my IBS. Somewhat ignorantly, I included gluten in the rotation of food substances that I eliminated. That was the first thing that made me feel better. I have been gluten free ever since.

After going gluten free, I immediately consulted my family physician, who believes based on the diet evidence that I have celiac disease. However, the doctor has been ineffective in getting an appointment with a gastroenterologist even though she agrees that such a referral is the right course of treatment.

Based on recommendations from this site, I contacted Sheila Crowe of UVA hospital, and her office indicated that they would accept me with a referral. Now, I am leaning on my family doctor's office to make that referral. Because my family physician doctor's office is dragging its feet, I may need to see another family doctor with greater motivation or resources. I live in Charleston, WV. I move to Washington, DC on August 5, 2006. I am happy to drive as far as Roanoke, Richmond, Louisville, Columbus, or Charlotte to get to a family doctor who will follow through on making referrals.

If I am able to get an appointment with a gastroenterologist, I want to be tested for celiac disease and receive accurate results as soon as possible. If I don't have celiac disease, I need to move on in my pursuit of feeling better. I want to be in testable condition on the day of my visit. So, for how may days/weeks prior to the visit should I eat gluten containing foods?

You say you want to receive "accurate results". What does that mean to you? There are false negatives, so a negative result will not rule out celiac. If your doctor tells you you do not have celiac based on the results of the tests he or she runs, will you go back to eating gluten in direct contradiction to your own observations of dietary response?

[tarnalberry]

3 months, 3 slices of bread a day.

BUT, a positive response on the diet IS a *very* valuable diagnostic, and most doctors who know much about celiac will tell you the same.

[penguin]

3 months, 3 slices of bread a day.

BUT, a positive response on the diet IS a *very* valuable diagnostic, and most doctors who know much about celiac will tell you the same.

Yep, that's very true. I'm eating gluten now to have a biopsy done, but my GI doc said that I am at the very least intolerant, and that after the biopsy I have to be gluten-free regardless. I was gluten-free 4 months after inconclusive bloodwork and had a positive dietary response. I'm lucky though, my GI doc's wife has celiac and he goes to celiac conferences and seminars by Dr. Green. I've now had 3 doctors and a PA tell me that I'm intolerant, so make sure you find someone who knows what they're talking about.

[Stagiary]

To me, "accurate results" means true positive or true negative and not false positive or false negative. I have felt a lot better on the diet, and that probably means I'll stick with it no matter how the test results come out. I can't do my job feeling the way I did before. I get paid to think and I can't think straight when I have gluten induced brain fog. I want to know for sure that this is the problem and the whole problem. If there's something else I can treat, I want to know that I should be looking for it.

In addition, I need more data in order to persuade my family to get tested. None of them has symptoms, and they are unlikely to go through the trouble of testing unless there's concrete evidence that they are at risk.

Finally, my husband only halfheartedly accepts that I have gluten intolerance/celiac disease. I want him to join me in accepting that I have it.

Thank you to all who responded. I appreciate your help. Please be well and take care.

FYI, I have an appointment with a gastroenterologist in 9/20. Hopefully, answers are near.