Military And Celiac Diagnosis

[desmarj]

I'm in the Navy have been gluten-free for 4 months. The problem is that I am on a ship and we will be going out to sea... I saw a GI doctor and he suggested I eat gluten from now until Feb. 20th when I have a scope/biopsy scheduled. I pray that will be enough of a gluten challenge. Any advice on a course of action? Should I do Enterolab tests? I need to convince the Navy this is a REAL problem, and not some malingering tactic. Thanks in advance

[tom]

Doesn't celiac = 4F?

I'd be asking Navy Dr.s what it'll take to prove it to them.

No way does a celiac belong on a ship, subject to a general diet.

[Tim-n-VA]

I think 4F is a draft term and not relevent if someone is already in the military.

These policies are always subject to revision and to local commander's interpretation.

In general, the military has medical standards for entering the service and medical standards for staying in the service.

You need to be aware that a diagosis could mean not only a restriction from deployment but could also result in you being medically discharged.

Still, you need to find out the specific case for your command.

For what its worth, I was diagnosed by a navy GI at Bethesda and the standard he used was the traditional positive biopsy.

[ravenwoodglass]

As mentioned you will most likely be discharged with a medical discharge if they confirm celiac. That said how severe are your reactions to gluten? If they are very severe could they put you into the base hospital during the early stages of your challenge? If they can actually see the effects the doctor may cut the challenge short so do not suffer in silence. Many of us have neuro reactions to gluten that can lead to some real dicey emotional meltdowns so I am glad they are trying to eliminate this as an issue before you head out to sea. I am sorry you are going through this, I went through this myself with my DS a few years ago. The doctors never discovered he was celiac until after he was discharged, no one thought to check for it. He was so sick and it was an extemely difficult time. I hope they are able to get this diagnosed quickly for you.

[debmidge]

I'm in the Navy have been gluten-free for 4 months. The problem is that I am on a ship and we will be going out to sea... I saw a GI doctor and he suggested I eat gluten from now until Feb. 20th when I have a scope/biopsy scheduled. I pray that will be enough of a gluten challenge. Any advice on a course of action? Should I do Enterolab tests? I need to convince the Navy this is a REAL problem, and not some malingering tactic. Thanks in advance

Did GI run blood tests IgA, IgG, ARA, tTG, EmA as per Celiac Sprue Assn. recommedations?

How long have you been in Navy? Are you comfortable asking Navy GI this question without sounding like you have an edge in your voice "What proof do we need to make a positive diagnosis?"

[debmidge]

I think 4F is a draft term and not relevent if someone is already in the military.

These policies are always subject to revision and to local commander's interpretation.

In general, the military has medical standards for entering the service and medical standards for staying in the service.

You need to be aware that a diagosis could mean not only a restriction from deployment but could also result in you being medically discharged.

Still, you need to find out the specific case for your command.

For what its worth, I was diagnosed by a navy GI at Bethesda and the standard he used was the traditional positive biopsy.

Tim: We have had very bad, frustrating, malpractice-type experiences with Vet Adm. GI's ....is there a way that you can find name of that Navy GI at Bethesda and perhaps desmarj can go there? Tim were you medically discharged?

[desmarj]

Did GI run blood tests IgA, IgG, ARA, tTG, EmA as per Celiac Sprue Assn. recommedations?

How long have you been in Navy? Are you comfortable asking Navy GI this question without sounding like you have an edge in your voice "What proof do we need to make a positive diagnosis?"

I have been in the Navy for 3 years with 3 years to go. I have asked the GI doc what he needs for "positive proof"...he has told me that he needs a positive biopsy. I am worried that only a month and a half of a gluten challenge will not be enough since I've been gluten-free for 4 months. I have had the blood tests run and they've come back negative because I was gluten-free (I informed the GI doc that I was currently gluten-free but he didn't understood the relevance of that fact at the time) I do have DQ2 and my grandfathers brother has Celiac. I don't have crippling symptoms unless I completely overload on gluten. I will normally get TERRIBLE digestion, constant headaches, odd rashes, terrible skin, dizziness and "brain fog". I'm concerned that if the biopsy is negative that the Navy will have PROVED that I do not have celiac. Which is why im considering enterolab tests so I can have something to counter a possibly negative biopsy. I have been eating gluten for 2 days however and the headaches and terrible digestion are in full effect.

[ravenwoodglass]

I have been in the Navy for 3 years with 3 years to go. I have asked the GI doc what he needs for "positive proof"...he has told me that he needs a positive biopsy. I am worried that only a month and a half of a gluten challenge will not be enough since I've been gluten-free for 4 months. I have had the blood tests run and they've come back negative because I was gluten-free (I informed the GI doc that I was currently gluten-free but he didn't understood the relevance of that fact at the time) I do have DQ2 and my grandfathers brother has Celiac. I don't have crippling symptoms unless I completely overload on gluten. I will normally get TERRIBLE digestion, constant headaches, odd rashes, terrible skin, dizziness and "brain fog". I'm concerned that if the biopsy is negative that the Navy will have PROVED that I do not have celiac. Which is why im considering enterolab tests so I can have something to counter a possibly negative biopsy. I have been eating gluten for 2 days however and the headaches and terrible digestion are in full effect.

You have nothing to lose by getting the enterolab tests done so I would do so. Make sure you keep a record of the effects and symptoms caused by the challenge, DO NOT suffer in silence. Keep a detailed diary of when you are consuming the toxin and the effects that happen, physical and emotional. I would get the record to your doctor on a weekly basis not hold it till the end. Also get if you can details of any other family members that have this, celiac is strongly genetic and does not follow the usual recessive, dominent pattern of inheritence. If one family member is officially diagnosed many more are likely to be gluten intolerant also.

[sneezydiva]

Unfortunately, I don't have any advice. But please keep us updated on what happens and what the GI says. My DH is also military, and I strongly suspect he is celiac/gluten intolerant. He fits the profile much better than I do, and he is feeling so much better since I started the gluten-free diet and his own gluten consumption is way down. I don't know if I can convince him to go to the doctor or get tested for fear of being dischrged, so I would be interested to see how your doctor and command handles this.

Best of luck to you.

[debmidge]

I have been in the Navy for 3 years with 3 years to go. I have asked the GI doc what he needs for "positive proof"...he has told me that he needs a positive biopsy. I am worried that only a month and a half of a gluten challenge will not be enough since I've been gluten-free for 4 months. I have had the blood tests run and they've come back negative because I was gluten-free (I informed the GI doc that I was currently gluten-free but he didn't understood the relevance of that fact at the time) I do have DQ2 and my grandfathers brother has Celiac. I don't have crippling symptoms unless I completely overload on gluten. I will normally get TERRIBLE digestion, constant headaches, odd rashes, terrible skin, dizziness and "brain fog". I'm concerned that if the biopsy is negative that the Navy will have PROVED that I do not have celiac. Which is why im considering enterolab tests so I can have something to counter a possibly negative biopsy. I have been eating gluten for 2 days however and the headaches and terrible digestion are in full effect.

Has this Navy gastro had any cases of Celiac in his practice before? Tell him that celiac.com exists and/or csaceliacs.org (national celiac organization).

Photo is of my husband in Navy during Vietnam. At time, he was not active Celiac. He came down with it a few years after he did his "hitch."

We have had serious problems with military gastro doctors.....to the point of malpractice. They were the first gastros to misdiagnose my husband. Hate to say it.....I have no confidence in military doctors now. Please stress to gastro that if biopsy is negative that they might have to "do-over" after staying on gluten diet for a few more months...... However, you obviously have something gastro going on even if it isn't celiac...... The Veterans Hospital accused my husband of going there for testing just to get drugs from them....duh! they weren't giving him any drugs to take.... he was asking them for a lower GI series (this was prior to CAT scans, prior to MRI's, prior to colonoscopies - all you got then was either an upper or lower GI). They gave him the upper GI and didn't find anything (which is true of celiac, you really need the endoscopy). The gastro gave up on him and called him a "junkie." Refused to do any more testing. He did not get a diagnosis from them at all. Had to go and get a private gastro to do the testing. This is why I feel veterans should have health care plan and not have to rely on the VA hospital system. VA Hospital system is a waste of tax payers money when they treat veterans like this.

[Tim-n-VA]

A doctor in the military or the VA system has had the same training and is subject to the same medical certifications as any other doctor. All doctors are human. Any generalization about groups is probably wrong.

I've encountered good and bad doctors in the military (I'm a 20-year not medical retiree). I'm sure people have had misdiagnosis with military and VA doctors but you can find similar stories on this website about civilian doctors also.

I had no significant symptoms, just some fluctuation in liver tests and a military GI tested for and diagnosed celiac. That is far superior to the typical celiac 10-years-to-diagnose story that you typically hear.

With regard to the original question, any external to the military testing will probably not carry a lot of weight with the navy medical processing. That is even more true if it is a non-standard (from a peer-review/published perspective) test. That isn't to say that other testing wouldn't help you from a peace of mind or other perspective.