Saw The Gi Doc Today

[Live2BWell]

Hey Guys, so I had my first appointment with a GI doctor today. He took my history, and what's been going on, and said he wants me to have a Sigmoidoscopy and an H-Pylori breath test (I have a history of H-Pylori, which is why he wants to do that test again.) As for the Sigmoidoscopy, I wasn't going to the GI doctor specifically for Celiac and/or Gluten Sensitivity, but I told him about my overall GI symptoms and the autoimmune thyroiditis, etc. So...

Has anyone had a Sigmoidoscopy? I'm nervous. It certainly doesn't sound pleasant (although he said that they could do it under ansthesia, which I quickly agreed to the whole anesthesia part, haha)

[cruelshoes]

A sigmoidoscopy (in the back door) is not a test for celiac. If you are looking for villi damage, the test you want to ask for is an endoscopy (in the front door).

I have had several sigmoidoscopies. While it wasn't the most fun I have ever had in my life, it wasn't the most horrible exam I have ever had.

[Live2BWell]

A sigmoidoscopy (in the back door) is not a test for celiac. If you are looking for villi damage, the test you want to ask for is an endoscopy (in the front door).

I have had several sigmoidoscopies. While it wasn't the most fun I have ever had in my life, it wasn't the most horrible exam I have ever had.

So what exactly does the sigmoidoscopy detect/diagnose? Is an endoscopy something that a person can request?

[ravenwoodglass]

So what exactly does the sigmoidoscopy detect/diagnose? Is an endoscopy something that a person can request?

From the NIH-

Open Original Shared Link

Flexible sigmoidoscopy (SIG-moy-DAH-skuh-pee) enables the physician to look at the inside of the large intestine from the rectum through the last part of the colon, called the sigmoid or descending colon. Physicians may use the procedure to find the cause of diarrhea, abdominal pain, or constipation. They also use it to look for early signs of cancer in the descending colon and rectum. With flexible sigmoidoscopy, the physician can see bleeding, inflammation, abnormal growths, and ulcers in the descending colon and rectum. Flexible sigmoidoscopy is not sufficient to detect polyps or cancer in the ascending or transverse colon (two-thirds of the colon).

The doctor was not looking for celiac at all. You should tell your doctor directly that you suspect celiac and want an endo. Yes you can do that, although your doctor should have suggested it most look for celiac AFTER they have run us through a few thousand dollars of other tests first.

[Live2BWell]

From the NIH-

Open Original Shared Link

Flexible sigmoidoscopy (SIG-moy-DAH-skuh-pee) enables the physician to look at the inside of the large intestine from the rectum through the last part of the colon, called the sigmoid or descending colon. Physicians may use the procedure to find the cause of diarrhea, abdominal pain, or constipation. They also use it to look for early signs of cancer in the descending colon and rectum. With flexible sigmoidoscopy, the physician can see bleeding, inflammation, abnormal growths, and ulcers in the descending colon and rectum. Flexible sigmoidoscopy is not sufficient to detect polyps or cancer in the ascending or transverse colon (two-thirds of the colon).

The doctor was not looking for celiac at all. You should tell your doctor directly that you suspect celiac and want an endo. Yes you can do that, although your doctor should have suggested it most look for celiac AFTER they have run us through a few thousand dollars of other tests first.

Thanks for the reply, Ravenwoodglass. I did not tell him I suspected Celiac or Gluten Intolerance, but I did tell him about my symptoms (and I also mentioned my abnormal esophogeal motility, for which the do an endoscopy.) In the end, he determined a Sigmoidoscopy. I was scared to say anything or be presumptous. I have had unpleasant experiences with doctors in the past, who have been totally unreceptive to listening to me if my symptoms don't run parallel with what THEYthink the problem is. Um, yea, it's been a nightmare and many doctors later and many thousands of dollars later as well. I did call and leave a messege with the nurse and she is going to relay it to my doctor (asking what he wants to do about the abnormal esophogeal motility test) - I do know that they usually do an endoscopy for that, so in a round about way I guess I was hoping they could kill two birds with one stone (do both the sigmoidoscopy and endoscopy all in one go-round, I mean I'm going to be under anesthesia anyway!)

... So, my doctor is supposed to call me back

Any other words of wisdom or advice?

I feel as though I'm in a catch 22 situation.

Thanks!

[dlp252]

I don't think you go under sedation for sigmoidoscopy...at least here they don't put you out. I haven't had one for several years though...but my aunt had one recently and she didn't have sedation (i.e., she could drive herself home). For a colonoscopy yes. My first endoscopy was done at the same time as a colonoscopy.

[WW340]

I think you need to tell your doctor directly that you would like to be tested for celiac disease. Even if he does an endoscopy for the motility problem, it is unlikely he would do biopsies for celiac disease if you don't ask him to do so. Don't be afraid to discuss your concerns openly. If the doctor is not receptive, you may need a different one.

Unfortunately, celiac disease is not in the forefront of most doctors thinking. Speak up, or you may never get your answer until you have the "classic signs" of celiac.

I am surprised that a GI specialist is doing a sigmoidoscopy rather than a colonoscopy. GI's generally opt for the colonoscopy under anesthesia, as a sigmoidoscopy misses the majority of the colon.

[Live2BWell]

The doctor said I was too young to need a Colonoscopy, so he wanted to start with the Sigmoidoscopy and do as little as needbe for my age. He also said I could choose if I wanted anesthesia or not for the Sigmoidoscopy (which I said I wanted it!)

I have not heard back from him, but I will let you all know when I do. Thanks!

[ravenwoodglass]

The doctor said I was too young to need a Colonoscopy, so he wanted to start with the Sigmoidoscopy and do as little as needbe for my age. He also said I could choose if I wanted anesthesia or not for the Sigmoidoscopy (which I said I wanted it!)

I have not heard back from him, but I will let you all know when I do. Thanks!

Jessica, With a comment like this from him you may end up finding you need to find another doctor. Perhaps not the case but there is no age limit for a colonoscopy and to give your age as the reason for doing the sigmoid instead of the colonoscopy is bogus IMHO. If nothing is found then he will be paid to do a colonoscopy as well, which is like doing things half way once and then doing it right the second time. I would not be surprised if he balks at testing for celiac. Do insist though if he does do the endo that you have a minimum of 5 biopsy samples taken and do get actual printouts of the actual test results that were sent from the lab. Don't just go with a verbal rendition, look at the actual lab report. You have a right to copies of all doctors notes, labs and testing results so don't let them intimidate you into thinking you don't.

[Live2BWell]

Jessica, With a comment like this from him you may end up finding you need to find another doctor. Perhaps not the case but there is no age limit for a colonoscopy and to give your age as the reason for doing the sigmoid instead of the colonoscopy is bogus IMHO. If nothing is found then he will be paid to do a colonoscopy as well, which is like doing things half way once and then doing it right the second time. I would not be surprised if he balks at testing for celiac. Do insist though if he does do the endo that you have a minimum of 5 biopsy samples taken and do get actual printouts of the actual test results that were sent from the lab. Don't just go with a verbal rendition, look at the actual lab report. You have a right to copies of all doctors notes, labs and testing results so don't let them intimidate you into thinking you don't.

I heard back from the nurse, and she spoke with my doctor, who basically said at this time nothing further is really necessary, and we'll go ahead with the sigmoidoscopy as scheduled.

Unfortunately I've had horrible luck with doctors, so 'standing my ground' so to speak, is easier said than done. I recently went through the ringer with my last doctor (and endo) who wrote a letter to my psychiatrist (whom I see for ADD/ADHD) and sent a copy to my other treating doctor (who sent a copy to ME!) questioning if my problems are more psychosomatic than actually physically valid (the letter was a 2 page letter!) Even though my tests keep coming back as abnormal, and things keep popping up that clearly are not "normal," I'm certainly fed up with trying to stand my ground and being labeled as "dramatic" and written off (why do doctors have to be so difficult to deal with?) It amazes me how nobody seems to realize that in 2 years time things "showing up" (Hashimotos, Diabetes, etc.) actually MEANS something (to me, that's common sense!)

So, I do have another question, and am curious as to what you think.

I ordered one of those home allergy test kits - and it tests for: Gluten, Weat (excluding Gluten), Oat, Rice, Milk, Egg, Shrimp, Lobster, Prawn, Crab, Mussel, Almond, Cashews, Hazelnut, Peanut, Soybean, Cocoabean, Mushroom, Yeast, Chicken, & Beef. Do you think those tests are good (or atleast adequate) for diagnostics? Also, say I decide to go Gluten Free anyway, without any type of diagnostics, whatever an endoscopy could diagnose (and isn't, since I'm not having one) - going Gluten Free could only help, right?

Well, thanks again !!

[cruelshoes]

I ordered one of those home allergy test kits - and it tests for: Gluten, Weat (excluding Gluten), Oat, Rice, Milk, Egg, Shrimp, Lobster, Prawn, Crab, Mussel, Almond, Cashews, Hazelnut, Peanut, Soybean, Cocoabean, Mushroom, Yeast, Chicken, & Beef. Do you think those tests are good (or atleast adequate) for diagnostics? Also, say I decide to go Gluten Free anyway, without any type of diagnostics, whatever an endoscopy could diagnose (and isn't, since I'm not having one) - going Gluten Free could only help, right?

Celiac is not an allergy. It is an intolerance. If you are indeed celiac or gluten intolerant, it would not show up on an allergy test. Allergy tests measure a completely different class of antibodies (IgE). Celiac is an IgA and IgG response. One can have allergies and not intolerances and vice versa. The test you ordered may give you some allergy information, but it is not diagnostic for celiac disease.

Going gluten free certainly can't hurt you, and it may well help you. Your doctor sounds like he is not looking for celiac, and is (ahem) "barking up the wrong tree" with the sygmoidoscopy. I had my first sygmoidoscopy at 16, and my first colonoscopy at 18, so there is certainly no age limit on either procedure.

[CeliacAlli]

A Sigmoidoscopy is a test for celiac, I am not sure where some of you get your info. but it does, that is how I was diagnosed as a baby, they take a piece of your intestine and it is not from the front end.

[WW340]

A Sigmoidoscopy is a test for celiac, I am not sure where some of you get your info. but it does, that is how I was diagnosed as a baby, they take a piece of your intestine and it is not from the front end.

I will show you links to my information if you would like.

A sigmoidoscopy gets no where near the small intestine which is where celiac disease occurs. Even a colonoscopy, which goes much further up than a sigmoidoscopy, cannot get to the area of the small intestines needed for biopsy. Endoscopy is needed to biopsy the small intestine.

Sigmoidoscopy is used for diagnosing crohns and ulcerative colitis and some colon cancers. It only goes into the rectum and descending colon. It does not even go the full length of the colon, let alone the small intestine.

Open Original Shared Link

Open Original Shared Link

I can give you links to hundreds of experts that say celiac disease is diagnosed by a biopsy of the small intestine.

[ravenwoodglass]

A Sigmoidoscopy is a test for celiac, I am not sure where some of you get your info. but it does, that is how I was diagnosed as a baby, they take a piece of your intestine and it is not from the front end.

Perhaps the person who told you that you were diagnosed with a Sig was simply mistaken. To many a scope is a scope and when someones infant is ill the name of the specific test may not be formost on their mind. You may have had a Sig and an Endo in the same procedure.

We really aren't pulling info out of the air. If you read my first post my source was the NIH or the National Institute of Health. If celiac could be diagnosed by a colonoscopy or a sigmoidoscopy I would have been diagnosed a really long time before I was. Since my bloodwork was always negative they never thought to scope my small intestine only the large.

[Live2BWell]

Woops, I was mistaken about the tests - they are food intolerence tests, not food allergy tests

Here is the link

Open Original Shared Link

[ravenwoodglass]

Woops, I was mistaken about the tests - they are food intolerence tests, not food allergy tests

Here is the link

Open Original Shared Link

If I had the test in my hands I would go ahead and do it. It does appear though that the test is only going to tell you if you are forming antibodies but not what they are antibodies to so I don't know how helpful that is going to be. Do be sure when all is done with the testing you are going to let them do that you give the diet a good serious try for a couple months even if all results are negative. I hope you get some answers soon and are feeling better.

[cruelshoes]

Here's what the Open Original Shared Link:

Important notes on test results:

If you are worried about a particular food or suffer from a

classical IgE mediated food allergy e.g. shellfish, but it has

not given a positive result in this test, we advise you to

continue to avoid such foods.

A positive result for gluten does not necessarily indicate

coeliac disease, but we strongly suggest that medical

advice is sought and a coeliac screen be carried out

(available from CNS service laboratory).

It doesn't specifically say what variant of IgG it is measuring. So you don't really know if the celiac tests are in there (EMA and TtG). If it is a home test kit that you administer yourself, I'm not really sure how specific it could be. To date, I do not know of a self-administered celiac test thta you don't have to send off to a lab somewhere for processing.

[Live2BWell]

Thanks again for your replies. I am not expecting all that much (although hoping for something, so maybe I'll have some answers.) I think if anything, I figured that for the money, taking the test would do no harm and couldn't put me any worse off than I am now, since the doctors aren't getting me very far

So we'll see ...

[Live2BWell]

Hey Everyone, so I had the procedure yesterday. They ended up doing a Colonoscopy instead of a Sigmoidoscopy, and they took biopsies of 3 areas. The doc said that everything appeared normal' but they wanted to do the biopsies to be sure. I feel pretty cruddy today now that the med cocktail they gave me, has worn off

They said they results should be back in about a week.

So, that's that ..

Just wanted to update