Enterolab Results Received 8/22/08

[glutenfreewithease]

I've been visiting this forum for a while and have received a lot of help from all the posts and wanted to see what you guys could tell me about these enterolab results. I was sick for all my life with many different symptoms that I can explain later, but the doctors could not give me answers. I turn for the worse when the seizures and convulsions started in July of 05 and I could not get the doctors to tell me why! I knew food was causing my probems so after I stayed in the University of Texas epiliepsy monitoring unit for 7 days being videoed having seizures and then told I had the same syndrom that gulf war vets from Iraq have when they come back from the war and was causing the seizures due to my psychological issues-even though I could give them a seizure on que when I ate certain food - I stopped going to doctors and stopped eating! I started a very limited elimination diet. I didn't have another seizure from that day forward. July of 07 I found a great allergist/immunologist that mention celiac disease. Never heard of it even though the diet that I was on was gluten free, just by chance. I was terrified of food! We did blood tests and they were negative. No surprise to me now. So i began adding gluten back into my diet because I was feeling so much better. 2 years and 4 months later I had another seizure. I was devastated, yet I knew I was eating gluten so after researching enterolab and their stool testing I sent off for the test results. I have has many symptoms, seizures being the worst that I will do anything to keep from having. I just need to see how the experienced celiacs on this panel view these results. I took the results to my doctor and he said yep, you need to go off gluten and my kids too. So any help understanding is appreaciated.

Thanks, Marsha

A) Gluten Sensitivity Stool and Gene Panel Complete *Best test/best value

Fecal Antigliadin IgA 32 (Normal Range <10 Units)

Fecal Antitissue Transglutaminase IgA 13 Units (Normal Range <10 Units)

Quantitative Microscopic Fecal Fat Score 849 Units (Normal Range <300 Units)

Fecal anti-casein (cow's milk) IgA antibody 8 Units (Normal Range <10 Units)

HLA-DQB1 Molecular analysis, Allele 1 0201

HLA-DQB1 Molecular analysis, Allele 2 0604

Serologic equivalent: HLA-DQ 2,1 (Subtype 2,6)

Interpretation of Fecal Antigliadin IgA: Intestinal antigliadin IgA antibody was elevated, indicating that you have active dietary gluten sensitivity. For optimal health, resolution of symptoms (if you have them), and prevention of small intestinal damage and malnutrition, osteoporosis, and damage to other tissues (like nerves, brain, joints, muscles, thyroid, pancreas, other glands, skin, liver, spleen, among others), it is recommended that you follow a strict and permanent gluten free diet. As gluten sensitivity is a genetic syndrome, you may want to have your relatives screened as well.

Interpretation of Fecal Antitissue Transg! lutamina se IgA: You have an autoimmune reaction to the human enzyme tissue transglutaminase, secondary to dietary gluten sensitivity.

Interpretation of Quantitative Microscopic Fecal Fat Score: A fecal fat score greater than 300 Units indicates there is an increased amount of dietary fat in the stool which usually is due to gluten-induced small intestinal malabsorption/damage when associated with gluten sensitivity. This could indicate there is gluten in your diet. If you are following a strict gluten-free diet (and prepare all meals yourself and eat no commercially processed foods), other possible causes include - Another inflammatory bowel disease (such as Crohn's disease which is associated with gluten sensitivity); Deficiency in the production or secretion of pancreatic enzymes or bile salts; Overgrowth of bacteria in the small intestine; Diarrhea from any cause which can, in turn, cause dietary fat to rush through the intestine unabsorbed; Consuming very large amounts of dietary fat, eating unabsorbable synthetic dietary fat substitutes, or taking "fat blockers" ; Resection of the small intestine causing "short bowel syndrome" (if you have had an intestinal resection).

Interpretation of Fecal anti-casein (cow's milk) IgA antibody: Levels of fecal IgA antibody to a food antigen greater than or equal to 10 are indicative of an immune reaction, and hence immunologic "sensitivity" to that food. For any elevated fecal antibody level, it is recommended to remove that food from your diet. Values less than 10 indicate there currently is minimal or no reaction to that food and hence, no direct evidence of food sensitivity to that specific food. However, because 1 in 500 people cannot make IgA at all, and rarely, some people can still have clinically significant reactions to a food antigen despite the lack of a significant antibody reaction (because the reactions primarily involve T cells), if you have an immune syndrome or symptoms ! associat ed with food sensitivity, it is recommended that you try a strict removal of suspect foods from your diet for up to 12 months despite a negative test.

Interpretation Of HLA-DQ Testing: HLA-DQB1 gene analysis reveals that you have one of the main genes that predisposes to gluten sensitivity and celiac sprue, HLA-DQB1*0201 or HLA-DQB1*0302. Each of your offspring has a 50% chance of receiving this gene from you, and at least one of your parents passed it to you. You also have a non-celiac gene predisposing to gluten sensitivity (any DQ1, DQ2 not by HLA-DQB1*0201, or DQ3 not by HLA-DQB1*0302). Having one celiac gene and one gluten sensitive gene, means that each of your parents, and all of your children (if you have them) will possess at least one copy of a gluten sensitive gene. Having two copies also means there is an even stronger predisposition to gluten sensitivity than having one gene and the resultant immunologic gluten sensitivity or celiac disease may be more severe.

[ravenwoodglass]

Those are positive results for gluten and malabsorption. You should get back on the diet.

You also have a DQ 1 which predisposes many for more neurological issues, like you are seeing with the seizures. They could very well be connected.

It does appear that you are not having as much of an issue with milk protein but you may still want to avoid it while you are healing.

[glutenfreewithease]

Those are positive results for gluten and malabsorption. You should get back on the diet.

You also have a DQ 1 which predisposes many for more neurological issues, like you are seeing with the seizures. They could very well be connected.

It does appear that you are not having as much of an issue with milk protein but you may still want to avoid it while you are healing.

Thanks for the reply. The second I recovered from the seizure the gluten free diet was back! My doctor was explaining to me about the malabsorption of the fat, but I just can't seem to get my brain wrapped around it. Is the malabsorption of fat meaning that my body is most likely not able to absorb fat soluble vitamins like A,E, D and k? Does this mean my two girls are sensitive to gluten just from my test results. We are getting them both tested and should have the results soon of their genetic testing and stool testing.

I'm divorced from their father and I tried speaking with him and he says he wants to wait till their tested to go gluten free even though my doctor says it would be good to go gluten free now. They are both willing and have different symptoms that I'm concerned are related. My oldest has so many nose bleeds that we have to count how many she doesn't have! Pedi doesn't have any answers. So we are hoping they stop after going gluten free. Again, thanks for your input.

[Rya]

Thanks for the reply. The second I recovered from the seizure the gluten free diet was back! My doctor was explaining to me about the malabsorption of the fat, but I just can't seem to get my brain wrapped around it. Is the malabsorption of fat meaning that my body is most likely not able to absorb fat soluble vitamins like A,E, D and k? Does this mean my two girls are sensitive to gluten just from my test results. We are getting them both tested and should have the results soon of their genetic testing and stool testing.

I'm divorced from their father and I tried speaking with him and he says he wants to wait till their tested to go gluten free even though my doctor says it would be good to go gluten free now. They are both willing and have different symptoms that I'm concerned are related. My oldest has so many nose bleeds that we have to count how many she doesn't have! Pedi doesn't have any answers. So we are hoping they stop after going gluten free. Again, thanks for your input.

The fat malabsorption is one of the first things to occur with damage to the villi caused by gluten. Part of the problem is the receptors that usually wait for the fat, grab the fat, and put it on the other side of your intestinal wall are damaged. Once this happens, you don't reabsorb bile (the substance that helps fat get to its receptors). So now you have two reasons that the fat leaves your body via stool.

Yes, your absorption of fat soluble vitamins is also decreased. Most especially A, E, and D. Vitamin K is affected to a lesser extent because primary our source of it comes from bacteria in the colon, not so much via our diets (at least that's the theory).

As for the genes, what I am understanding is that there is not a guarantee that your kids have Celiac, though it seems likely. It would be ideal to go gluten-free now, but if ex-hubby is not on board, it's better, in my opinion, to continue them on a regular diet than having them go on and off a gluten-free.

[Rya]

Marsha,

I got bogged down in the technical response I was giving (see above post)! Here is the rest of it....getting your head around all of this is something I still aspire to do. This forum is a massive help though.

I wouldn't be surprised if your girls get better on the diet. So glad to hear that you have! And a thanks for bringing this to the forum - my boyfriend and I learned a lot about Celiac genetics tonight

Rya

[glutenfreewithease]

The fat malabsorption is one of the first things to occur with damage to the villi caused by gluten. Part of the problem is the receptors that usually wait for the fat, grab the fat, and put it on the other side of your intestinal wall are damaged. Once this happens, you don't reabsorb bile (the substance that helps fat get to its receptors). So now you have two reasons that the fat leaves your body via stool.

Yes, your absorption of fat soluble vitamins is also decreased. Most especially A, E, and D. Vitamin K is affected to a lesser extent because primary our source of it comes from bacteria in the colon, not so much via our diets (at least that's the theory).

As for the genes, what I am understanding is that there is not a guarantee that your kids have Celiac, though it seems likely. It would be ideal to go gluten-free now, but if ex-hubby is not on board, it's better, in my opinion, to continue them on a regular diet than having them go on and off a gluten-free.

I was really surprised by the malabsorption number because I didn't think that I was eating enough gluten. I cheated here and there because I had doubt in my mind that gluten was the issue (especially when blood tests were negative-took tests when I had gone off gluten) and ate in restaurants were cross contamination was likely and that french toast at Denny's was a definate no-no.

The ex thing is hard, but I guess what I need to understand fully is if you have a gluten sensitive gene and not a celiac gene, does this mean that gluten hurts your gut the same as it does in celiac disease or that you have irritating reations like being lactose intolerant without damaging the villi? Does that make sense? If this is so then do my girls really need to go gluten free? I do not want them to suffer like I have. I am waiting for there genetic tests to come back and if either of them have DQ 2 or 8 I think they should go 100% gluten free, but if they do not...............

[Rya]

I was really surprised by the malabsorption number because I didn't think that I was eating enough gluten. I cheated here and there because I had doubt in my mind that gluten was the issue (especially when blood tests were negative-took tests when I had gone off gluten) and ate in restaurants were cross contamination was likely and that french toast at Denny's was a definate no-no.

The ex thing is hard, but I guess what I need to understand fully is if you have a gluten sensitive gene and not a celiac gene, does this mean that gluten hurts your gut the same as it does in celiac disease or that you have irritating reations like being lactose intolerant without damaging the villi? Does that make sense? If this is so then do my girls really need to go gluten free? I do not want them to suffer like I have. I am waiting for there genetic tests to come back and if either of them have DQ 2 or 8 I think they should go 100% gluten free, but if they do not...............

First, the "not enough gluten" - the tiniest amount of gluten will cause the same autoimmune reaction that attacks your body and does damage. Each time you are glutened - either by cross contamination or by eating a wheat bagel - you become less likely to respond to the diet, and you have done 3 months worth of damage to your body. Do accidents happen? Of course. Did anyone on this forum go gluten-free and not get glutened after that? I doubt it. But, purposefully cheating and not being careful just adds to the pot. It's certainly akin to playing with fire.

If you want a "french pancake" recipe, I have an amazing one by the way...

The boyfriend and I did some more research on the genes - it is much much more complex than what the explanation says. I'm no geneticist, although the boyfriend sort of is, but we understood that Celiac is dependent on many many variables.

To answer your question about the gluten-sensitive gene as directly as possible - no it doesn't mean they have Celiac or gluten sensitivity. Not all Celiacs carry the genes they have found so far. I would be more concerned with their antibody levels and also their response to the diet (should you and the ex work that out). If your girls have high IgA levels and fat malabsorption I would certainly have them be gluten-free. Even if they aren't, I would have them be gluten-free at your house for your sake.

Lastly, you're armed with good information, smart questions, and concern for your family. Everything else will fall in place shortly.

Rya