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Villi Still Damaged After All These Years?


frec

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frec Contributor

I was diagnosed with celiac disease in 2002. I have never cheated on the diet and only get glutened occasionally--maybe once or twice a year. My new gastro gave me an IgA/tTg test, just to check things, and I came out slightly positive (23). He did an endoscopy last week to check on things and found villous atrophy--not totally flattened, but damaged.

I am still baffled as to how I am being glutened, and several nice people gave me suggestions on another thread. I am sooo careful! I am still going over everything with fine toothed comb. I just thought I should let people know that this can happen. If your gastro hasn't recommended a blood test periodically (my old one never did), ask for one. Apparently you can damage your villi even with a very low positive score.

I also would like to know if it has happened to anyone else?


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Green Eyes Rookie

I get results from a blood test today after 3 months of eating gluten free. I'm anxious to see what my results are!! I have a very difficult time because my system doesn't react to small amounts of gluten. I watch it ever so carefully - but I don't even know when I get those trace amounts so I never know to be more careful. Could this be your problem as well?

Jennifer

fedora Enthusiast

just wanted to say I am sorry, hope you figure it out

happygirl Collaborator

After reviewing your diet, I would discuss the possibility of refractory sprue with your doctor. If he isn't knowledgable, I'd find one who is.

dilettantesteph Collaborator

A GI celiac specialist gave a talk at our local chapter recently. He said that true sprue was very rare. Almost always people are getting small amounts of gluten accidentally. Since I am not all the way healed yet, I still react fairly quickly and can tell you that all sorts of things that are supposed to be gluten free seem to be cross contaminated with enough gluten to make me sick. It could be that even though you aren't getting obviously sick, you are still getting flattened vili from the same sorts of items. I try to only get things made in dedicated facilities. He recommended checking things like make-up, soap, lotion etc. I would also say that sprue is unlikely since your blood test was positive. It indicates that you are getting gluten somewhere. The same specialist said that now he considers under 20 negative, but that he is beginning to think that he should be lowering that figure to under 10. He also said that a dose as small as 0.5 mg. is enough to cause a reaction. I am sorry for your problems.

neesee Apprentice
A GI celiac specialist gave a talk at our local chapter recently. He said that true sprue was very rare.

That's interesting. When I was diagnosed my gastroenterologist told me I was only the fourth real and true case of sprue he had ever seen in all of his career. Then he said one had died. I took that last statement to mean it was very important to follow the diet.

neesee

Lisa Mentor

Happygirl made a comment about Refractory Sprue. Having a conversation with someone who has been diagnosed with Refractory Sprue, due to the many years and severe symtoms of undiagnosed Celiac, her villi will no longer grow back, regardless of a dedicated gluten free diet. They're just gone. :(

Although perhaps rare, it does happen.


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Mike M Rookie
I was diagnosed with celiac disease in 2002. I have never cheated on the diet and only get glutened occasionally--maybe once or twice a year. My new gastro gave me an IgA/tTg test, just to check things, and I came out slightly positive (23). He did an endoscopy last week to check on things and found villous atrophy--not totally flattened, but damaged.

I am still baffled as to how I am being glutened, and several nice people gave me suggestions on another thread. I am sooo careful! I am still going over everything with fine toothed comb. I just thought I should let people know that this can happen. If your gastro hasn't recommended a blood test periodically (my old one never did), ask for one. Apparently you can damage your villi even with a very low positive score.

I also would like to know if it has happened to anyone else?

Hello Frec, I haven't posted for very long, so I don't carry much clout, having said this, if you find the time, keep an eye on the gluten test strip thread. ShayFl will be doing some testing to see if the Elisa test strips are accurate or not. From the tests that I have performed, there are indeed issues with the so called "gluten free" foods that are out there and just food in general. Whole foods are just about the only safe way to go in my opinion and even then there can be problems. I was buying an entire organic non injected Turkey breast that was whole. (It was just the breast but it had been cut by the store) and I cooked it myself. I got gluttened from it. Tested it after the fact with the test strip and it was positive. Maybe it had been injected or something along the way or maybe a CC'd knife from the store. I don't know what the answer to this is, it makes me very upset. So now I have switched to almost only canned meats and buying local farm fresh raised meats from the local Amish. I also have a local fish farm that I buy my fish from. It seems like if the meat has been cut and packaged at the store, it is suspect for CC. So far all of the canned meats that I have been buying and testing from Sams Club are ok. Of course that can change. I might as well bring this up also (man are they going to attack me for this one) I have not found a salad dressing that contains vinegar, that does not test positive for some gluten. Mike

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But I want to knos if it would be enough to do damage.” NO - this is OCD brain at its best! Hijacking your thoughts and justifying it because of the very real fear of gluten contamination. That’s OCD all over. Like a devil in the driving seat. Fears that are based on some kind of reality are hard to argue with. Boss it back! Recognise this for what it is. OCD using fear of gluten as its excuse to keep you entrapped. Own the OCD in this scenario, don’t let it own you. Normal cleanliness rules apply. Washing your hands before you handle food you’re putting in your mouth is fine. Washing after the gym is normal. Once daily cleansing wipe of your phone etc. Even if you did go rubbing your hands all over surfaces and licking them there might be a trace exposure to gluten possible. But I’m guessing you don’t usually do that sort of thing. Even if you inadvertently were to ingest trace gluten - it won’t be enough to do damage, no. It takes weeks to months of at least a few hundred milligrams of gliadin daily for the innate immune system followed by the adaptive immune system in coeliac disease to kick in and start producing antibodies and cause villous atrophy. “3. Is an endoscopy (without biopsy) enough to tell if my intestines are healed? I’d pay privately if it could help and if i dont get a refferal. Or do i need a biopsy?” Only biopsy, as the gold standard of diagnosis, can tell for certain if villi have recovered. Having said that video capsule etc. can give an indication of any inflammation. “4. Could my job (powder coating, sandblasting, etc.) expose me to gluten or damage my intestines through air/dust?” Assuming your employer provides all necessary PPE - appropriate mask and overalls etc. All you can do is take the precautions that are advised according to risk assessments and regulations of the relevant industry governing bodies? (I don’t know what this would be in the USA. Sorry. But there’s safety and governing regs in the UK for this sort of thing. Assuming it would be very similar over the pond in fairness). “5. Do I need certified gluten-free toothpaste, hand soap, shampoo, or moisturizer? (For example: Vaseline and Colgate don’t contain gluten ingredients but say they can’t guarantee it’s gluten-free.)” This comes down to personal threshold of gluten tolerance. People that are highly sensitive may need certified products. Especially those with dermatitis herpetiformis - the skin manifestation of gluten sensitivity. Listen to your body on this one. “6. Is spices like pepper with “may contain traces of gluten” safe if no gluten ingredients are listed? Or does everything need to be labeled gluten-free?” This one is easy - when following a strict gluten free diet, avoid products that say May contain traces of gluten. But it does not have to be labelled gluten free. There are many foods naturally gluten free. 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