Endoscopy/biopsy

[noobasaur]

okay so I've had a variety of symptoms spanning the past 3 years. I'm 21 and female.

I've only recently started a gluten-free diet, and am waiting to see if my health improves.

my doctors have been absolutely 0 help in determining what's wrong. I say 3 years because that's when the symptoms became more severe; I developed lactose intolerance, was throwing up more frequently, and just had overall horrible abdominal pain. my primary physician diagnosed me, over the next three months, with ovarian cysts (via an ultrasound), broken and bruised ribs (cause undetermined, no trauma), and no real cause for the vomiting and stomach pain.

I was prescribed various painkillers and steroids, but they didn't help. fast forward two and a half years. this past january I decided to see a gastroenterologist who scheduled an endoscopy.

this is where my question comes in:

there has never been a mention of celiac out of any of my doctors' mouths. I've been told ulcers, Crohn's/other types of colitis, endometreosis, general acid reflux, and many things along those lines.

they have done bloodwork, and said "it was fine". is celiac's an automatic test for these types of symptoms?

they did an endoscopy. the results were: no ulcers. esophagitis presumably (not definitely) from GERD, and damaged intestines. they took a biopsy and told me there was "no infection", but didn't mention anything about celiac or gluten intolerance.

would I have to bring it up or is this something they automatically check for? is it possible that I have a gluten intolerance and/or celiac despite the "no infection" result of the biopsy?

I browsed the site and didn't find anything that quite answered my question, I apologize if this is redundant.

[WW340]

Just because you have had a lot of tests, including endoscopy, does not mean your doctor has tested for celiac. Generally, they test for that only if they have some suspicion you may have the disease. Some doctors will be very thorough and test during routine workup, but most only do it if it is something they believe you may have.

If the doctor found some suspicious areas in the small intestine, he might have biopsied those. You had a biopsy which showed no infection, which was probably from the stomach looking for Hpylori. This doesn't mean they took biopsies of the small intestine where celiac is found.

It would be best to ask the doctor if he did the celiac blood test, or took biopsies to look for celiac. If he says yes to any of those, I would ask to see the actual results.

You say in the results that you had damaged intestines, where in the intestines and what kind of damage did you have?

What did he say was causing this damage?

[noobasaur]

You say in the results that you had damaged intestines, where in the intestines and what kind of damage did you have?

What did he say was causing this damage?

Thanks for the response.

He did not specifically say what caused it, but I was prescribed Nexium this time around (which actually made me worse and unable to ingest anything at all).. my impression was that he was blaming it all on GERD. he said there was some erosion on the intestines.

[WW340]

Usually, nexium is used to treat GERD, which occurs in the upper gastrointestinal tract. Your doctor may be referring to damage to the duodenum, which could be caused by GERD. Since celiac and crohn's can also cause damage to the small intestine, it would be good to know for sure that those have been ruled out.

I would suggest that you talk to your doctor. Ask him if he has tested you for celiac disease, and what does he think is causing the intestinal damage, and where exactly is the damage.

These are all things that would be good for you to know, and he should not mind answering.

[ravenwoodglass]

I agree stongly with the previous responses. If your doctor was not looking for celiac he would not find it. In addition I think the broken ribs really need to be addressed. There was a reason for that. It should be found. At the very least they should be evaluating you for osteoporosis. I would ask for a referral to an bone specialist. Also do not go gluten free until all the testing YOU want to have for celiac is done. If you do you run a higher risk of a false negative and that risk is high enough even on a full gluten diet.

[noobasaur]

I agree stongly with the previous responses. If your doctor was not looking for celiac he would not find it. In addition I think the broken ribs really need to be addressed. There was a reason for that. It should be found. At the very least they should be evaluating you for osteoporosis. I would ask for a referral to an bone specialist. Also do not go gluten free until all the testing YOU want to have for celiac is done. If you do you run a higher risk of a false negative and that risk is high enough even on a full gluten diet.

I scheduled an appointment for this Tuesday for bloodwork to be done. is there anything else I should ask about? I'm worried that he will brush off my concerns about osteoporosis because I haven't had any other problems since the ribs. every time I ask him about something in particular, he will say, "well that's probably not it. the risk is low", etc.

so. for the next week I am not to eat gluten free, correct?

thanks for the help so far.

[ravenwoodglass]

I scheduled an appointment for this Tuesday for bloodwork to be done. is there anything else I should ask about? I'm worried that he will brush off my concerns about osteoporosis because I haven't had any other problems since the ribs. every time I ask him about something in particular, he will say, "well that's probably not it. the risk is low", etc.

so. for the next week I am not to eat gluten free, correct?

thanks for the help so far.

If the bloodwork you are having done is for celiac then please stay on gluten. I might also suggest with a due respect for your present doctor that you see if you can find one who listens a bit better. There are many things that folks suffer from that are 'low risk' but that doesn't mean that they may not be something that shouldn't be ruled out.

With the testing for celiac being as unreliable as it is you should do a dietary trial after all your testing is done.

IMHO there is no reason not to at least do a bone scan to check for osteoporosis. If the breaks were healed long ago they may have been from something that happened when you were too young to remember. Do any family members recall something that may have occured?

[noobasaur]

I was tested today, but my doctor said he wants me to have a CCK-HIDA scan of my gall bladder to see if it's not functioning properly. he said he'd be willing to bet on the fact that it isn't celiac, but obliged per my insistence of being tested. I'll find out friday.

I'm going gluten-free regardless of the test results. from what I've gathered, false negatives are extremely common, yes?