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Md Wants To Do Biopsy Now


jkr

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jkr Apprentice

Hello,

I've been reading all of the posts for a while and thought I would finally share some thoughts. I had iron deficiency anemia (ferritin was 9 with & low H & H) last year and underwent the colonoscopy and upper endoscopy. I suspected celiac but the doctor really did not think so because he said I didn't have diarrhea! But I had every other symptom. Anyway, he didn't do biopsies. I told him I wanted the blood test so he ordered the TTG antibodies. This was last November. (the TTG IGA was high, 67); I work in a MD office with a lab so I got the results before him. I just started the gluten-free diet because I knew in my heart I had celiac. Well, I finally went to see him yesterday because I've had some stomach issues (burning, cramps). Now he wants to do the biopsy and of course he wants me to go back to eating gluten for six weeks. I'm so hesitant to go back to eating gluten. From reading these posts I know some of you would say forget it, the blood test is enough. I'm just on the fence about it.


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ravenwoodglass Mentor

I can't write what I would like to about this doctor. I personally would find another GI and I would get my hands on complete records from his office and any and all procedures you had done. You may find that there were strong indications of celiac even without the biopsies as there are changes that can be seen in some of us but for him to not even take one biopsy was in mind negligent.

If you are feeling better on the diet at this point I would just continue with it. When you go to your new GI doctor if he thinks an endo is required I would consider having it done to rule out any other issues but the choice whether to go back on gluten for 6 weeks to 3 months is up to you. If your symptoms from gluten are severe I wouldn't.

Many of us do have other intolerances in addition to the gluten. Casien and soy being high on the list. For me soy was the direct cause of my continued stomach pain and my reaction to soy is very different to that from gluten. You could try eliminating soy and milk casein yourself and see what happens. Pepto bismal helps get rid of that pain immediately for me. I tryed that before using the acid blockers that my ex-GI wanted to put me on.

jkr Apprentice

What type of foods have soy in it?

ravenwoodglass Mentor
What type of foods have soy in it?

A lot. As with gluten you will need to read the labels. A great deal of the gluten free baked goods have soy for example. Soy is one of the 8 major allergens so it has to be on the ingedient label if it is there. The most troublesome for me was to find a margerine that was soy and casien free. I finally gave up and for a few months used Ghee, which is clarified butter or coconut oil for baking. I now use good old fashioned butter but liked the flavor of the coconut shortning so much I still use it.

mattathayde Apprentice

my doc told me "if gluten free is working for you then stick to it, there is no point to make you sick for a month to get a blood test that will just confirm what we already know, and the only thing its going to change is your insurance premiums"

i had gotten diagnosed by my alternative medicine doc and went gluten free before i knew about getting any blood test or biopsy but they have a snow balls chance in hell of getting me to eat gluten to just get a freaking test

-matt

mushroom Proficient
What type of foods have soy in it?

More than you can imagine :o

You don't realize until you start looking for it. For example, it seems most gluten free baked goods contain soy (that's what rose up and bit me and made me so sensitive to it). You will find soy lecithin used as an emulsifier in many foods, like chocolate :( Now some people are able to tolerate soy lecithin; I am not one of them unfortunately. Soy also hides as hydrolized vegetable protein.; edamame beans are fresh soy beans. You will find soy bean oil in many salad dressings and soy is in most asian sauces (not just soy sauce). Once you start looking for it you will find it on almost as many labels as gluten, I'm sorry to say.But you can live without it :)

LDJofDenver Apprentice
Hello,

I've been reading all of the posts for a while and thought I would finally share some thoughts. I had iron deficiency anemia (ferritin was 9 with & low H & H) last year and underwent the colonoscopy and upper endoscopy. I suspected celiac but the doctor really did not think so because he said I didn't have diarrhea! But I had every other symptom. Anyway, he didn't do biopsies. I told him I wanted the blood test so he ordered the TTG antibodies. This was last November. (the TTG IGA was high, 67); I work in a MD office with a lab so I got the results before him. I just started the gluten-free diet because I knew in my heart I had celiac. Well, I finally went to see him yesterday because I've had some stomach issues (burning, cramps). Now he wants to do the biopsy and of course he wants me to go back to eating gluten for six weeks. I'm so hesitant to go back to eating gluten. From reading these posts I know some of you would say forget it, the blood test is enough. I'm just on the fence about it.

I'd also consider a different G.I. doc. And you may not have to go back on gluten for the endoscopic small bowel biopsy. I don't know how old you are, but I was 56 when diagnosed and everything doesn't heal in a couple of months (more like a year, possibly more when diagnosed later in life).

My GI doc thought there'd still be plenty of evidence of it, even after 7 months eating gluten free. She was right, biopsies confirmed the celiac and just now starting to showing signs of regrowth of villi, in response to gluten free diet. If you have a good GI, they'll know what is best.


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jkr Apprentice
I'd also consider a different G.I. doc. And you may not have to go back on gluten for the endoscopic small bowel biopsy. I don't know how old you are, but I was 56 when diagnosed and everything doesn't heal in a couple of months (more like a year, possibly more when diagnosed later in life).

My GI doc thought there'd still be plenty of evidence of it, even after 7 months eating gluten free. She was right, biopsies confirmed the celiac and just now starting to showing signs of regrowth of villi, in response to gluten free diet. If you have a good GI, they'll know what is best.

Thanks for the info. I haven't been gluten free for as long as you were. I will be 50 next week and I'm sure I've had this since I was a child.

LDJofDenver Apprentice
Thanks for the info. I haven't been gluten free for as long as you were. I will be 50 next week and I'm sure I've had this since I was a child.

I'm sure mine was there throughout childhood as well . Sounds like we're in the same boat (lots of celiacs in our boat!).

My GI doc also had ordered blood work (re-test) at the 6 month mark, and even that wasn't normal yet. And I'm careful (not to say I haven't been occasionally glutened accidentally during that time). My levels had gone down, but still are not normal. She said it takes a while, especially given my age at diagnosis (that again), and to keep doing what I'm doing, it was going in the right direction. Initially when she said she wanted to do the endoscopy I told her there was no way I could go back on gluten, it whams me so violently now whenever it sneaks into something I've eaten. And, as I said before, she said I didn't have to. That I wouldn't be healed in this short a period of time (sure wasn't!).

Do you have a local Celiac Group of some sort? THings like that often also have links to GI docs in your area that specialize in (or at least have a high knowledge level of) celiac disease.

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      Not necessarily. The "Gluten Free" label means not more than 20ppm of gluten in the product which is often not enough for super sensitive celiacs. You would need to be looking for "Certified Gluten Free" (GFCO endorsed) which means no more than 10ppm of gluten. Having said that, "Gluten Free" doesn't mean that there will necessarily be more gluten than "Certified Gluten" in any given batch run. It just means there could be. 
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      I think it is wise to seek a second opinion from a GI doc and to go on a gluten free diet in the meantime. The GI doc may look at all the evidence, including the biopsy report, and conclude you don't need anything else to reach a dx of celiac disease and so, there would be no need for a gluten challenge. But if the GI doc does want to do more testing, you can worry about the gluten challenge at that time. But between now and the time of the appointment, if your symptoms improve on a gluten free diet, that is more evidence. Just keep in mind that if a gluten challenge is called for, the bare minimum challenge length is two weeks of the daily consumption of at least 10g of gluten, which is about the amount found in 4-6 slices of wheat bread. But, I would count on giving it four weeks to be sure.
    • Paulaannefthimiou
      Are Bobresmill gluten free oats ok for sensitive celiacs?
    • jenniber
      thank you both for the insights. i agree, im going to back off on dairy and try sucraid. thanks for the tip about protein powder, i will look for whey protein powder/drinks!   i don’t understand why my doctor refused to order it either. so i’ve decided i’m not going to her again, and i’m going to get a second opinion with a GI recommended to me by someone with celiac. unfortunately my first appointment isn’t until February 17th. do you think i should go gluten free now or wait until after i meet with the new doctor? i’m torn about what i should do, i dont know if she is going to want to repeat the endoscopy, and i know ill have to be eating gluten to have a positive biopsy. i could always do the gluten challenge on the other hand if she does want to repeat the biopsy.    thanks again, i appreciate the support here. i’ve learned a lot from these boards. i dont know anyone in real life with celiac.
    • trents
      Let me suggest an adjustment to your terminology. "Celiac disease" and "gluten intolerance" are the same. The other gluten disorder you refer to is NCGS (Non Celiac Gluten Sensitivity) which is often referred to as being "gluten sensitive". Having said that, the reality is there is still much inconsistency in how people use these terms. Since celiac disease does damage to the small bowel lining it often results in nutritional deficiencies such as anemia. NCGS does not damage the small bowel lining so your history of anemia may suggest you have celiac disease as opposed to NCGS. But either way, a gluten-free diet is in order. NCGS can cause bodily damage in other ways, particularly to neurological systems.
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