Question About Results

[huenix]

I hesitate to even post this because I am sure the "correct" answer is talk to my GI, but...

Two years ago I was diagnosed with GERD. Last fall, I got giardiasis from contaminated water, and after about 6 weeks of suffering finally got a positive result in testing. My regular doc (actually his PA) gave me Flagyl, and the giardiasis cleared up. In the followup appointment, the PA found occult blood in my stool, and did bloodwork.

My liver function tests were a bit high (140s for AST and ALT) and my total bili was high (I have Gilberts, or at least thats what I have been told for a couple years...) I was also mildly anemic. PA requested that I see the gastro, which I did. Gastro repeated blood tests (6 weeks or so later..) and did a RUQ sono of the liver.

Repeat bloodwork was mostly perfectly normal. Total bili was still high (1.2) and the gastro had screenings done for Hep, Celiac and some other stuff. Everything was negative except:

tTG-IgA was 14, with >8 as positive

The other AGA test was right dead in the middle of maybe. I don't have the sheet here with me so while I remember the result was inconclusive, I don't remember the range.

Last but not least, I am still anemic, even talking an iron supplement and dietary changes to increase iron consumption.

RUQ sono came back as perfectly normal.

Last week I had an Endo and Colonoscopy per the gastro. Everything was fine as far as it went with mild gastro irritation (even on Prilosec...) The biopsy report says"No flattening of the villi is observed. There is, however, a slight increase in the number of plasma cells in the core of the villi and a slight increase in the number of lymphocytes in the epithelium..." It mentions that if clinically suspected, this could represent a mild form of celiac disease and recommends seriologic testing and clinical pathological correlation.

I've had gastro discomfort for a long time and always wrote it off as GERD, Frequent mild diarrhea. Very occasional nausea.

Last but not least I should at least mention that I am somewhat of a distance runner, and I'm in overall good shape (barring the last few months due to the giardia...)

Any thoughts? Anything I should specifically talk with the GI about?

Thanks!

[Luvbeingamommy]

Your story sounds similiar to mine and I don't see my GI doc for another two weeks.

I've also had high bilirubin, although usually around 1.2, not real high. I had some liver enzyme problems as well. My sypmtoms are stomach pain, nausea (bad sometimes), on and off diarrhea. Also had a stroke, and am a very healthy 25 year old. I just decided to give the diet a try, only on day 2 though. So while I can't offer any advice, just wanted to let you know you are not alone.

[ravenwoodglass]

I would start the diet. You have had a positive blood test and a endo that showed that you may be (probably are with the positive blood work) in the early stages of celiac. I would start the diet. That is the truest test. It is very common for us to have elevated liver panels, GERD and the other symptoms you are having. If you have any questions please feel free to ask and read as much as you can here.

[nora-n]

This biopsy finding is typical for early celiac, and the ttg test is quite specific for celiac, but may be positive in giardiasis.

But by the time it was done, it should probably have gone down.

to read more about the significance of the biopsy findings, go to Dr. Lewey's blog somewhere on his site, www.thefooddoc.com .

[huenix]

Crap. Reading all the giardia/celiac disease links just gets more confusing. I agree with you that it -should- have gone away and I certainly have had zero giardia-specific symptoms since finishing the run of Flagyl.

Whats stressing me out about all this is that I don't want this to end with "Well, we don't know what's wrong with you." Especially since, in 9 days since starting the gluten-free diet, I have not had any anxiety issues whatsoever, a decrease in stomach pains, and I've been sleeping a lot better. I don't want that to be psychosomatic.

[ravenwoodglass]

Especially since, in 9 days since starting the gluten-free diet, I have not had any anxiety issues whatsoever, a decrease in stomach pains, and I've been sleeping a lot better.

I don't want that to be psychosomatic.

It's not. Please do stick with the diet, it does sound like it is helping.