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Doctor Won't Confirm


bellac

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bellac Newbie

Ok, my husband and I are in turmoil about what to do...

Here's a recap of our story. Our daughter's bloodwork and biopsy showed early stages/symptoms of celiac (she didn't have any symptoms - diarhea, etc). She's been on a gluten-free diet for 7 months. I just got back from the GI appt and he said based on these two things we are lead to diagnose celiac, however, he can not confirm it. He said we could put her back on a main-stream diet and see what happens (if symptoms arise she'll go in for another biopsy right awa, if no symptoms arrive then she'll go in for a biopsy in about a year). The idea of putting us all thru that again doesn't sound appealing, however, the idea of having an unconfirmed diagnosis and forcing my daughter to live her life as though she has celiac even though she may not doesn't sound too appealing either. We could do a genetic test and if it came back negative then she does not have it, however, if it comes back positive it's inconclusive....


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adab8ca Enthusiast

Ok, my husband and I are in turmoil about what to do...

Here's a recap of our story. Our daughter's bloodwork and biopsy showed early stages/symptoms of celiac (she didn't have any symptoms - diarhea, etc). She's been on a gluten-free diet for 7 months. I just got back from the GI appt and he said based on these two things we are lead to diagnose celiac, however, he can not confirm it. He said we could put her back on a main-stream diet and see what happens (if symptoms arise she'll go in for another biopsy right awa, if no symptoms arrive then she'll go in for a biopsy in about a year). The idea of putting us all thru that again doesn't sound appealing, however, the idea of having an unconfirmed diagnosis and forcing my daughter to live her life as though she has celiac even though she may not doesn't sound too appealing either. We could do a genetic test and if it came back negative then she does not have it, however, if it comes back positive it's inconclusive....

Hello!

I am not sure I understand-if her blood work and biopsy indicated Celiac, she has it. There are many Celiacs called "silent" celiacs that have little to no symptoms and the celiac disease comes out while they are being tested for something else. I had no GI symptoms, none of my Dr's can believe I have Celiac disease but it is what it is...Even if there are little to no symptoms, damage is still being done to the intestines and it may not remain silent forever. If there was damage during the biopsy, then it isn't necessarily early stages.

can you post a few more details about what the blood work and biopsy results stated?

txplowgirl Enthusiast

There's no such thing as being a little bit pregnant. Either you are are you aren't. If the blood tests are indicative then that means it is. Simple, period. She is having an auto immune reaction and she has some kind of intestinal damage and may have other possible auto immune disorders that may develop as well as can develop possible cancer later in life as well as short stature. Please keep her gluten free.

tarnalberry Community Regular

Yeah - she's got an immune response to it, and she's got intestinal damage from it: that means she has it!

The doc is probably wishy washy because he's in the "oh, the diet is so hard, unless her life is unmanageable with symptoms, she won't stay on the diet, so lets not label her". Bubkis. You, and she, are smarter than that!

bellac Newbie

Hello!

I am not sure I understand-if her blood work and biopsy indicated Celiac, she has it. There are many Celiacs called "silent" celiacs that have little to no symptoms and the celiac disease comes out while they are being tested for something else. I had no GI symptoms, none of my Dr's can believe I have Celiac disease but it is what it is...Even if there are little to no symptoms, damage is still being done to the intestines and it may not remain silent forever. If there was damage during the biopsy, then it isn't necessarily early stages.

can you post a few more details about what the blood work and biopsy results stated?

I don't have all her numbers, one number was a 12 when 4 is good/normal. After her endoscopy the doctor didn't expect celiac to be an issue because everything looked healthy but biopsy results stated "early stages/symptoms".

I think we are going to ask the dr to re-do her bloodwork. She's been on a gluten-free diet for 7 months and at least if we have the bloodwork re-ran her numbers should be down/normal and that can help me and my husband feel more confident that her diet is doing something.

Please, no one think we are in denial of celiac - we can deal with it. There's just so much grey area, even the doctor says it's a grey diagnosis....

seezee Explorer

Is it possible for you to send the biopsy and lab tests to another GI doctor who specializes in celiac. I found that some doctors aren't too knowledgeable. There are a number of celiac disease centers at hospitals around the country. It seems that you could possibly send the lab work there or maybe talk to someone else. I can't quite get the logic of making a child ill and damaging their digestive system for months.

mstroud Rookie

I agree that it sounds like she has positive test results and I don't understand why the doctor would hesitate to diagnose her. My son was 7 when he was diagnosed and his results were on the 'mild' side as well. He had definite symptoms (abdominal pain, dark circles, pain in his legs / joints) and they told us that his biopsy results showed early signs of celiac disease and his blood results were 'low positive.' They diagnosed him, but did say that his results were probably on the low side because we caught it early. He did have the genetic test and it came back positive as well.


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mushroom Proficient

I am a little confused by this whole thread too. As I understand it, the celiac panel was not run because she was having any symptoms, but for some other reason??? That is why the results were a surprise to everyone? However, both results were positive, but because she was a silent celiac the doctor will not make a diagnosis. The reason the biopsy samples are taken is because the flattened villi often only show up under microscopic examination; i.e, they are not visible to the naked eye during the scope. But the microscopic exam showed early stage celiac, confirming the blood work. I am at a loss as to why anyone is doubting this diagnosis.

scarlett77 Apprentice

OK, my take on the situation is this: she tested positive for BOTH blood and scope. How can the doctor not diagnose based of those results? If it acts like a horse and looks like a horse it is a horse. My suggestion is to take the results of the positive labs and endoscopy to another GI and see if s/he can give an official diagnosis.

There is NO WAY in HECK that I would subject my child to an entire YEAR of gluten just for a diagnosis. That is ridiculous. I myself may be looking at making a decision to do a gluten challenge with my youngest and I'm still on the fence about it(leaning towards NOT though). I understand that you don't want to have her miss out if she isn't Celiac, but you have had 2 tests that are positive.

lovegrov Collaborator

Positive on both. She has it. Be glad you caught it before she got REALLY sick. I had to get to the point where I was hospitalized for 11 days and missed 10 weeks of work.

BTW, if your doctor truly said that he wanted her to go back to gluten and if symptoms arise he's do another biopsy RIGHT away, then he's showing his ignorance about celiac. Most experts agree you need to be eating gluten for many weeks, months, actually, before you could have an accurate biopsy.

richard

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    • Mmoc
      Thank you kindly for your response. I have since gotten the other type of bloods done and am awaiting results. 
    • Aretaeus Cappadocia
      I wanted to respond to your post as much for other people who read this later on (I'm not trying to contradict your experience or decisions) > Kirkland Signature Super Extra-Large Peanuts, 2.5 lbs, are labeled "gluten free" in the Calif Costcos I've been in. If they are selling non-gluten-free in your store, I suggest talking to customer service to see if they can get you the gluten-free version (they are tasty) > This past week I bought "Sliced Raw Almonds, Baking Nuts, 5 lbs Item 1495072 Best if used by Jun-10-26 W-261-6-L1A 12:47" at Costco. The package has the standard warning that it was made on machinery that <may> have processed wheat. Based on that alone, I would not eat these. However, I contacted customer service and asked them "are Costco's Sliced Almonds gluten free?" Within a day I got this response:  "This is [xyz] with the Costco Member Service Resolutions Team. I am happy to let you know we got a reply back from our Kirkland Signature team. Here is their response:  This item does not have a risk of cross contamination with gluten, barley or rye." Based on this, I will eat them. Based on experience, I believe they will be fine. Sometimes, for other products, the answer has been "they really do have cross-contamination risk" (eg, Kirkland Signature Dry Roasted Macadamia Nuts, Salted, 1.5 lbs Item 1195303). When they give me that answer I return them for cash. You might reasonably ask, "Why would Costco use that label if they actually are safe?" I can't speak for Costco but I've worked in Corporate America and I've seen this kind of thing first hand and up close. (1) This kind of regulatory label represents risk/cost to the company. What if they are mistaken? In one direction, the cost is loss of maybe 1% of sales (if celiacs don't buy when they would have). In the other direction, the risk is reputational damage and open-ended litigation (bad reviews and celiacs suing them). Expect them to play it safe. (2) There is a team tasked with getting each product out to market quickly and cheaply, and there is also a committee tasked with reviewing the packaging before it is released. If the team chooses the simplest, safest, pre-approved label, this becomes a quick check box. On the other hand, if they choose something else, it has to be carefully scrutinized through a long process. It's more efficient for the team to say there <could> be risk. (3) There is probably some plug and play in production. Some lots of the very same product could be made in a safe facility while others are made in an unsafe facility. Uniform packaging (saying there is risk) for all packages regardless of gluten risk is easier, cheaper, and safer (for Costco). Everything I wrote here is about my Costco experience, but the principles will be true at other vendors, particularly if they have extensive quality control infrastructure. The first hurdle of gluten-free diet is to remove/replace all the labeled gluten ingredients. The second, more difficult hurdle is to remove/replace all the hidden gluten. Each of us have to assess gray zones and make judgement calls knowing there is a penalty for being wrong. One penalty would be getting glutened but the other penalty could be eating an unnecessarily boring or malnourishing diet.
    • trents
      Thanks for the thoughtful reply and links, Wheatwacked. Definitely some food for thought. However, I would point out that your linked articles refer to gliadin in human breast milk, not cow's milk. And although it might seem reasonable to conclude it would work the same way in cows, that is not necessarily the case. Studies seem to indicate otherwise. Studies also indicate the amount of gliadin in human breast milk is miniscule and unlikely to cause reactions:  https://www.glutenfreewatchdog.org/news/gluten-peptides-in-human-breast-milk-implications-for-cows-milk/ I would also point out that Dr. Peter Osborne's doctorate is in chiropractic medicine, though he also has studied and, I believe, holds some sort of certifications in nutritional science. To put it plainly, he is considered by many qualified medical and nutritional professionals to be on the fringe of quackery. But he has a dedicated and rabid following, nonetheless.
    • Scott Adams
      I'd be very cautious about accepting these claims without robust evidence. The hypothesis requires a chain of biologically unlikely events: Gluten/gliadin survives the cow's rumen and entire digestive system intact. It is then absorbed whole into the cow's bloodstream. It bypasses the cow's immune system and liver. It is then secreted, still intact and immunogenic, into the milk. The cow's digestive system is designed to break down proteins, not transfer them whole into milk. This is not a recognized pathway in veterinary science. The provided backup shifts from cow's milk to human breastmilk, which is a classic bait-and-switch. While the transfer of food proteins in human breastmilk is a valid area of study, it doesn't validate the initial claim about commercial dairy. The use of a Dr. Osborne video is a major red flag. His entire platform is based on the idea that all grains are toxic, a view that far exceeds the established science on Celiac Disease and non-celiac gluten sensitivity. Extraordinary claims require extraordinary evidence, and a YouTube video from a known ideological source is not that evidence."  
    • Wheatwacked
      Some backup to my statement about gluten and milk. Some background.  When my son was born in 1976 he was colicky from the beginning.  When he transitioned to formula it got really bad.  That's when we found the only pediactric gastroenterologist (in a population of 6 million that dealt with Celiac Disease (and he only had 14 patients with celiac disease), who dianosed by biopsy and started him on Nutramegen.  Recovery was quick. The portion of gluten that passes through to breastmilk is called gliadin. It is the component of gluten that causes celiac disease or gluten intolerance. What are the Effects of Gluten in Breastmilk? Gliaden, a component of gluten which is typically responsible for the intestinal reaction of gluten, DOES pass through breast milk.  This is because gliaden (as one of many food proteins) passes through the lining of your small intestine into your blood. Can gluten transmit through breast milk?  
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