A New Celiac Diagnosis(?)

[stephsteph]

Well, I guess I may finally have an answer for my digestive issues, and perhaps some other symptoms.

Now that I think back, I would say my first symptoms started back in college, with upset stomachs occasionally for no reason, and the first of my migraines, but nothing super bothersome. I chalked it up to stress. After college, the upset stomachs got a little worse, and the migraines got a little worse, and I was tired a lot. Nothing I couldn't handle with a bottle of pepto, excedrin migraine, and a nap. These things slowly kept getting worse. I would complain to my doc that I was tired a lot, they'd run blood tests for anemia, cell counts, etc, but it was always normal. I complained that my head hurt, she sent me to a neurologist, had tests run, and got put on a daily med for migraines. I never really mentioned the digestive problems.

Two years ago or so at Christmas, I noticed that my abdomen was sore. I went to the doctor a few weeks later, and was told it was nothing. No tests or anything. Fast-forward to last October, I went on a cruise, and my stomach was constantly upset. I thought maybe I had picked up a bug, but it stayed upset even after I got home (diarrhea, nausea, stomach cramps). I went back to the doctor, who told me it was IBS, and once again ran the standard blood tests, which came back normal. She told me to avoid dairy and fatty foods, and that was it.

My digestive issues continued to worsen. It was now interfering in daily life - constant trips to the bathroom, constantly complaining that my stomach hurt, and that I was tired. It was such a part of my daily life that I didn't even realize I was even mentioning it to my fiance. I went back to the doctor a few weeks ago, where she once again said IBS, and that there wasn't anything else she could do for me in a very distant manner. I was about ready to burst into tears, when she actually looked at my chart and realized she had never done any diagnostic tests for my digestive issues, and ordered (once again) the blood tests for anemia and such, but also antibody testing for celiacs and a ct scan of my abdomen.

I got a nice letter in the mail today, saying all my blood tests were normal (surprise surprise) EXCEPT for my tissue transglutaminase which was 'STRONGLY POSITIVE', and that we'd discuss those results at my next appointment.

Long story short, I am beginning a gluten free diet

[mushroom]

Welcome to the board, and I am so glad you are finally getting someone to listen to you. All the posters on this forum would have tested you for celiac years ago

I would give you one caution - she may want to do an endoscopy of the small intestine with biopsies (instead of the CT scan) to confirm the diagnosis, in which case you should stay on your regular diet until after all testing is done because some healing could take place in the meantime if you stop eating gluten now. While that would be good from your point of view, it may well invalidate the biopsy results depending on how long you have to wait. The biopsy is considered to be the so-called gold standard of diagnosis, and you know how the medical profession is about their tests With no positive test result they think you can't have it. So stick it out until all testing is completed - you have come this far, and while you feel sure of the answer your doc may not.

If you can get her to order further testing with a positive diagnosis, this should include vitamins A, E K, D, B12 and folate, also mineral levels of zinc, potassium, magnesium and selenium, together with a thyroid test (TSH, free T4 and free T3), as these are common deficiencies in the celiac disease malabsorption disorder (if she has not already done all these).

Stick around and keep us posted. This board is a fabulous resource of information and everyone is always willing to help, no matter the question.

[stephsteph]

Thanks! I'm already finding these boards useful Would being gluten free for even a few weeks affect the results of a biopsy? I only ask because I'm getting married in two months. I have engagement photos next weekend, dress fittings, and all the other wonderful wedding related events coming up. I'm at a point right now where I'm dreading this stuff because I'm constantly running off to the bathroom. I had already found that not eating=stomach feeling better for a bit (I'm pretty sure my future in laws think I have some sort of eating disorder which I don't). I'm miserable enough that I'm willing to risk a biopsy coming back normal (couldn't it come back normal even if I was eating gluten?) if it means going gluten free and feeling better.

[mushroom]

Yes, as I said, it is not uncommon to have positive blood results and negative biopsy. It is up to you entirely whether or not you choose to do the biopsy. If you are happy eating gluten free from the blood results alone there is no reason to mess up your wedding plans for the sake of getting a test. The only reason to do the biopsy would be if you needed the doctor's sanction to keep yourself eating gluten free. Many of us here are totally self diagnosed and would not dream of eating gluten just for the sake of getting a medical diagnosis.

And yes, not eating gluten for a couple of months could well make the difference between a positive and a negative biopsy

So you have to make the choice of whether to do the biopsy or not if she says she wants to do it. By declining it, you are not ruling out that it would have been positive. By taking it a couple of months from now and virtually guaranteeing it will be negative, you risk her saying, well, you do not have celiac and then she may not be as cooperative in ordering the additional blood tests you need. What it comes down to is you must do what is best for you I know what I would do

[jencs]

Yes, as I said, it is not uncommon to have positive blood results and negative biopsy. It is up to you entirely whether or not you choose to do the biopsy. If you are happy eating gluten free from the blood results alone there is no reason to mess up your wedding plans for the sake of getting a test. The only reason to do the biopsy would be if you needed the doctor's sanction to keep yourself eating gluten free. Many of us here are totally self diagnosed and would not dream of eating gluten just for the sake of getting a medical diagnosis.

And yes, not eating gluten for a couple of months could well make the difference between a positive and a negative biopsy

So you have to make the choice of whether to do the biopsy or not if she says she wants to do it. By declining it, you are not ruling out that it would have been positive. By taking it a couple of months from now and virtually guaranteeing it will be negative, you risk her saying, well, you do not have celiac and then she may not be as cooperative in ordering the additional blood tests you need. What it comes down to is you must do what is best for you I know what I would do

Well a couple thoughts come to mind, from someone who is struggling with many of the same issues but my bloodwork came back normal. I would be concerned that she sent your blood test results saying you likely have Celiac by mail....to me that warrants a phone call. Also, when is your next appointment? If it isn't this week, I would either call to ask if it can be made a priority so you can figure out what your next steps are or at the very least ask her if she plans to do additional testing that would prevent you from beginning a gluten free diet immediatley.

But...given the fact you have been struggling with this for so long and she only just tested you now, I personally would search for a doctor in your area that specializes in Celiac. Going forward, it makes sense to me to be with a doctor who fully understands the disease.

Good luck with your wedding plans, if anything this should make your wedding and everything associated with it so much better.

[GFinDC]

Going gluten-free is the only treatment for celiac disease. But you should be aware that for many people the first months after going gluten-free are not especially smooth sailing on the digestive front. There can be ups and downs, back-slidings and advances. but a steady progression to healing is not the norm, IMHO. Your best path to heal is to stop eating all processed foods, and cut out wheat, rye, barley, oats, dairy, and soy. If it was me I'd cut out nightshades (potatoes, peppers, tomatoes) too. Also eat only foods you cook yourself from scratch.

[stephsteph]

UPDATE: Went back to the Dr. today. CT scan was all normal. Since going gluten free, my most annoying symptom (D) has completely stopped. Still some stomach cramping and bloating, but I could still be getting small amounts of gluten from somewhere (prescription meds maybe). I hope as time goes on, this too will get better. I tried to bring up food allergies, she didn't really listen (I'm not surprised). Next time, I guess.

Based on abnormal blood test and diet response, the official dx is Celiacs. She did apologize for not figuring out what was wrong with me sooner, that of all the people she's tested for Celiacs, mine was the first blood test to come back positive...