Biopsy Result Negative

[~sara~]

Hi everyone,

I'm going to tell you my symptoms and my biopsy result, the symptoms are:

1. flatulence, the main complain (15 years ago, and that is why I didn't go to any doctor).

2. chronic constipation (long time ago)

3. bloating and discomfort.

4. urgent need to the bathroom ( when I have to go, I have to go now, not in a few minutes!!).

few years ago:

5. different pattern of constipation and diarrhea cycle( for example the last time I had constipation for a week then 2 days diarrhea, and before that I had morning diarrhea for a month)

6. very dry hair ( I used to have a nice hair).

7. knee pain, once or twice a year ( I didn't have it for a while, and one doctor told me that it may be due to thalassemia minor.

8. bad memory.

9. itchy skin when going to bed, once in a while( I don't have rash or eczema or any kind of skin disease, and I didn't have it for a while either).

and now to the doctors

The first doctor wanted to refer me to a psychiatric , but she did something with barium swallowing and x-ray and told me that there is something wrong in the peristaltic movement.

The second doctor did gastroscopy (mild inflammation), colonoscopsy (normal), gave me a bunch of medication for the G and nothing helped, and he told me that he did everything he could, and what I have is dyspepsia.

When I went to the third doctor I decided to be in charge, so I asked him to do a breath test for SIBO, which I suspected (the second doctor knew nothing about it!!), and a test for Celiac, so he did a breath test for H.Pylori(negative), SIBO breath test(positive), lactose intolerance (positive), Celiac blood test(negative). I used rifaximin for SIBO(which was difficult to find,not available in my country).I felt great during the course and all the G went away but not the urgent need, and when I finished the course all the G came back, I did some reading on lactose intolerance and SIBO and I figured out that there must be an underlying condition, so I came back to the doctor and asked him to do endoscopy and a biopsy and the result was:

Microscopic Examination:

1.Antrum- Sections show gastric mucosa. Lamina propria shows focal hemorrhages and mild infiltration of chronic inflammatory cells, which in a few foci are seen invading the foveolar epithelium. Reactive changes in foveolar epitheliun are evident in some foci. No H.pylori seen in Glemsa staining.

2.small intestine: Sections shows duodenal mucosa. Lamina propria shows focal edema, dilated capillaries and mild increase in lymphocytes and plasma cells. Some villi are mildly shortened or broadened, but no villous atrophy is evident. Occasional lymohocytes are seen infiltrating surface epithelium.

Impression:

1. Antrum: chronic non-specific inflammatory changes.

2. small intestine: findings are consistent with chronic duodenitis.

The day I did the biopsy I decided to go on gluten free diet, it has been a month now and I don't feel I'm getting better, not even a little. One day during this month I had bread and I did not feel sick, not more than usual, I was 90% sure that I have celiac, but now I'm not that sure.

I was supposed to go to the doctor 3 weeks ago to discuss the biopsy result and to discuss the treatment options, but I wanted to continue my gluten free diet.

My questions are:

Does the biopsy result sound like celiac and misdiagnosed with duodenitis?

should I continue with the gluten free diet?

I could not find many info about duodenitis, what I understood that there must be an underlying condition and it does not happen by itself, does anyone know?

Is there a cure for duodenitis?

There was something about the H.pylori in the report(No of H.pylori seen in Glemsa staining), I did breath test for H.pylori and it was negative, so is it accurate?

If the G came from SIBO, which came from duodenitis, This means I had duodenitis since I was 12, is it possible?

what kind of other test I should ask the doctor for?, because I'm pretty sure I have other undiscovered problem along with duodenitis.

what are the motility test?

Thanks alot.

Actually I have more than 100 questions, but I'm going to force myself to stop

[starrytrekchic]

I would get your thyroid tested, as a lot of those symptoms can indicate a problem there. You could have a couple of issues resulting in these symptoms, so you might not find one thing that covers everything.

Have you had your vitamin/mineral levels checked?

For the gluten free diet, I'd continue for a bit, but I'd check everything in your food/drinks/house/work/etc that could be cross contaminating you.

[~sara~]

Thanx alot for your reply, I actually didn't mention that I went to endocrinologist to discuss this issue along with the hyperhydrosis that I have. I did a thyroid function test and the result was:

TSH 3.680 (0.4 - 4.O)

T4 0.97 (0.2 - 3.5)

T3 1.59 (1.45-3.48)

The doctor thought I may had hyperthyroidism, and he didn't expect a high TSH which indicate hypothyroidism. he told me I have to do another test in a couple a month.

I did ferrtin and Iron test which was normal.

I did Vitamin D3 which was very low, 5.0 which indicate deficiency, and I am the reason is that I stopped drinking milk and all dairy product long time before I found out that I have lactose intolerance. The doctor gave me Vitamin D3 injection

I did Cortisol test which was normal.

My diet is mainely rice with meat, chicken or fish for lunch, fruit with black tea for breakfast, homemade french fries with gluten free ketchup for dinner at the weekend,gluten free, lactose free cookies.

[Skylark]

SIBO can be a "stand-alone" problem and if you're not positive on celiac tests or feeling better off gluten celiac may not be the issue. Have you looked at the Specific Carbohydrate diet? It does happen to be gluten-free as well, but because wheat is a good food for bacteria. Open Original Shared Link

[~sara~]

I have tried a low carb diet just for 2 days, and I was going to faint, no energy at all.

I'm losing too much weight, and I have thalassemia minor. I don't think I'll be able to handle this Diet, it is so restricted with no enough calories.

I said before:

If the G came from SIBO, which came from duodenitis, This means I had duodenitis since I was 12, is it possible?

Could it all start with inflammation or food poisoning triggered the SIBO as a kid( because my main complain was G), then with all these years the bad bacteria caused the duodenitis, lactose intolerance ?, it does make more sense this way, right?.

I already took one course for SIBO and the symptoms came back immediately, so does this mean there is something causing the SIBO?, or simply I will need several courses?

[Skylark]

I have tried a low carb diet just for 2 days, and I was going to faint, no energy at all.

I'm losing too much weight, and I have thalassemia minor. I don't think I'll be able to handle this Diet, it is so restricted with no enough calories.

Gosh, two days doesn't sound like enough for your body to get used to a new diet. Also a lot of people make the mistake of cutting out grains and then not eating enough rich foods like cheese, eggs, or nuts. You will have no energy at all trying to eat low carb and low fat. You need either carbs or fats to burn for energy.

SCD is supposed to be really good! It is not a low-calorie diet and there are some fruit carbs allowed. There is no restriction on how much food you eat and there are plenty of high-calorie foods allowed like nut butters and cheese. There are also some carbs in fruits and legumes. It is specifically designed to heal SIBO without antibiotics by limiting certain carbs and adding good bacteria with the yogurt.

If you prefer pills, I suppose that's your choice, but you're likely to have a recurrence when you stop taking them again if that's what happened in the past. Your gut is full of bacteria by design. Nature abhors a vacuum so whatever tiny percentage of bacteria are left after the antibiotic will grow right back, possibly even newly antibiotic resistant. My understanding is that it's much like fighting yeast, where you starve them out (SCD) and fill your intestines with healthy bacteria that can crowd out the bad ones (yogurt, fermented foods, probiotics).

I don't know how to untangle your problems, as I'm not a doctor. I'm just a scientist who reads a lot on celiac. Your idea that it started with food poisoning makes a lot of sense. It seems to me like doctors are just starting to figure out the profound effect of bacteria on our GI systems.