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Gluten Challenge (After Being Gluten Free For 2 Years)


nutbutters

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nutbutters Rookie

Hello, I was previously diagnosed with celiac disease based on mild indicators on blood tests. My doctor asked me to immediately start the diet since I wasn't absorbing any of the food I was eating and he did not want to risk it. I was severely underweight. Anyway, I went to a gastroenterologist this year who requested, begged, that I get the biopsy done just to make sure I was properly diagnosed. Well, I started the "gluten rich" diet the day he asked me to, three weeks ago, for a February 25th biopsy. I'm 22 years old, teaching full time, so it's sort of a strain sometimes. Well, I started the diet the same day I started my period (it was regulated, on birth control). I'm severely anemic so I was on birth control to regulate and shorten my period, but after I started the diet, I thought my period really exaggerated itself. I was convinced I was on my period for the entire time, but I stopped bleeding last night and wasn't bleeding when I woke up this morning. After a bowel movement this morning, my "period" seemed to have returned. I realized it was coming from somewhere on my backside (can't specify because I don't know). There is no pain but I bleed all day, like it's a period. It's not heavy at all, and at most, it fills, altogether, one regular pad after a day. At first I just thought it was my period giving me a normal complication (I often have had problems with it), but I stopped the birth control because I thought that was contributing, and I realized it was rectal bleeding. It's not painful at all, but I'm a bit concerned. It had been two years since I'd consumed even the smallest bit of gluten, and now I've been bleeding from my rectum/eating gluten for three weeks! I called my GI but he's closed so he's going to see me Tuesday. What could this be? My BMs are not painful, I don't strain at all, I really have no pain, the only pain I ever have is after consuming milk or wheat, a stomach ache, but nothing during the BM. Could it be hemorrhoids? Could it be something else? I'm just really frustrated and want to stop eating gluten...now.


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kareng Grand Master

I'm a little confused about that doc. If you are well healed, why is he asking you to hurt yourself and cause damage? Just because he makes a good profit on endos and colonoscopies, doesn't make it right. His oath says something like " Do no harm".

Would you say to a well controlled diabetic, " your blood sugars have been stable for years on insulin. Let's take you off. Eat all the sugar/ carbs you want until you go into a diabetic coma. Then we will know we are on the right treatment."

Time to get a new GI.

nutbutters Rookie

I'm a little confused about that doc. If you are well healed, why is he asking you to hurt yourself and cause damage? Just because he makes a good profit on endos and colonoscopies, doesn't make it right. His oath says something like " Do no harm".

Would you say to a well controlled diabetic, " your blood sugars have been stable for years on insulin. Let's take you off. Eat all the sugar/ carbs you want until you go into a diabetic coma. Then we will know we are on the right treatment."

Time to get a new GI.

He wants to diagnose via biopsy, so he's asking me to do it again. A pain, a really big pain.

sa1937 Community Regular

I think I'd tell him exactly what he could do with that scope!

ravenwoodglass Mentor

He wants to diagnose via biopsy, so he's asking me to do it again. A pain, a really big pain.

Three weeks on gluten is likely not long enough for a postive biopsy after you have been healed for as long as you have. You would need to continue on gluten for at least 3 months. There is no reason, other than to line the doctors pockets, for you to continue the challenge now that you are clearly reacting. Your in pain, your bleeding. That is a good reason to stop the challenge now. The challenge is positive and you don't have to prove anything to this doctor.

kareng Grand Master

Three weeks on gluten is likely not long enough for a postive biopsy after you have been healed for as long as you have. You would need to continue on gluten for at least 3 months. There is no reason, other than to line the doctors pockets, for you to continue the challenge now that you are clearly reacting. Your in pain, your bleeding. Your challenge is positive and you don't have to prove anything to this doctor.

Exactly!

He wants to biopsy you? So what! I want to slap him! Should I? No. Just cause needless suffering and pain.

beebs Enthusiast

I would be going to the hospital for that mate. rectal bleeding can be dangerous.


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    • trents
      Being as how you are largely asymptomatic, I would certainly advise undertaking a gluten challenge in order to get formal testing for celiac disease. We have many forum participants who become violently ill when they undertake a gluten challenge and they therefore can't carry through with it. That doesn't seem to be the case with you. The reason I think it is important for you to get tested is that many or most people who don't have a formal diagnosis find it difficult to be consistent with the gluten-free diet. They find ways to rationalize that their symptoms are due to something other than celiac disease . . . especially when it becomes socially limiting.  The other factor here is by being inconsistent with the gluten free diet, assuming you do have celiac disease, you are likely causing slow, incremental damage to your gut, even though you are largely asymptomatic. It can take years for that damage to get to the point where it results in spinoff health problems.
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    • trents
      Welcome to the celiac.com community, @ThomasA55! Before I give my opinion on your question about whether or not you should undergo a gluten challenge, I would like to know how you react when you get a good dose of gluten? Are you largely asymptomatic or do you experience significant illness such as nausea and diarrhea? You mentioned intermittent joint pain before you began experimenting with a low gluten diet. Anything else?
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