Celiac Or Ncgs... An Interesting Doctor's Perspective

[MsCurious]

Still here, lurking, and playing the waiting game. Hopefully, will have EMA results Monday, provided the lab didn't screw things up (should have been back by now). I have no idea if test results will be positive or negative... no idea if I'm celiac or NCGS.... but regardless, after reading endless posts of frustration, and sometimes heartwrenching stories, I can empathize with all of you. I found this article very validating... no matter WHAT is going on with you, and the doctor admittedly agrees that there is a huge need for massive research, and they really know next to NOTHING about the different gluten sensitivities, and the "journey" of gluten sensitivity people have to endure to reach the "golden ring" of a celiac diagnosis. Personally, I think there are several "kinds" of gluten sensitivity that manifest different symptoms, but the result is all the same... we are sick, and gluten makes us sick. They seem to have no research to "validate" us so they make us feel crazy. Well, this article made me feel better, just by virtue of doctor admitting that they really can't diagnose something for which they have no hard scientific proof. I guess that's why when they can't diagnose celiac disease, they just say, try the gluten-free and if it works, great. I have a feeling its going to be a LONG time before there are difinitive answers for a lot of us. Thank goodness for this forum.

Here, Dr. Sheila Crowe, a professor in the division of gastroenterology and hepatology in the department of medicine at the University of Virginia, responds to readers who asked whether you can be intolerant to gluten, the way some people might be intolerant to milk, without having full-blown celiac disease.

Intolerant to Gluten Without Having Celiac Disease?

Q.What is your take on non-celiac gluten intolerance? There are some medical professionals who say that without the definitive markers of celiac disease (blunt villi, positive blood work), there is no reason to ever change to a gluten-free diet.

Could it be that the markers only become evident after a certain degree of damage and ill heath has been attained, and that celiac is really part of a spectrum of disease relating to the body

[ravenwoodglass]

I wonder what her take is on DH. Having DH is considered a firm diagnosis of celiac disease and is not referred to as gluten sensitivity or intolerance instead. But many times folks with DH have no intestinal symptoms or villi atrophy for years if at all. So much we still don't know.

[MsCurious]

I wonder what her take is on DH. Having DH is considered a firm diagnosis of celiac disease and is not referred to as gluten sensitivity or intolerance instead. But many times folks with DH have no intestinal symptoms or villi atrophy for years if at all. So much we still don't know.

Hey Raven,

I looked it up for you... Dr. Crowe responds...

The ABCs (and TTGs) of Celiac Disease Testing

First, by definition, a diagnosis of celiac disease requires abnormal microscopic findings in small intestinal biopsy specimens. One exception to this rule occurs when a patient has a skin condition known as dermatitis herpetiformis, in which case a characteristically abnormal skin biopsy result can substitute for checking intestinal biopsies.

You make an interesting point though... in these cases... there need not be villous atropny to make a diagnosis! Rather inconsistent with the "gold standard" isn't it?

[Igg postive]

You did it again. Great Post!! Your post help me answer what I should be doing after I have my biospy. I have a positive DGP IGG test. Should I consider a gluten free diet if my biopsy comes back negative? Here is what the doctor Sheila Crowe said;

It depends on the type of patient. Some patients have symptoms of celiac disease but do not have an abnormal intestinal biopsy that is taken before starting a gluten-free diet (by definition, they are not categorized as having celiac disease). If blood tests show that such patients also have antibodies to tissue transglutaminase (TTG) or deamidated gliadin peptide (DGP), I would suggest that these individuals consider going on a truly gluten-free diet, since they are most likely on their way to celiac disease. The same advice could apply to those who have H.L.A. DQ2 or DQ8 genes without elevated antibodies, though in this case the recommendation is more ambiguous, since there are no immune abnormalities or intestinal damage.

You can see the rest of her post on (Open Original Shared Link).

I felt I was in limbo until I had the results of the test. (I know you have the same feeling). Now I feel I can proceed forward with my healing process what ever my biopsy results are. Your post really help me find the answer I needed. Big Thanks!

[MsCurious]

You did it again. Great Post!! Your post help me answer what I should be doing after I have my biospy. I have a positive DGP IGG test.

I felt I was in limbo until I had the results of the test. (I know you have the same feeling). Now I feel I can proceed forward with my healing process what ever my biopsy results are. Your post really help me find the answer I needed. Big Thanks!

Igg, YOU JUST MADE MY DAY! It's so nice to know I could have helped even one person in some small way! This is a long journey... feel like I've been in the "pre-diagnosis forum" forEVER, and I'm sure you do, too! LOL But, I'm learning a lot and it feels good to know I can make even a teensy difference in relieving someone's frustration level. Thanks for letting me know it helped!

[GFinDC]

Scott posted this article link not long ago about NCGI research. you might find it interesting.

Study Shows Gluten Intolerance Without Celiac Disease - Celiac.com

[ravenwoodglass]

Hey Raven,

I looked it up for you... Dr. Crowe responds...

The ABCs (and TTGs) of Celiac Disease Testing

First, by definition, a diagnosis of celiac disease requires abnormal microscopic findings in small intestinal biopsy specimens. One exception to this rule occurs when a patient has a skin condition known as dermatitis herpetiformis, in which case a characteristically abnormal skin biopsy result can substitute for checking intestinal biopsies.

You make an interesting point though... in these cases... there need not be villous atropny to make a diagnosis! Rather inconsistent with the "gold standard" isn't it?

I am glad she does address this and yea I agree it is rather inconsistent with the 'gold standard' and is why I personally consider 'gluten intolerance' and celiac to be basically two names for the same thing but perhaps with different organ impact.