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Does Something Other Than Celiac Cause Villous Blunting?


DiagnosedandDealing

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DiagnosedandDealing Newbie

I was diagnosed with Celiac in Jan 2011 with a positive biopsy. My blood test was negative, but at the time I was told that is common and the biopsy is the gold standard. The first 3-4 months on gluten-free diet were WONDERFUL!!! No stomach issues at all. After being on a gluten-free diet for 7 months I went to another Dr for a second opinion because I started having some stomach/digestive issues again about 3 months ago and my previous Dr just wanted to put me on prilosec and wouldn't consider any other allergy possibilities. This new Dr said she doesn't think I have celiac because my blood test was negative. I thought the biopsy was the true teller of celiac. Has anyone else had this type of situation? I am nervous to try gluten becase the few times I think I have gotten it I have gotten very sick for a couple of days. Any thoughts????


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sa1937 Community Regular

I was diagnosed with Celiac in Jan 2011 with a positive biopsy. My blood test was negative, but at the time I was told that is common and the biopsy is the gold standard. The first 3-4 months on gluten-free diet were WONDERFUL!!! No stomach issues at all. After being on a gluten-free diet for 7 months I went to another Dr for a second opinion because I started having some stomach/digestive issues again about 3 months ago and my previous Dr just wanted to put me on prilosec and wouldn't consider any other allergy possibilities. This new Dr said she doesn't think I have celiac because my blood test was negative. I thought the biopsy was the true teller of celiac. Has anyone else had this type of situation? I am nervous to try gluten becase the few times I think I have gotten it I have gotten very sick for a couple of days. Any thoughts????

Your Dr. is wrong! A positive biopsy trumps the negative blood test (and vice versa). If you've been gluten-free for several months, it is quite likely that you will have a negative blood test. You do have celiac and need to stick with a strict gluten-free diet. There's no way I would go back on gluten to satisfy a doctor's curiosity.

After being gluten-free for awhile, you may have developed other intolerances to dairy or soy. It might be worth eliminating those from your diet to see if your symptoms improve.

DiagnosedandDealing Newbie

Your Dr. is wrong! A positive biopsy trumps the negative blood test (and vice versa). If you've been gluten-free for several months, it is quite likely that you will have a negative blood test. You do have celiac and need to stick with a strict gluten-free diet. There's no way I would go back on gluten to satisfy a doctor's curiosity.

After being gluten-free for awhile, you may have developed other intolerances to dairy or soy. It might be worth eliminating those from your diet to see if your symptoms improve.

Thank you for the quick reply. This dr put me on an antibiotic for a bacterial overgrowth. Is it common to develop bacterial overgrowths from Celiac?

chasbari Apprentice

I am going to gently disagree here. Read Elaine Gottschall's work "Breaking the Vicious Cycle" and you will find that soy can cause the same villus atrophy as seen in celiac. I found, after positive biopsy and negative serology that I have a much more painful reaction to soy than that of gluten. Gluten is bad, mind you, but soy is much worse. I have been noticing some residual problems after having gone through the SCD approach as I tried to add some fruit back into the diet. Cramps, both muscular and intestinal, as well as palpitations and general problems. I thought, at first, it was related to how much fat an protein I was consuming. Stopped the fructose intake 4 days ago and things are much better. There were other strategies I employed along with this but the driver for me was what I learned from the above mentioned book. I was shocked to read her take on over diagnosis of celiac and the fact that soy can create the same appearance in the gut. Food for though, perhaps?

sa1937 Community Regular

That's interesting, chasbari. I know a lot of people have problems with soy but I honestly didn't know it could cause villous atrophy.

DiagnosedandDealing Newbie

I am going to gently disagree here. Read Elaine Gottschall's work "Breaking the Vicious Cycle" and you will find that soy can cause the same villus atrophy as seen in celiac. I found, after positive biopsy and negative serology that I have a much more painful reaction to soy than that of gluten. Gluten is bad, mind you, but soy is much worse. I have been noticing some residual problems after having gone through the SCD approach as I tried to add some fruit back into the diet. Cramps, both muscular and intestinal, as well as palpitations and general problems. I thought, at first, it was related to how much fat an protein I was consuming. Stopped the fructose intake 4 days ago and things are much better. There were other strategies I employed along with this but the driver for me was what I learned from the above mentioned book. I was shocked to read her take on over diagnosis of celiac and the fact that soy can create the same appearance in the gut. Food for though, perhaps?

Thanks for the reply. You mention soy causing similiar blunting...this is the first I have heard of this. Also you mention fructose causing you issues. With a positive biobsy, were you diagnosed with Celiac? Also if you seem to have a worse reaction from fructose and soy, do you now eat gluten without a problem?

kareng Grand Master

WHat explanation did this doctor give for the blunting?


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DiagnosedandDealing Newbie

WHat explanation did this doctor give for the blunting?

The original diagnosis back in Jan was celiac due to the villious blunting. A gluten-free diet did wonders and I felt great for over 3 months. Then I started having some mild nausea and stomach issues, returned for a follow up biopsy and was told (after 5 months on gluten-free diet) that my intestines no longer showed signs of celiac (good this was the goal) but nothing was really idenfied as cause of bloating and nausea. I went off milk for 2 weeks with no change (milk has a tendency to settle my stomach) and after the second endoscopy I was told there was no sign of lactose intollerance. The first dr suggested GERD (even though I had no other symptoms of GERD) and the new Dr is saying it is likely not celiac but something else, possible bacterial overgrowth or soy allergy? I am so confused and just tired of feeling crappy. It surprises me that different Dr think totally different things based on the same clinical evidence?????

sa1937 Community Regular

I really don't know anything about bacterial overgrowth but I know there are some members here that are knowledgeable. You might also use the google search button at the top right of your screen to see what threads there are so you can read up on it.

Personally I'd give up soy to start with...the problem is that it seems to sneak into everything. I don't know why manufacturer's have to include it in so many things.

DiagnosedandDealing Newbie

I really don't know anything about bacterial overgrowth but I know there are some members here that are knowledgeable. You might also use the google search button at the top right of your screen to see what threads there are so you can read up on it.

Personally I'd give up soy to start with...the problem is that it seems to sneak into everything. I don't know why manufacturer's have to include it in so many things.

Thank you. I may end up going this route, but you are right....wheat and/or soy seem to be in EVERYTHING!!!

sa1937 Community Regular

Thank you. I may end up going this route, but you are right....wheat and/or soy seem to be in EVERYTHING!!!

You might also want to ditch dairy for the time being just in case you have an unknown problem with it. You can always try adding it back in later.

bartfull Rising Star

According to this, gluten, corn soy and casein can all cause villous atrophy.

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chasbari Apprentice

Thanks for the reply. You mention soy causing similiar blunting...this is the first I have heard of this. Also you mention fructose causing you issues. With a positive biobsy, were you diagnosed with Celiac? Also if you seem to have a worse reaction from fructose and soy, do you now eat gluten without a problem?

I have gone into more detail about my journey on another discussion here but will recap a bit. I have a host of autoimmune issues and several years after being positively Dx'ed for rheumatoid Arthritis and Sjogren's I was diagnosed for celiac by endoscopic biopsy following a negative blood panel but very high RA factor. I responded positively to a gluten free diet in that I no longer felt like I was going to die the next day but still had a host of complications. When I went totally grain free as in rice, corn, and any other alternative grain, I turned a corner and started to get noticeably better. I lost weight way too fast though and could not keep my hunger in check. There was a period early on when I ate nothing but meat for a period of about two weeks. In hindsight I realize that is when I felt the best. No carbs at all. I went back to a lot of fruit and the raging hunger came back. For a period of about a year I could not go more than about an hour without needing a lot of calories and I was still losing weight. I switched to lower carb but kept a modicum of fruit in the diet and got a bit better and actually started to gain a little bit of muscle mass. I finally read Elaine Gottschall's book "Breaking the Vicious Cycle" and that is where I first read about soy being able to cause villous atrophy similar in appearance to celiac damage. I have also read about enough anecdotal evidence here on the incidence of celiac symptom onset being coincident with antibiotic use in many folks. That is the discussion I expanded more on this whole theory. I found it interesting because a number of years ago after my lupus indicators were so high (unusual for a male) I read on the SLE foundation website that while antibiotics may prove to be a trigger for episodic flares of lupus symptoms, the foundation was unwilling to take the position that antibiotics might be causative. I began to examine the whole gut flora research project at the NIH. Any of my turning points with my autoimmune issues always seemed to be linked to broad spectrum antibiotic use. In light of Gottshall's writing this seemed to put a mechanism in place for gut flora disruption, small intestinal bacterial overgrowth and candidiasis. I decided to take a number of steps to re-establish a functioning gut flora that seemed to have been damaged through my lifetime of antibiotic overuse. I started consuming a lot of raw coconut and coconut oil to knock down yeast overgrowth with the naturally occurring capryllic acid. I cut carbs way down and upped my intake of protein in the form of meat, tuna and salmon raw eggs and raw dairy. The raw dairy was purposefully added in to help repopulate the gut flora in a more natural way. I also added sauerkraut for more fermented gut support. The convergence of all these led to a rather scary 48 hours at one point. It was like I was living a viral infection I had twenty five years ago in reverse. I broke out in a rash that I would get when I had it and was given biaxin. My skin felt like it was burned for about forty eight hours and then it just suddenly cleared up. I had this very palpable sense of mental clarity at this time as well. I have added kefir in to the mix as it takes the place of the raw dairy when I am too broke to travel to get the raw dairy from an excellent farmer I have had the privilege of meeting. I have been consuming so much fat and so many eggs but was troubled recently by heart palpitations. I thought it was because of all the cholesterol and protein. I don't believe the lipid hypothesis put forward years ago by Ancel Keyes that has led to our grain centric fat avoiding diet but there was still a bit of doubt in the back of my mind with the thought that maybe I was not really doing the right thing after all. I dropped all fruit from my diet five days ago. I was eating bananas because I found myself cramping after workouts. I was eating pineapple for the bromelein. And I was eating a small serving of frozen cherries after dinner just because it was the closest thing to a treat for me any more. As soon as I dropped the fruit, the cramps stopped, the palpitations stopped and I feel much better. I realized that the gut discomfort might have been related to the same cramping I was experiencing with my skeletal muscles. Today I have eaten 14 raw eggs and I feel so good it is frightening. The fruit was really messing me up. I don't know what use any of this info will be to you but you just have to keep digging and asking and reading and researching. We are the ones who spend 24/7 in our personal research laboratories and we often don't get much hlep from outside consultants (doctors) who only have anecdotal clinical evidence to support or refute our very powerful personal observations. Trust your gut!

Even If I find that I never had celiac ( I am next to positive I do in spite of my observations of soy causing damage) I will never eat grains again. I am too healthy now and no longer miss my death foods.

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    • trents
      So, essentially all of the nutrition in the food we eat is absorbed through the villous lining of the small bowel. This is the section of the intestinal track that is damaged by celiac disease. This villous lining is composed of billions of finger-like projections that create a huge amount of surface area for absorbing nutrients. For the celiac person, when gluten is consumed, it triggers an autoimmune reaction in this area which, of course, generates inflammation. The antibodies connected with this inflammation is what the celiac blood tests are designed to detect but this inflammation, over time, wears down the finger-like projections of the villous lining. Of course, when this proceeds for an extended period of time, greatly reduces the absorption efficiency of the villous lining and often results in many and various nutrient deficiency-related health issues. Classic examples would be osteoporosis and iron deficiency. But there are many more. Low D3 levels is a well-known celiac-caused nutritional deficiency. So is low B12. All the B vitamins in fact. Magnesium, zinc, etc.  Celiac disease can also cause liver inflammation. You mention elevated ALP levels. Elevated liver enzymes over a period of 13 years was what led to my celiac diagnosis. Within three months of going gluten free my liver enzymes normalized. I had elevated AST and ALT. The development of sensitivities to other food proteins is very common in the celiac population. Most common cross reactive foods are dairy and oats but eggs, soy and corn are also relatively common offenders. Lactose intolerance is also common in the celiac population because of damage to the SB lining.  Eggs when they are scrambled or fried give me a gut ache. But when I poach them, they do not. The steam and heat of poaching causes a hydrolysis process that alters the protein in the egg. They don't bother me in baked goods either so I assume the same process is at work. I bought a plastic poacher on Amazon to make poaching very easy. All this to say that many of the issues you describe could be caused by celiac disease. 
    • catnapt
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    • trents
      Welcome, @catnapt! The most recent guidelines are the daily consumption of a minimum of 10g of gluten (about the amount found in 4-6 slices of wheat bread) for a minimum of two weeks. But if possible stretching that out even more would enhance the chances of getting valid test results. These guidelines are for those who have been eating gluten free for a significant amount of time. It's called the "gluten challenge".  Yes, you can develop celiac disease at any stage of life. There is a genetic component but also a stress trigger that is needed to activate the celiac genes. About 30-40% of the general population possesses the genetic potential to develop celiac disease but only about 1% of the general population actually develop celiac disease. For most with the potential, the triggering stress event doesn't happen. It can be many things but often it is a viral infection. Having said that, it is also the case that many, many people who eventually are diagnosed with celiac disease probably experienced the actual onset years before. Many celiacs are of the "silent" type, meaning that symptoms are largely missing or very minor and get overlooked until damage to the small bowel lining becomes advanced or they develop iron deficiency anemia or some other medical problem associated with celiac disease. Many, many are never diagnosed or are diagnosed later in life because they did not experience classic symptoms. And many physicians are only looking for classic symptoms. We now know that there are over 200 symptoms/medical problems associated with celiac disease but many docs are only looking for things like boating, gas, diarrhea. I certainly understand your concerns about not wanting to damage your body by taking on a gluten challenge. Your other option is to totally commit to gluten free eating and see if your symptoms improve. It can take two years or more for complete healing of the small bowel lining once going gluten free but usually people experience significant improvement well before then. If their is significant improvement in your symptoms when going seriously gluten free, then you likely have your answer. You would either have celiac disease or NCGS (Non Celiac Gluten Sensitivity).
    • catnapt
      after several years of issues with a para-gland issue, my endo has decided it's a good idea for me to be tested for celiac disease. I am 70 yrs old and stunned to learn that you can get celiac this late in life. I have just gradually stopped eating most foods that contain gluten over the past several years- they just make me feel ill- although I attributed it to other things like bread spiking blood sugar- or to the things I ate *with* the bread or crackers etc   I went to a party in Nov and ate a LOT of a vegan roast made with vital wheat gluten- as well as stuffing, rolls and pie crust... and OMG I was so sick! the pain, the bloating, the gas, the nausea... I didn't think it would ever end (but it did) and I was ready to go the ER but it finally subsided.   I mentioned this to my endo and now she wants me to be tested for celiac after 2 weeks of being on gluten foods. She has kind of flip flopped on how much gluten I should eat, telling me that if the symptoms are severe I can stop. I am eating 2-3 thin slices of bread per day (or english muffins) and wow- it does make me feel awful. But not as bad as when I ate that massive amnt of vital wheat gluten. so I will continue on if I have to... but what bothers me is - if it IS celiac, it seems stupid for lack of a better word, to intentionally cause more damage to my body... but I am also worried, on the other hand, that this is not a long enough challenge to make the blood work results valid.   can you give me any insight into this please?   thank you
    • trents
      The biopsy looks for damage to the mucosal lining of the small bowel from the inflammation caused by celiac disease when gluten is ingested. Once you remove gluten from the diet, inflammation subsides and the mucosal lining begins to heal. 
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