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Elevated Fecal Calprotectin


Ginger7

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Ginger7 Rookie

Hi, I've posted b4 about my 8 year son who has persistent stomach aches and diarrhea with occasional constipation. His labs came back mostly normal, although a few notable things:

Low ferritin

Low vitamin D

CBC normal

ESR 9 (cutoff less than 10)

Celiac panel negative serology, one positive gene DQ2

Fecal calprotectin 222

Way down in growth charts (2% height, 12% weight)

GI said retest fecal calprotectin in 6 weeks. Really? I suggested its time to schedule endoscopy and colonoscopy given low vitamin levels/growth and fecal calprotectin results. 222 is pretty high for a child and possibly a sign of celiac and or IBD like crohns or UC. Given it will take 2 weeks at least to schedule plus GI said he needs to go back on gluten. We've been trying gluten-free for last ten days with some minor improvements although he has lost 6oz since last visit about 3 weeks ago. What do you think out there?

I'm hoping it is "just" celiac. We can manage this but I feel so sad thinking it could be IBD plus or minus celiac. I know that celiac alone is difficult but I feel overwhelmed with the possibility of both.


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StephanieL Enthusiast

If you are even considering Celiac testing with a scope, you need to get back on gluten NOW. Like, NOW NOW.

I am not sure how much 10 days would give you in the healing process but it's said a person needs to be on gluten for at LEAST a few months for the MOST accurate testing.

FC just means there is inflammation. I am not sure how much they very so I don't know that the "resets in 6 weeks" is a bad idea per say. Again, most important is that I would get the child back on gluten now. Does your Dr. know you were planing on going gluten-free? most would warn against that if you want a scope.

Ginger7 Rookie

Oh yes, we discussed the pros/cons of gluten-free B4 scope and he is back on gluten until scope. So, I'm looking forward to more information from scopes, which I hope r soon. I sure hope his colonoscopy prep is not as bad as mine was...

StephanieL Enthusiast

Go-lightly is the most misleading "drug" name EVER!

Good luck with that :( I do not envy you!

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    • Scott Adams
      This is a very common question, and the most important thing to know is that no, Guinness is not considered safe for individuals with coeliac disease. While it's fascinating to hear anecdotes from other coeliacs who can drink it without immediate issues, this is a risky exception rather than the rule. The core issue is that Guinness is brewed from barley, which contains gluten, and the standard brewing process does not remove the gluten protein to a level safe for coeliacs (below 20ppm). For someone like you who experiences dermatitis herpetiformis, the reaction is particularly significant. DH is triggered by gluten ingestion, even without immediate gastrointestinal symptoms. So, while you may not feel an instant stomach upset, drinking a gluten-containing beer like Guinness could very well provoke a flare-up of your skin condition days later. It would be a gamble with a potentially uncomfortable and long-lasting consequence. Fortunately, there are excellent, certified gluten-free stouts available now that can provide a safe and satisfying alternative without the risk.
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      Interestingly, this thought occurred to me last night. I did find that there are studies investigating whether vitamin D deficiency can actually trigger celiac disease.  Source: National Institutes of Health https://pmc.ncbi.nlm.nih.gov/articles/PMC7231074/ 
    • Butch68
      Before being diagnosed coeliac I used to love Guinness. Being made from barley it should be something a coeliac shouldn’t drink. But taking to another coeliac and they can drink it with no ill effects and have heard of others who can drink it too.  is this everyone’s experience?  Can I drink it?  I get dermatitis herpetiformis and don’t get instant reactions to gluten so can’t try it to see for myself. 
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      I will assume you did the gluten challenge properly and were eating a lot of gluten daily for 6-8 weeks before your test, but if not, that could be the issue. You can still have celiac disease with negative blood test results, although it's not as common:  Clinical and genetic profile of patients with seronegative coeliac disease: the natural history and response to gluten-free diet: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5606118/  Seronegative Celiac Disease - A Challenging Case: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9441776/  Enteropathies with villous atrophy but negative coeliac serology in adults: current issues: https://pubmed.ncbi.nlm.nih.gov/34764141/  Approximately 10x more people have non-celiac gluten sensitivity than have celiac disease, but there isn’t yet a test for NCGS. If your symptoms go away on a gluten-free diet it would likely signal NCGS.
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