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Gastroenterology (Expert Forum)
Celiac Disease and Giardia
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
Celiac Disease and Giardia
by Pati__0__0, Jan 05, 1999 12:00AM
Dear Doctors,
My 2 /2 year old daughter, Emily, has recently been diagnosed with Celiac Disease. Her diagnosis was a long time in coming. She began to get sick at the end of August, 98, with uncontrollable, foul smelling diarreha, gas, stomach cramps, lack of appetite, lethargy and general irritability. We took her to her regular pediatrician and he felt it was a virus. After 4 weeks, she was so sick and run down that the doctor put her in the hospital for some IV fluids. She goet better, was discharged and proceeded to get sick again. After 2 more weeks we were referred to a pediatirc GI specialist. He took one look at Emily and felt she had Celiac. She had the blood test for IgG and IgA and then, because she was still so sick, was hospitalized again for more fluids and to have a small bowel biopsy. When all the results were in, they all pointed to Celiac. We were satisfied that she should be on the Gluten free diet and that she in fact did have CD. Then, last week (about 8 weeks since here initial diagnosis) she got sick again. The same diarreha and gas, cramping etc... When I called the GI people, they told me that they forgot to tell us Emily had a positive Giardia test from a stool sample taken during her second hospitalization. I couldn't believe that something like this could have been overlooked. The stool test was repeated and came back negative. (The doctor only ordered one stool sample, not a series like I have heard is sometimes necessary to find Giardia and I was told that the "antigen" was not found). Emily has since gotten much better and is having regular BM's and eating very well. The GI doctor feels that the initial tests were wrong and Emily has Celiac, end of story. Because Celiac is a life long disorder with sometimes drastic consequences, I need to look further. My questions to you are: Is it possible to have a false positive Giardia test? What would be a possible rational for not treating Giardia, can it just go away? Could Emily's biopsy and blood tests have been wrong, indicating Celiac when she really has a chronic case of Giardia? What would you do to make sure that she in fact has Celiac? My thanks in advance for your help. Pati Robben
Dear Pati,
In order to diagnose celiac disease the following tests need to be positive for the diagnosis: 1) a positive anti-gliadin or endomysial antibody 2) characteristic small bowel biopsy specimen 3) response to gluten free diet. Giardia can be treated with antibiotics, however, if there is no evidence of Giardia on the small bowel biopsy specimens, subsequent tests were negative and your daughter is feeling better it may not be necessary to treat at this time. If the diagnostic criteria for celiac disease have been met, celiac disease is the most likely diagnosis. These issues should best be addressed by a pediatric gastroenterologist. Unfortunately, this forum no longer has the availability of a pediatric gastroenterologist. You may also want to post this message in the Maternal/Child Forum. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
HFHSM.D.-ym
*Keywords: celiac disease, Giardia
My 2 /2 year old daughter, Emily, has recently been diagnosed with Celiac Disease. Her diagnosis was a long time in coming. She began to get sick at the end of August, 98, with uncontrollable, foul smelling diarreha, gas, stomach cramps, lack of appetite, lethargy and general irritability. We took her to her regular pediatrician and he felt it was a virus. After 4 weeks, she was so sick and run down that the doctor put her in the hospital for some IV fluids. She goet better, was discharged and proceeded to get sick again. After 2 more weeks we were referred to a pediatirc GI specialist. He took one look at Emily and felt she had Celiac. She had the blood test for IgG and IgA and then, because she was still so sick, was hospitalized again for more fluids and to have a small bowel biopsy. When all the results were in, they all pointed to Celiac. We were satisfied that she should be on the Gluten free diet and that she in fact did have CD. Then, last week (about 8 weeks since here initial diagnosis) she got sick again. The same diarreha and gas, cramping etc... When I called the GI people, they told me that they forgot to tell us Emily had a positive Giardia test from a stool sample taken during her second hospitalization. I couldn't believe that something like this could have been overlooked. The stool test was repeated and came back negative. (The doctor only ordered one stool sample, not a series like I have heard is sometimes necessary to find Giardia and I was told that the "antigen" was not found). Emily has since gotten much better and is having regular BM's and eating very well. The GI doctor feels that the initial tests were wrong and Emily has Celiac, end of story. Because Celiac is a life long disorder with sometimes drastic consequences, I need to look further. My questions to you are: Is it possible to have a false positive Giardia test? What would be a possible rational for not treating Giardia, can it just go away? Could Emily's biopsy and blood tests have been wrong, indicating Celiac when she really has a chronic case of Giardia? What would you do to make sure that she in fact has Celiac? My thanks in advance for your help. Pati Robben
Dear Pati,
In order to diagnose celiac disease the following tests need to be positive for the diagnosis: 1) a positive anti-gliadin or endomysial antibody 2) characteristic small bowel biopsy specimen 3) response to gluten free diet. Giardia can be treated with antibiotics, however, if there is no evidence of Giardia on the small bowel biopsy specimens, subsequent tests were negative and your daughter is feeling better it may not be necessary to treat at this time. If the diagnostic criteria for celiac disease have been met, celiac disease is the most likely diagnosis. These issues should best be addressed by a pediatric gastroenterologist. Unfortunately, this forum no longer has the availability of a pediatric gastroenterologist. You may also want to post this message in the Maternal/Child Forum. I hope you find this information helpful.
This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.
HFHSM.D.-ym
*Keywords: celiac disease, Giardia
