Celiac and other WHat are your thoughts!

[DVK]

I inquired before with you about elevated lipase and normal blood work and CT scan, normal amylase. Lipase has been off and on since 2002 with the first elevation of 454 normal 59-300. Since I got sick over a month ago and first asked you about my symptoms of this and nausea, lots of motility in intestines, loss of weight,Anxiety, Neuropothy issues youname it, you had said celiac may be looked at. Well I did do that and my Doctor ran the tga and CD panel and it came back within normal range. I then went to a GI doctor and showed him all my results and ct scans and he said nothing other than its my pancreas causing the elevation which is mild never 1 time the limit. I am not a heavy drinker and I have not had a drink in 90 days. So I decided to request a fecal test from Enterolab,results below.

A) Gluten Sensitivity Stool and Gene Panel Complete
Fecal Antigliadin IgA    30   (Normal Range <10 Units)
Fecal Antitissue Transglutaminase IgA    16 Units   (Normal Range <10 Units)
Quantitative Microscopic Fecal Fat Score    443 Units   (Normal Range <300 Units)
Fecal anti-casein (cow’s milk) IgA antibody    25 Units   (Normal Range <10 Units)
HLA-DQB1 Molecular analysis, Allele 1    0302
HLA-DQB1 Molecular analysis, Allele 2    06xx
Interpretation of Fecal Antigliadin IgA:  Intestinal antigliadin IgA antibody was elevated, indicating that you have active dietary gluten sensitivity. For optimal health, resolution of symptoms (if you have them), and prevention of small intestinal damage and malnutrition, osteoporosis, and damage to other tissues (like nerves, brain, joints, muscles, thyroid, pancreas, other glands, skin, liver, spleen, among others), it is recommended that you follow a strict and permanent gluten free diet.

Interpretation of Fecal Antitissue Transglutaminase IgA:  You have an autoimmune reaction to the human enzyme tissue transglutaminase, secondary to dietary gluten sensitivity.

Interpretation of Quantitative Microscopic Fecal Fat Score:   A fecal fat score greater than or equal to 300 Units indicates there is an increased amount of dietary fat in the stool which usually is due to gluten-induced small intestinal malabsorption/damage when associated with gluten sensitivity. Values between 300-600 Units are mild elevations, 600-1000 Units moderate elevations, and values greater than 1000 Units are severe elevations. Any elevated fecal fat value should be rechecked in one year after treatment to ensure that it does not persist because chronic fat malabsorption is associated with

I also had the DNA test done blood and swab and I carry both Genes of CD.
I have been on a GLUTEN FREE DIET for one month I have had 3 tests for lipse in a month all were slighty elevated, this week I had another and its finally normal. what are your thoughts? I do feel MUCH BETTER, but they wont recognize anything else other than pancreas problem, but they blew me off and wont scope me, said I have to go to the University and find someone else

[Kevin Pho, MD]

Difficult to say without evaluation.  With the resolution of symptoms on a gluten-free diet, this points to a mild case of celiac disease - especially with the results you have written above.  

It is curious that the panels that your physician drew differs from the results above.  I do not have an explanation for that.  Perhaps repeating the tests is warranted.  

Treatment of celiac disease involved the gluten-free diet, unless the symptoms are refractory, there does not need to be further treatment.

You can discuss the results of the Enterolab with another GI specialist, preferably at a major academic medical center.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[CalGal]

Hi there,

My husband had mild digestive problems but some fairly heavy-duty skin problems for many years before we finally got him tested for gluten problems. Blood tests showed nada, but the Enterolab results were positive for both gluten problems, and as in your case, casein cross-reactivity.

He's been on a gluten-free diet for 2 years, and when we finally figured out he'd have to do it, he went casein-free also - that was about 8 months after he first went gluten-free. He had good result with the gluten-free, but it was the addition of being casein-free that finally allowed his health to rebound to what it probably should be.

Although difficult, consider going casein-free also. It will make a difference.

Make sure that you aren't getting hit by 'hidden' gluten. We've found that we've had (and continue) to contact any company whose products we use. When you do that, you may find small amounts of what manufacturer's and the FDA consider safe, but if you're like my husband even small 'hits' are very deleterious.

The safest thing is just to cook your own foods, and watch out for spices. They can contain hidden gluten, too.

[PrincessKatie]

I have CD along with other stuff and it took 9 months for diagnosis. Tests seemed to vary from lab to lab. Like the doctor above said, going to a doctor at a large academic institute might be a very good idea. Although techniqualy, you could just stay Gluten-free without diagnosis, diagnosis could be helpful for you in the future if you have other GI problems. The downside now is that a lot of the CD tests have to be done on a body that has been eating gluten which means you would have to go back on gluten for a bit prior to the tests. If you really want to get this figured out though, you should seek out a doctor that has experience with CD. I wish you the best of luck!