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Ask the Doc: Are there different levels of celiac disease?

Posted By Alison On Aug 5, 2010 @ In Ask the Doc,Celiac Disease | 1 Comment

Q. I was just recently diagnosed with celiac disease after a positive biopsy last week.  I don’t get real sick, other than bloating and gassy.  Those were my only symptoms.  My question is, are there different levels of celiac disease?  If I go to a restaurant and ask for gluten free foods, but they happen to get cross contaminated with something containing wheat, rye or barley, am I at that serious of a risk by dining there since I don’t get the diarrhea and vomiting, etc.?  It’s been real hard on my family and me trying to dine out at a restaurant who has a true understanding of celiac sprue.

A. Ask your doctor to obtain the Marsh classification of your biopsy. The higher the class, the longer it will take to heal on a gluten-free diet. Symptoms often do not correlate with the level of biopsy abnormality.  Those who have been diagnosed with celiac and have their biopsies return to normal — Marsh 0 — will develop damage after being exposed to 7 grams of gluten, or about the amount in a slice of bread. I hope this helps.

Health and happiness,
Dr. Aron

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