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Ask the Doc: Was my celiac blood test wrong?

Posted on July 9th, 2009 by Alison | Posted in Ask the Doc, Celiac Disease, Gluten Intolerance | Comments Off on Ask the Doc: Was my celiac blood test wrong?

questionmarkgreen1.jpg Q. Last year I had a test to see if I had Celiac Disease. The test came back negative. When I eat things like bread and chicken nuggets or cereal etc. I end up with nausea and headache and feel really bad. Could the test have been wrong or am I just sensitive to gluten? Eating has become a real problem!

A. Many of the commercial lab tests for celiac disease are only about 40% sensitive. Ask your doctor to order a Celia-Plus test from Prometheus labs. If those are negative (they include genetic testing) you could still be sensitive to gluten: celiac disease only accounts for about 50% of those sensitive to gluten.  We know of at least 6 other genes that are involved in gluten sensitivity, but we don’t know how they are involved. The bottom line is: if gluten bothers you, see a dietician, and go on a gluten-free diet. It’s healthy and harmless, and is getting easier to follow every day.

Health and happiness,
Dr. Aron

Have a question for the doc?

Ask the Doc: Celiac triggered by abdominal surgery?

Posted on March 21st, 2009 by Alison | Posted in Ask the Doc, Symptoms | Read 3 Comments - Add Your Own »

questionmarkgreen1.jpg Q. I noticed your answer to a question about celiac disease that its onset could be caused by abdominal surgery. How is this possible? How often does it happen? I have just recently started seeing a homeopathic MD and one of the tests showed a borderline gluten allergy and thyroid imbalance. All of my symptoms have worsened through 2 pregnancies that resulted in post partum induced thyroidism and an ectopic that ruptured requiring surgery. Your comment about surgery causing celiac disease is interesting. Thank you for any info you can share.

A. Many with latent celiac disease will have activation of the disease after any abdominal surgical procedure; the mechanism is obscure, but is thought to be a result of an intense inflammatory response to the operation.  Non-celiac mimicking conditions such as the Irritable Bowel Syndrome are similarly activated.

Health and happiness,
Dr. Aron

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Ask the Doc: Celiac, endometriosis and PCOS

Posted on February 17th, 2009 by Alison | Posted in Ask the Doc, Symptoms | Read 9 Comments - Add Your Own »

questionmarkgreen1.jpg Q. I have had polycystic ovarian syndrome (PCOS) for several years and luckily, though various fertility treatments, was able to conceive and give birth to two beautiful boys (ages 5 and 2).  Since my youngest was born via C-section, I had been having abdominal pain, cramping, intermittent diarrhea, etc.  I had never had gastro problems before this.  Last month, I had a laparoscopy that found endometriosis/adenomiosis/ovarian cysts, all of which were cauterized. I continued to be extremely fatigued, losing weight, diarrhea, etc., so on a whim I had a blood test for celiac that was suggested months earlier by my gastro.  Of course, it was positive.  I am just coming to grips with all this right now.  I am unable to work because I am in the bathroom half the day, on my heating pad for the continued back pain from the laparoscopy, and always exhausted.  My family is going on the gluten-free diet to see if that helps me feel better and I am going to have my allergist check me for other food allergies and for a Candida albicans yeast allergy (the allergist found earlier last year that I had virtually no immunity to any strep infection strains and after a pneumonia vaccine shot, the numbers improved – I had been having 8-10 sinus infections a year, flu/bronchitis twice in the past 3 years, and various other weird infections requiring multiple rounds of antibiotics).

My question is – are all of these (PCOS, endometriosis, celiac) related? Are there good resources on these diseases if they are or people who actually have all 3? I feel like every few months I find out something new about myself, so I feel like I flit from problem to problem instead of addressing a larger cause.

A. Endometriosis is a completely independent condition, but PCOS and celiac are related.  Treatment of the endometriosis should be explored with your gynecologist.  The gluten-free diet should help with the other problems, but remember that celiac disease is an inherited condition, so you’ve had this all your life, only to be unmasked by the C-sections.  Thus, it will be several months before you’ll see a major benefit of the diet.

Q. Can endometriosis be made worse by celiac disease?

A. There is no doubt that untreated celiac disease can lead to an excessive sensitization of the enteric nerves, and thus augment any pain that might arise from endometriosis. Endometrial implants on the outer surface of the gut are surrounded by connective tissue-as a way of encasing these abnormal tissues. That process can also involve the intestinal muscles and nerves, and, when activated by the immune cells in the celiac patient, the painful sensation is enhanced. I see this also in IBS and IBD and coexisting endometriosis. When I control the inflammation with gut anti-inflammatory drugs, the pain improves. Other than that, these are two independent phenomena that often interact, and one should not consider celiac disease as a cause or effect of endometriosis.

Health and happiness,
Dr. Aron

Have a question for the doc?

Ask the Doc: Can celiac cause other food allergies?

Posted on January 6th, 2009 by Alison | Posted in Ask the Doc, Celiac Disease | Read 1 Comment - Add Your Own »

questionmarkgreen1.jpg Q. I had my gall bladder removed just over a year ago and then went through a series of tests because I wasn’t feeling better after the surgery. After much pushing on my part, I had the blood test done for Celiac and tested positive on one of the antibodies. My doctor sent me to an allergist who has done RAST tests on me and found allergies to numerous other foods. I am now on a very restricted diet. I know the Celiac is here to stay but is there any possibility that as my gut heals some of the other food allergies will resolve themselves? Should I be re-tested for these other allergies at some point or are they here to stay too? I’m frustrated and struggling to find safe foods. I feel so much better but I’m tired of rice and broccoli!

A. It is not uncommon for latent celiac disease to be activated by abdominal surgery. Celiac disease is often the primary cause for many other food allergies, but these secondary or “downstream” allergies all improve on a gluten free diet. I would recommend staying on the restricted diet for two months to allow the GFD to heal the gut, and then eliminate all the other restrictions but stay on the GFD for life.

Health and happiness,
Dr. Aron

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