Crohn's or Celiac?

[tj060306]

I have had a couple of procedures over the past year or so. My GI doc is sort of old school. I orignally had a endoscopy because of gerd symtoms (symptoms). The first bx was positive for celiac and EOE. Doctor did celiac panel negative. The only numbers that were off were low vit D and low iron. So he gave me meds for gerd and EOE and sent me on my way.Well I was still having bloating and constapation isssues so a colonoscopy we did. That looked comeplete normal. But he said the bx were microscopic colitits. I dont think thats what the pathology says. So I was given another med and sent on my way. It didnt work. So another endo and it didnt come back as celiac this time but still EOE. So he said it was ibs and EOE and was told to manage it. Well that was nov 10' flash forward to nov 11 and the same issues where still happening. (constipation, bloating, gross smelling flatuence and stools, muscusy stools, and intermitten diarhhea like once a week). So another endo we went in nov 11 and again this time positive for celiac EOE. So the doc said well maybe it is celiac try gluten free. He did a blood test again neg for celiac but again low iron. I have been trying to do gluten free but i think i keep get glutened some how. I almost dont feel any better and its been 2 months. I think it may be time for another colonscopy but I am in nursing school and can not do one until july. I sometimes wonder if maybe it is crohns i have. Any input would be greatly appricated! I am pretty sure I have celiac but the way the doc is so like well lets see how a gluten-free diet works, makes me question is it? I am in the process of waiting for another gi doc.
Thanks
Janelle

10/25/10
Duodenal

biopsies: Duodenal

mucosa with villous blunting and numerous intraepithelial lymphocytes.

Gastric Biopsies: Mild to moderate chronic gastritis.

Esophageal biopsies: Eosinophilic esophagitis.

12/22/10 Colon
Terminal ileum biopsies: No diagnostic abnormalities recognized.

Random colon biopsies: Mild acute and chronic colitis with focal cryptitis.

1/24/11
Duodenal Biopsies: Focal Brunner's gland hyperplasia and mild chronic duodenitis.

Esophageal biospies: Esophageal squamous mucosa with subacute and chronic inflammation.

12/19/11
Duodenal Biospies: Fragments of duodenal mucosa with areas of villous blunting, intraepithelial lymphocytes, along with actue and chronic duodenitis.

Gastric biopsies: Fragments of gastric fundic and antral mucosa with chronic inflammation along with areas of regenerative/reactive glandular atypia.

Esophageal biopsies: Fragments of esophageal squamous mucosa with basal layer hyperplasia and slight subacute and moderate chronic inflammation. .

 

[Jennifer]

I don't have Celiac disease but I image that being on a completely gluten free diet would take time to rebuild and heal the intestines for you to notice any positive change. Unfortunately I don't know enough about it to know how long it may take for someone to start feeling better if they do in fact have a gluten intolerance. Here's info on Celiac disease: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001280/

An endoscopy and colonoscopy are common tests for Crohn's as well as blood work but there are a lot of other tests out there, some of which will actually show whats going on in the small intestine like an x-ray (barium swallow/small bowel follow through), CT scan (with or without contrast), MRI, ultrasound, pill cam etc (in case I forgot something). Maybe one of these tests will help get you a diagnosis sooner.

What were the meds they tried on you?

 

[GFinDC]

Hi,

Sure suonds like celiac to me. You seem to have two issues though? Celiac and EE? So it might be hard to separate which is causing which symptom.

Going guten free can be done many ways. People can go out and buy all kinds of gluten free baked goods and such to replace their current gluteney foods. And eat lots of frozen meals marked gluten free. There is a pretty wide range of gluten free items available now. This is the non-optimal way of going gluten free though.

The better way to start is to not eat any processed foods, stop all wheat, rye, barley, oats, dairy, soy, alcohol and caffeine. Instead eat only whole foods you cook yourself from scratch. No eating in restaraunts. Basically think of a medieval monk's diet except for the bread and the wine and cheese are no goes. This can be loosened up after 3 months if things are going well.

Time to heal is variable, and a recent study suggests 18 months is more likely for most people. That doesn't mean you won't start feeling better before then though. A celiacs gut never gets back to "normal" though, it is always a celiac gut and sensitive to many things that other people don't notice.

Some other things to do are take probiotics and use digestive enzymes.

One of the issues that surprise people sometimes are other food intolerances that can pop up after going gluten free. Identifying those food intolerances is best done using an elimination diet. Celiacs have something called "leaky gut" where they intestinal walls allow larger protein fragments through to the bloodstream than they should. That can lead to additional food intolerances and other autoimmune conditions in some cases.

EE is a separate thing in theory, and they treat it with immune suppressors or steroids I believe.