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Hello,

Let me start by apologizing for writing again, but I have really benefited
from your help.  I recently wrote with questions about biopsies and tTG
tests after being on a gluten-free diet for a month.  To reintroduce my
question, I had symptoms that made by primary care physician test me for
anti-gliadin IgG (slight positive 14 units, >10 high) and anti-gliadin IgA
(negative 0.26, <4 normal).  I was already dairy-free because it helped
somewhat-- even a little yogurt makes me sick.  She told me to go on a
gluten-free diet, which I did.  Ended up being GF and dairy-free for about
one month.  Specialist told me to go off the GF diet and biopsied me 5 days
later, took blood for tTG tests after 11 days back on non-GF diet.  No
specific gluten-challenge, but I did eat gluten each day.  Both tTG and
biopsy were negative, but symptoms didn't come back until after the biopsy.
I asked the doctor whether these tests were sufficient given the GF diet and
short time back on gluten.  He said that there is absolutely no doubt that I
do not have CD and that he would be able to tell a healed celiac because the
villi never completely recover and some blunting always remains.  He said my
villi were perfect, that IgG is the least specific of the tests (many people
with GI problems have elevated anti-gliadin IgG, apparently), and issued a
diagnosis of IBS. Do any of you know if it is true that CD never heals
completely so he could tell if I had ever experienced damage due to CD?  I
will ask him if he took biopsies from more than one area and how many he
took and whether he looked for lymphocyte infiltration.  Should I request
the slides for a second opinion?  He showed me the EGD photos, and they did
look fine to me (in the one photo he took of the villi).  But, I heard that
IBS is never associated with blood, which I have (but no fever).  It
certainly seemed that a dairy-free, gluten-free diet helps if I stay on it
long enough, so I'm staying on it for now.  Doctor recommended that I
occasionally try to eat yogurt and whole-grain foods, since food
sensitivities will probably cycle over time with IBS. Doesn't it seem like a
bad idea to eat something against which my body makes antibodies?  I am
considering getting genotyped for HLA.  Does anyone know if HLA-DQ2 and
HLA-DQ8 are associated with other GI disorders, i.e., would positive tests
be a strong indicator that CD should still be considered, or not?  I don't
think my blood tests included total IgA, so I'm not sure that IgA deficiency
might not explain my negative IgA test. My initial blood tests showed
slightly elevated lymphocytes, CO2, calcium, albumin, and protein.  I
thought the slightly elevated calcium was a little weird if CD was the
problem, but I take calcium supplements (because I don't eat dairy), and
someone (a nursing student) told me that blood calcium might be elevated if
the body is taking calcium out of the bones during osteoporosis.  Although I
was relieved to have a diagnosis of something more benign (but unfortunatley
incurable), I really want to be sure CD is not the problem, especially since
two first-degree relatives have much worse problems that I do (one loses
balance now on top of GI problems) and can't afford or aren't willing to do
more tests.  Maybe I should just pay for them to have the tTG test through
an independent lab, if I can convince them to do it. They are not GF and
refuse to try because of the cost.

Thanks again for all of your help.
Erin




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