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How Is Coeliac Disease Diagnosed?

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Posted on Wed, 5 Nov 2014
Question: Hi. I hope you can help. I have been to two family doctors, my psychiatrist and a gastroenterologist. I have had significant changes in my bowel movements and for the past 6 months have not had normal stool. It is lighter in color, narrow, floating, loose. Sometimes I have excessive foul smelling flatulence that can last for 2-6 days. Sometimes instead of these small pieces of floating stool, I have squirty yellow diarrhea. It is not excessive and at these times can not have any kind of movement except for a few squirts. And yet other times I don;t go at all. Now, I have had a colonoscopy and stomach scope. The gastro dr gave me a med and diagnosis for GERD and the best answer I could get from him is that there was slight inflammation. Colonoscopy - normai and it must be all the meds I take for psych conditions or IBS. I do not think it is any of these. I was looking at celiac disease online. I do not want to self-diagnose, but would like your opinion on whether I should request a blood test for celiac disease. There was also something unusual that happened to me a few months back. i had standard uti symptoms with the first sign of blood in my urine. By the time I arrived at the doctors that afternoon the urine was reddish-brown and not translucent. He tested my urine and the results were off the chart for what looked like an infection. He prescribed an antibiotic and I did not take it because I saw that my urine was lightening in color again. It magically healed by itself. I don't know if it's related but I do want to give you all info that i can. also few weeks later had blood after intercourse, i started my period four days later, but the bleeding in general and the amount of blood that had NEVER occurred frightened me. Now my period is kind of out of whack starting 2-3 days early or 2-4 days late. had always been like clockwork seemingly prior to this with an oral contraceptive. Still taking it but husband getting vasectomy so not much longer. Made appt with ob-gyn and chickened out because it did not happen the next time we had sex and it didn't hurt, and no, there was nothing unusual about this encounter when I bled and no roughness. Now I am getting headaches daily. not bad enough to be migraines but bad enough to make me feel it a lot. My stomach hurts daily - not exactly cramping - kind of in between cramping and a nervous stomach. It's unsettling. I am 41 years old and have taken psych meds for 25 years. My doctors ordered different blood screenings - b12, iron, thyroid, blood sugar - all okay. The only things that were high were only high by a small amount and all doctors said not to worry about it. The reason I worry is because some of the psych drugs are known to contribute to development of diabetes and the levels that were high when tested (I looked up) related to kidney functioning. There was also too much protein in my urine. one thing when i read about the celiac disease is the dermatitis symptom some experience. Both my upper and lower arms have itched frequently - kind of goes in bouts so I assumed dry skin. The other day though, I scratched so hard I bled from several scratches. I saw very small bumps but nothing that looked like herpes to me. Well, i guess in a way it does resemble such because especially on my upper arms i have been able to see a few small spots that are blister-like but bleed when scratched. They are very small. They just look like little red dots if they have bled but continued to itch until they subside and another episode occurs. I have begun to bruise very easily. I have a huge raised bruise above my knee and have no idea where it came from. i admit i am clumsy, even tripping, and falling at times. But i have no clue about most of the bruises i get. there are little circular bruises that appear about the size of a nickel that I can almost see as they rise to the surface, it's the weirdest thing. I do not drink, smoke or do drugs and have not had a drink in 14 years or a drug in 16 years. I seem to lose my balance easily and sometimes feel a bit faint. Recently I have began to sweat and it is cold sweat. I will feel the back of my neck and it is cold yet my whole body is sweating. This has been happening for about a month. It does not feel like I would think a hot flash felt, it feels like i am sick, almost weakness. I am not losing any weight. I am overweight at 5'5 and 162 pounds. I wear a size 12 and most of my weight is in my abdomen and probably my breasts. I gain weight pretty evenly throughout my belly fat is really bad and the bloating does not help. And yes, I do know how bad belly fat is. I am trying to be more active now that I all of my kids are in school (ages 5,7, and 14) and I am not working but it is slow coming. My weight has fluctuated over the years at the lowest a size 4 ( I ran a marathon shortly after my second child was born:)) and once exceeded the usual "high" of size 12, to a size 14. I believe the medication has some affect and it appears only when I am in an exercise routine do I maintain a healthy weight. so yes, i know what to do. i am beside myself with some of these symptoms and know there is something unhealthy going on besides my mental illness which is chronic and my weight which is not. Would you please give me some suggestions as to what it could be or what kind of specialist to see? This has been going on so long it (my bowel movements) seem like the way they are now are normal, but of course they are not. Thank you so much for input you may have.
this is lengthy and scattered - thanks for reading and addressing. XXXX
doctor
Answered by Dr. Suresh Heijebu (2 hours later)
Brief Answer:
Coeliac disease suspicion is high.

Detailed Answer:
Hi XXXXXXX

I have carefully read your query and understand your concern.

Your symptoms quite rightly point to Coeliac disease in my opinion. But this needs scientific lab confirmation.

Coeliac disease is specifically known to cause certain set of symptoms which are clearly evident in your case.These are as follows.
1.stool changes
2.flatulence
3.Weakness and gait inco ordination-sense of imbalance
4 .Hormonal changes in the menstrual cycle irregularities.
5. skin changes-in the form of papulovesicular skin lesions-dermatitis herpetiformis?
6. bleeding tendencies in the form of post coital bleed and flash episodes of hematuria.
7. protuberant belly.

For the sake of confirmation I advise you to have following baseline investigations for the diagnosis of suspected cases of coeliac disease.
1. IgA TTG antibody testing.
2. Stool examination for malabsorption.
3. Prothrombin time-PT
4. Barium study of the small bowel.

Since coeliac disease is a multi system immunological disorder, I strongly recommend you to consult an Immunologist or immunopathologist.

I hope this info is helpful to you,
Post your further queries if any,
Thank you.

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Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju
doctor
Answered by
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Dr. Suresh Heijebu

Psychiatrist

Practicing since :2010

Answered : 3646 Questions

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How Is Coeliac Disease Diagnosed?

Brief Answer: Coeliac disease suspicion is high. Detailed Answer: Hi XXXXXXX I have carefully read your query and understand your concern. Your symptoms quite rightly point to Coeliac disease in my opinion. But this needs scientific lab confirmation. Coeliac disease is specifically known to cause certain set of symptoms which are clearly evident in your case.These are as follows. 1.stool changes 2.flatulence 3.Weakness and gait inco ordination-sense of imbalance 4 .Hormonal changes in the menstrual cycle irregularities. 5. skin changes-in the form of papulovesicular skin lesions-dermatitis herpetiformis? 6. bleeding tendencies in the form of post coital bleed and flash episodes of hematuria. 7. protuberant belly. For the sake of confirmation I advise you to have following baseline investigations for the diagnosis of suspected cases of coeliac disease. 1. IgA TTG antibody testing. 2. Stool examination for malabsorption. 3. Prothrombin time-PT 4. Barium study of the small bowel. Since coeliac disease is a multi system immunological disorder, I strongly recommend you to consult an Immunologist or immunopathologist. I hope this info is helpful to you, Post your further queries if any, Thank you.