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What are the symptoms confirming gluten intolerance ?

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Internal Medicine Specialist
Practicing since : 1998
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I am a 27 year old female, generally healthy, but overweight. My family has a medical history of several severe food allergies, as well as cancers.
I will try to make this as short as possible. I have good reason to suspect that I am suffering from gluten intolerance. My symptoms are worse when eating gluten, and have gotten better, but have not completely dissapeared since going on a gluten free diet. I have been gluten free for almost 4 weeks now. I do not currently have a family doctor, so I am having to go see the ER doctor to inquire about having tests done. My question is what tests should I ask to have done to check for Celiac's or gluten intolerance? I went to the Emergency and had bloodwork and a urine testing done 2 weeks ago. The bloodwork and urine testing came back fine, and the doc said that he was going to send some blood off to be tested in relation to gluten. He said I would hear back in 1-2 weeks if something showed up. I haven't heard back so I am assuming the test came back negative. My severe stomach pains have subsided since going gluten free, but I am still suffering from some nausea and fatigue even on a gf diet, as well as the headaches (although fewer and milder since gf), foggy brain, heavy limbs, and a few other things. Oh, and I have a re-occuring rash below my bum cheek that comes and goes, and that 2 different prescribed creams have failed to heal.
Anyways, all in all I know that all of this is related somehow to gluten, but I don't have a family doc to follow up with and consult with about all of this. Any advice as to further testing that I can request to have done at the ER, or elsewhere would be greatly appreciated! Thank you for your time :)
Posted Sat, 14 Apr 2012 in Digestion and Bowels
Answered by Dr. Jasvinder Singh 59 minutes later
Hello Kwhite,

Thanks for posting your query. There are many tests for confirming the diagnosis of celiac disease and these include:

1)     Serological tests like IgA antiendomysial antibodies which can detect celiac disease in most of the cases.
2)     This is followed by followed by an endoscopy/gastroscopy and biopsy of the duodenum (beyond the duodenal bulb) or jejunum.
3)     Your doctor may also perform capsule endoscopy in which you are asked to swallow a camera pill that collects pictures of the small intestine. The capsule leaves your body in your stool and can be flushed down the toilet.

You can talk to a gastroenterologist and get these investigations done for celiac disease.

Regarding gluten intolerance, there are no direct investigations as such but often many investigations are done which help in pinpointing the diagnosis. These include:

1)     Stool Fat test, to determine malabsorption level and presence of steatorrhea in stools
2)     Complete blood count to find out any anemia ( this you must have got done in the blood tests).
3)     Erythrocyte Sedimentation Rate (ESR) and C reactive protein to look for inflammation.
4)     Vitamin levels especially B12, D, and E to check for vitamin deficiency.
5)     Comprehensive metabolic profile (CMP) to analyze protein, calcium and electrolyte levels and liver and kidney functions. These may include albumin, Ca, K, and Na and alkaline phosphatase and PT
6)     Setrological markers like anti-tissue transglutaminase antibody (AGA) and anti-endomysial antibody
7)     A small-bowel biopsy from the second portion of the duodenum

You can get these investigations done to rule out both Celiac disease and gluten intolerance.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.
Above answer was peer-reviewed by
Follow-up: What are the symptoms confirming gluten intolerance ? 6 hours later
Thank you so much for your detailed answer! It will be very helpful!

Will I need a refferal to speak with a gastroenterologist? If so, without a family doctor how do I go about getting one?

And who do I go see to have the testing for gluten intolerance done? Is it the same, a gastroenterologist?

Thank you again for you time!
Answered by Dr. Jasvinder Singh 5 hours later

You need to consult a gastroenterologist and get your self evaluated and these investigations done. You may need to consult your family doctor and then get a referral for a gastroenterologist or you can take a direct appointment from a gastroenterologist if possible in your area.

For gluten intolerance testing also, a gastroenterologist should be consulted.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.
Above answer was peer-reviewed by
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