Get your health question answered instantly from our pool of 18000+ doctors from over 80 specialties

145 Doctors Online
Doctor Image
Dr. Andrew Rynne

Family Physician

Exp 50 years

I will be looking into your question and guiding you through the process. Please write your question below.

Diagnosed with gluten intolerance and celiac disease. Found ocult blood in stool. Any advice?

Answered by
Dr. Abhijit Deshmukh


Practicing since :2001

Answered : 492 Questions

Posted on Fri, 21 Dec 2012 in Digestion and Bowels
Question: My 10 year old daughter was diagnosed with Gluten Intolerance about a year ago after she gradually fell down the growth chart from close to 100th percentile at the age of 3 to 5th percentile at the age of 7. It took 2 years of convincing the doctors to test her and finally they found ocult blood in her stool and very high immunoglobulins in her blood. She had a GI consult who did a diagnostic endoscopy and confirmed findings consistent with Celiac disease.
She has been on a gluten free diet for 1 year now but has not shown significant growth. She has gained 6 lbs from 49 lbs to 55 lbs and height has gone up from 48 inches to 50 inches. However we feel like that would have happened if she was not on a gluten free diet. She is still around 5th percentile and is getting us very worried. We had her tested recently for her Ig levels and they were normal or borderline.

So could there be other reasons? please advise what to ask her specialist and what else to look for that could be causing this lack of growth.
Answered by Dr. Abhijit Deshmukh 7 hours later

Thanks for the query. I understand your concerns and I shall try to provide an useful and helpful answer.

Though it looks like your daughter is suffering from Celiac disease or gluten sensitivity, only biopsy and immunoglobulin levels are not sufficient levels to confirm the diagnosis. Were her tissue transglutaminase of IgG or IgA (antibodies) levels elevated or whether anti-gladin or anti-endomysial antibodies were elevated? If yes then it confirms the diagnosis.

Also it is important to know if her hemoglobin was low (anemia) and has it improved with treatment.

Now if her diagnosis of gluten sensitivity was correct and still she is not responding to treatment (both in the form of persistent growth or anemia) then we need to confirm "non response" by repeating antibody (specific once) to check for reduction in level as compared to pre-treatment levels and repeat biopsy to see if the endoscopic changes have reverted.
If your daughter is found as a case of "non responseā€ then we need to look/discuss the following things
1) Compliance to gluten free diet (deliberate intake since she is child with friends or at school without you knowing about it - to ensure strict diet)
2) Improper understanding of gluten free diet and inadvertent intake
3) Possibility of refractory celiac -rare entity - such cases may need additional drug therapy like steroids
4) Rule out uncommon but disease associated with celiac like thyroid dysfunction (checking thyroid function tests), vitamin D deficiency, bacterial overgrowth syndrome, associated diabetes or unrelated disorders like growth hormone deficiency

Sometimes avoiding oats and milk/ milk products may also help additionally

Hope this answers your query; please do reply in case you have further questions.

Wish her a speedy recovery...

Dr Abhijit

Above answer was peer-reviewed by : Dr. Prasad
Follow up: Dr. Abhijit Deshmukh 12 days later

Thanks for your detailed response. I will get a copy of her test results, however I am sure they were relevant to the diagnosis and yes she did have anemia when she was diagnosed, however since on gluten free diet, she does not have anemia any more.

We had an appointment with her GI today and he said that although the antibody levels have fallen but have not fallen as significantly. There was a repeat blood test done today (last one was 3 months ago) pending which she may need to get another endoscopy.

As per her diet, we are very strict and the school does not allow lunch sharing either. She is very conscious herself what not to eat. We will try to eliminate oat from her diet as well as per her nutrition consult try to give her high caloric food instead of "healthy meals". like using butter instead of margarine/spread and using clotted cream as a spread on corn bread.

Definitely hoping its not a Growth Hormone or Thyroid issue but will request her doctor to get those tests conducted as well.

Thanks again,

Answered by Dr. Abhijit Deshmukh 8 hours later
Thank you for the response and appreciation.

There is all hope that she may improve slowly and gain on her growth chart.

Apart from the current problem, just take care of her psychological aspect as children find it difficult to cope up with all this.

Wish her a speedy recovery...

Let me know if you need further assistance.
If all your queries are answered, please close this discussion.


Above answer was peer-reviewed by : Dr. Prasad

The User accepted the expert's answer

Share on
Question is related to
Diseases and Conditions ,   ,   ,   ,   ,   ,  
Medical Topics

Recent questions on  Vitamin-d deficiency

doctor1 MD

I have had pain in left flank area for months.Pain is mostly upon palpation though it does throb sometimes, and the affected area is growing. Also having digestive issues,polyneuropathy,chronic anemia & Vitamin D deficiency, sciatica, EDS, and antibodies suggesting SLE -to name a few other things going on.I have an impressive list of specialists I see, but no one has an answer for this one yet. Any thoughts? Thank you for your time.

doctor1 MD

My husband started having shortness of breath last August. Around the same time he had a vitamin D deficiency. Our doctor immediately sent him to a cardiologist who did a stress test. He found nothing to be wrong. This continued and we went to see a lung specialist who did a CT scan. Found nothing to be wrong. At the same time my husband started to lose some of his taste. That got worse and at the present time he asks me to smell his skin. I did and I do detect a slight smell. It is not familiar. My husband says he smells a horrible smell coming from inside him. We did see an ENT who found nothing wrong. We went to an endocrinologist and eventually a parathyroid was removed. Prior to that he was so fatigued he could hardly get into bed. After the surgery he wasn't as fatigued but still he not getting better. Since August he has lost around 35 lbs. We went to a neurologist who took extensive tests including an MRI. He saw some evidence of Myasthenia Gravis. When he gave him Mestonon, my husband was going to the bathroom alot and had a crampy stomach. He did not feel better and the medication was stopped. We tested for poisoning. Results are negative. We don't know where to turn because all the scans come back negative and the blood only showed the hyperparathroid. I'm desparate for help.

doctor1 MD

I started feeling a strong chest pain mid-way through taking a drink. I had no trouble breathing during the

pain it was a very griping pain. While this was happing I thought that I might be having a heart attack

but considering my age I realiest it was highly unprobable. After a few seconds the pain stoped then

I was sure it was not an heart attack. What could this be? I am a type one diabetic with a vitamin D deficiency and slightly a rased cholesterol all of them are being treated. I hope that info helps at least



doctor1 MD

My name is danielle and I am 23 years old and I have this bump on my breat bone since I was 14/15. I went to different doctors to figure out what it actually was. The last doctor I saw about this told me and my mother it was just overgrown cartilage. But it has grown bigger over the years and the pain is severe at times. My ribcage at times feels like it's being restricted. I can not even wear a bra because it is uncomfortable. I have recently been told on a separate matter that I have lipoma. And I have a vitamin D deficiency. I also have very high cholesterol,but that is because of genetics. Please please tell me what I can do. Thank you.

doctor1 MD

I feel no sense of my feet and it's cool analysis worked thyroid , sugar and hemoglobin are all excellent and used to pressure treat and cure Alklestrul two are good now, what is the reason for my sense of this

doctor1 MD

my wife is 35 weeks 2 days pregnent. She is having the pain in abdomen left side which is last for 5 to 10 minutes. my wife is having low AFI ie 6.6 cms when scanning done at 34 weeks. the gynecologist advised to take the argnine sachets twice a...

doctor1 MD

I am a 57 yr old female with burning chest pain upon exertion . When walking fast with arms hanging at my side.also both arms have pain. Could this be related to a rotated disc in my neck? Also muscle cramps I'm legs. Thank you.