Type
II Diabetes, Diarrhea and
Abdominal Bloating
I am 47 years old and have
type 2 diabetes. I use to
have diarrhea during the day
or while I sleep. My doctor
changed my medication to Glimepiride
4mg twice a day and Metoclopramide
10 mg also twice a day. I
do not have diarrhea at all,
but I have abdominal bloating
all the time. What can I do
or take??
Your
doctor has given you the right
medication. In the setting
of type II diabetes, strict
control of your blood sugar
will eventually improve the
bloating. Aim for a hemoglobin
A1c level of less than 6.
Once this happens, then the
bloating should gradually
go away. Your doctor may wish
to add a TDZ drug to your
regime, as this may help.
Good luck, be patient.
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Severe
abdominal pain on he right
side under rib-cage.
I went to do an upper GI series
last monday and the radiologist
had mentioned that everything
looks okay and I have nothing
to be worried. However, I
am still experiencing pain
and for some reason it's getting
worse. I went to the emergency
room last month about 2 times
in 2 weeks and both times
I was there they refused to
give me a CT Scan and they
just did an ultra sound because
they thought it was kidney
stones or gallbladder stones.
The pain is on the right side
under my rib-cage and it is
carried to the left lower
back area, shoots to the right
lower back and straight up
to my shoulders. My doctor
is convinced it could be an
inflamed gallbladder and she
ordered a CT Scan but they
gave me a date a few months
from now. I can't wait that
long, I'm in severe pain.
I'm nauseated, I barely eat
and I'm losing weight and
I'm gaining weight and I just
don't get it. Do you have
any idea? Not to mention I
haven't had a bowel movement
in days sometimes weeks. and
when I do it's not normal,
it's either diarrhea or it
comes out flat. I have a problem
with my face being dry and
I have pimples. I have tried
every pimple cream and lotion
and I don't know what else
to do.
You
need to see a gastroenterologist
very soon,and stop going back
and forth to the ER. There
are many potential causes
for your pain, and a lot of
them won't show up on a CT
scan. If you are in the San
Francisco Bay Area or northern
California, you can contact
my office.
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Continuous
loose stool.
I was wondering if you could
help me with some questions
I have? I've been looking
around for a while for pages
that have my symptoms, but
I can't find anything. I'm
also a full time student on
my own with no medical coverage,
so I can't go see a doctor.
My problem is with my digestive
tract. Anything I eat seems
to inflame something and I
need to go to the bathroom
asap. My symptoms are: hearing
my digestive tract make noises,
almost always wet and loose
stool, wet leaking throughout
the day so I have to wipe
every hour or so. If I drink
a protein shake, or take a
multi vitamin I loose my energy
and need to fall asleep, I'm
always thirsty and my face
is really dry on my nose and
upper cheeks. Anything would
help, even a point in the
right direction to somewhere
that I can get help.
You
may have inflammatory bowel
disease. Most gastroenterologists
could see you and arrange
an easy payment plan for you.
You could go to the student
health service at your school,
where they can recommend a
specialist. You need to see
someone. In the meantime,
take a couple of Pepto-Bismol
tablets to help with your
symptoms. They'll turn your
stools black but don't worry,
it's not blood but bismuth
oxide. Good luck.
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HLA-DQ
6 and relation to nerve damage
from gluten.
My son has tested positive
for HLA DQ 2 for Celiac, and
also HLA-DQ 6. Are you familiar
with what the DQ 6 means?
My understanding was that
it is a gluten sensitivity
gene, but not the classic
Celiac gene. The reason I
ask is because my mother-in-law
started showing signs of dementia
at age 55, and has deteriorated
to the point where the doctors
have ruled everything out
except Alzheimer's. My question
is, do some of these other
gluten sensitivity genes have
neurological effects, and
is it worth it to try and
convince my very stubborn
father-in-law to have her
tested? Incidentally, my son
was diagnosed with Pervasive
Developmental Disorder NOS,
but has responded very well
both physically AND mentally
to removing gluten from the
diet. That is what makes me
think that perhaps my mother-in-law
may improve on the diet as
well. Thank you so much for
answering.
HLA-DQ6
is on the same chromosome
as HLA-DQ2 and DQ8: chromosome
6. HLA genes control the production
of receptors on immune cells
which recognize proteins to
organize how the system will
respond-either react or tolerate
the protein. The exact role
of DQ-6 is unclear as are
the precise roles of other,
non-HLA genes on other chromosomes
that are involved with gluten
sensitivity. The bottom line
is that there is a strong
probability that these genes
may be involved in nerve damage
from gluten, and that your
mother must be tested. You
and your family may be interested
in participating in our research
cohort for celiac disease,
where we will explore the
roles of genes, ethnicity,
bacterial and viral factors
as well as geographic microclimates
in producing disease,and giving
strong clues on new treatments.
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Testing 7 month old baby when
mother and sibling have Celiac
Disease.
I have celiac disease and
my 2 1/2 year old daughter
was diagnosed with celiac
disease when she was 1 1/2
years old. Now I have a 7
month old baby and we have
been feeding solid foods but
avoiding all gluten containing
ones. Is that necessary? Will
eating gluten containing foods
in first year for a baby born
to a celiac mother increase
chances for that baby for
getting celiac. You do avoid
wheat in baby if mother has
wheat allergy? I know celiac
is not a food allergy and
is auto immune disease?? But
is there reason to avoid or
best to introduce?
There
is no guarantee that your
baby has celiac disease. You
must get her tested to know
for sure. If she is doing
well now and thriving, then
there is no urgency, but you
should test her. The expression
of the disease is quite variable,
ranging from infancy with
severe failure to thrive and
many developmental problems
to old age, with mild disease
often not related directly
to the gut. This depends on
the inheritance, what dose
of the genes and their expression,
so, again, test the baby.
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Dysmotility
of colon and in ability to
swallow in a 7-year old
My 7 year old daughter has
complete dysmotility of her
colon and rectum. She is in
pain daily. We have tried
all kinds of medicines. In
the last few years her symptoms
have increased to her upper
gi. Today she has choked several
times while eating claiming
the food is not going down.
Have you heard of children
with this? Is it progressive?
What causes this? What are
their lives like as they get
older?
Your
daughter may have one of a
variety of hereditary visceral
neuropathies or myopathies.
She needs to see a Pediatric
Gastroenterologist and a motility
specialist right away. Fortunately,
here at California Pacific
Medical Center in San Francisco,
we have a team that can help
her. Contact me if you would
like to come here for evaluation
and treatment.
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Role
of DQ2 gene in Celiac Disease.
I have just had a genetic
marker test for celiac disease
due to having severe digestive
problems, weight loss etc.
I had taken myself off gluten
to see if it was the issue
as the doctors could not find
anything wrong. Other celiac
tests showed negative. I showed
up positive for the marker
DQ2 but the doctor said he
really could not tell me anything.
From what I read that marker
can be linked to Gluten Sensitivity
that could lead into Celiac
disease. I guess I would like
to know if this positive result
for DQ2 is enough that I should
still stay away from Gluten.
While
DQ2 is associated with 90-92%
of proven celiac disease,
it is also present in 37%
of the general population,
so while being very suggestive,
it is not diagnostic. That
said, go back on gluten for
a month and then get an intestinal
biopsy (your gastroenterologist
should take 8-10 biopsies
starting in the duodenal bulb
and working down to the transverse
duodenum) and have the pathologist
stain for CD3 cells and count
the number per 100 intestinal
cells. More than 20/100 is
abnormal. This will earn you
the trophy diagnosis of celiac
disease. On the other hand,
there is emerging a condition
known as NCGS, or "non-celiac
gluten sensitivity",
where patients are clearly
sensitive to gluten, but test
negative for all diagnostic
tests. There are other genes
involved, as well as primary
injury to the gut from grain
protein fragments known as
peptides that are likely involved
here. The bottom line is if
you are better off gluten,
then by all means avoid it.
There is no side effect other
than inconvenience or expense.
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Bleeding
and hemorrhoids in colon.
I am 34 years old and about
a year and five months ago
I had a colonoscopy due to
periodic bright red blood
in my stools. My colonoscopy
showed only internal hemorrhoids.
I didn't have any polyps or
anything else. Both of my
grandfathers died of colon
cancer. Even though the doctor
told me that his banding of
the hemorrhoids would only
help a little, I am still
afraid when I occasionally
see bright red blood. Should
I be okay since I had a colonoscopy
done in July 2005 and it showed
nothing but the hemorrhoids?
How often should I repeat
a colonoscopy?
If
your grandfathers were 55
or less when they died, then
every 5 years. If older, then
every ten years. Try sitz
baths in a warm tub up to
your belly button for 15 minutes
at least three times a week,
don't strain, read on the
toilet. Apply aloe vera gel
to the anal area after bathing,
eat fresh fruits and veggies,
get regular exercise and relax.
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Irritable
Bowel Syndrome
I am a middle aged man who
has been diagnosed with IBS
for two years. My stool often
contains vegetables and I
wanted to know the real reasons
behind it. Normally, how long
does it take to recover from
IBS?
If you have IBS, then you
have a condition that represents
a continual intolerance of
your digestive tract's immune
system to the environment.
This causes persistent inflammation
which interferes with the
functioning of your gut. Until
you can find a way to reduce
inflammation in your gut,
you will have symptoms. It
is not uncommon to occasionally
see undigested food in your
stool, but, when you see it
all the time, you may have
a more serious condition associated
with poor absorption, and
will need to see a gastroenterologist.
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Blood
Test and Biopsies for Celiac
Disease
My blood test came back positive
for celiac sprue, but I have
yet to get a biopsy on my
small intestine. Is it very
likely that I do in fact have
the disease? Should I adhere
to a gluten-free diet until
I have a biopsy?
You should not be on a gluten-free
diet until you get the biopsy.
I don't understand the delay
in getting the biopsy, but
you want it to be as abnormal
as possible, because too many
inexperienced pathologists
will not diagnose a minimally
abnormal biopsy as celiac.
You should have your gastroenterologist
ask the pathologist to stain
the biopsy for CD3 cells,
and count the number of them
per 100 intestinal cells.
More than 20 25/100 are abnormal,
and indicative of celiac disease.
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Celiac
Disease and Thyroid Problems
I can't always keep gluten
free, sometimes I get a hit
from somewhere or something?
My hair has begun to fall
out at a rapid rate. Should
I be taking any special vitamins?
You
may have a thyroid problem,
quite common in celiac disease,
rather than a specific vitamin
deficiency. You should return
to your gastroenterologist
and be checked for thyroid
function, as well as for on-going
gluten exposure by ttG and
EMA antibody testing.
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Problems
started after going Gluten
free
I was diagnosed with celiac
this summer. I was tested
because my son had been diagnosed
with celiac the month before.
I myself had been entirely
asymptomatic. Prior to my
diagnosis I felt very healthy
and energetic. Since going
gluten free, I have not felt
well. I have gas, my skin
has broken out, I have periods
of unexpected weepiness, and
my hair is falling out. My
family follows a lacto-ovo
vegetarian diet and we continue
to eat a lot of beans and
whole grains (now quinoa,
brown rice, and corn instead
of whole wheat and barley).
I take a multivitamin supplement.
Any idea how my current functioning
could be related to going
gluten free or what I can
do to correct it?
How
were you diagnosed? If it
was just on an anti-gliadin
antibody test, it may be a
false positive result, and
you may have another auto-immune
problem. Did you have an intestinal
biopsy, and, if so, was it
an advanced lesion? (chances
are it wasn't since you were
asymptomatic). You should
go back to your gastroenterologist
and get full imaging of your
small intestine. You may have
unmasked a Cow's milk allergy
that was previously hidden.
Please keep me posted of your
progress.
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Bloating, hard stools and
possible chronic constipation
I am in my early 20's and
underweight and eat very little
mainly due to the bloating
that I experience if I eat
other foods and have hard,
pellet-like stools as well
as back pain (bone pain) and
have many other symptoms of
celiac esp. when eating high-fat
foods or cereal like wheetabix.
I had done a barium study
many years back and came out
negative. My blood test is
normal. I also went to see
a GI and got tested for celiac
(fasted and took laxatives
the day b4 the test as preparation)
- it came back normal. But
here's the thing -when I got
tested for celiac, my DAILY
diet consisted strictly only
of 1 glass of 1% milk, a fruit
(peach/nectarine), and 2 slices
of white wonder bread w/ jam.
Could this be the reason it
could have turned out negative
- I mean should I have eaten
things containing more gluten
(ie. wheatabix) before the
test?
You
were ingesting enough gluten
with the 2 slices of Wonder
bread to make a celiac test
positive if you really have
celiac disease. It sounds
as if you have either constipation-predominant
IBS, or just chronic constipation.
Have your gastroenterologist
try Zelnorm, or Miralax, or
Amitiza.
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Bloating
and discomfort following Beer
drinking
For 6 years, I prepared a
strict gluten & casein
free diet for my son with
autism. That was fine to do,
as he was a child & I
could control his food. Recently,
my husband has bouts of bothersome
gastrointestinal bloating
& discomfort (sometimes
pronounced discomfort), also
gas and diarrhea. This lasts
sometimes for several days.
Sometimes the occupancies
are rather frequent, yet sometimes
not. As he's observed the
pattern, he is certain that
he responds this way to beer
(he's a not so frequent beer
drinker), and now he suspects
food to be the culprit. He
had never been on-board with
my gluten & casein free
diet for my son (although
he never interfered with me
implementing it). Now, he's
looking at food in a whole
new way. He's eliminated beer
and I'm baking & cooking
gf. Is it beneficial to simply
reduce gluten in the diet,
or, as in autism, must he
eliminate it to restore himself
to good gastrointestinal health?
I want his eating habits to
help prevent further deterioration
in his system. However, he's
in sales & not home for
meals often. I don't think
he'd chose to go 100% gluten
free.
He
may not necessarily be gluten-sensitive;
he should get tested. He may
have IBS, and this could respond
to low doses of bowel anti-inflammatory
drugs like balsalazide. He
really needs to be evaluated
by a gastroenterologist.
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