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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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.

. . . . . . . . . . . . . . . . . . . . .