|
 Ask
Dr. Aron
 How
accurate are the blood tests for
celiac disease? |
 The
commonly used antibody tests (IgA
anti-gliadin and anti-tissue trans
glutaminase) can diagnose about
85-90% of those with celiac disease.
A total IgA (immunoglobulin A) level
must be done, because 10% of celiacs
are deficient in this immunoglobulin,
and these antibodies may be falsely
low in this setting.
On occasion, even those with biopsy-proven
disease may test negative, so it
is recommended that genetic testing
for HLA-DQ2 and HLA-DQ8 genes be
done.
Either one or both are positive
in 95-98% of celiacs, but are also
present in about 25-30% of the population
at large, so an intestinal biopsy
remains the gold standard for diagnosis.
Health and happiness,
Dr. Aron, JUNE
25, 2007
|
.
. . . . . . . .
. .
. . . . .
. . . . .
. . . . .
. . . . .
. . . . .
. . . . .
. . . . .
. . .
. . . . . . . .
|
How
long does it take to see symptoms
from a gluten-contaminated food?
I
have been gluten-free since Sept.,
2004, although a biopsy came back
negative at that time. I have experienced
a night and day difference on the
diet, and as a result, my partner
and I work very hard to keep my
diet extremely clean. However, I
have noted that there are some things
that I consider GF based on the
listed ingredients and what the
manufacturer tells me, that I get
gastrointestinal symptoms from.
Can you tell me if there is a way
to narrow down what the culprit
might be by how long it takes for
me to have symptoms? In other words,
if I go to a restaurant, and I eat
something that has cross contamination
from say a grill or utensils that
are used in the kitchen, I know
that within the hour. But there
are times when I don’t exhibit
any symptoms for 4 or 5 hours. I
am wondering if this is because
the ingredient I am responding to
is such a trace ingredient, that
I don’t feel it till the food
is broken down to a certain level,
way beyond the superficial. Is that
a possibility, or am I way off base
here?
|
We
know that small fragments or peptides
of glutens are directly injurious
to the gut. These are independent
from the celiac mechanism. It
probably depends on the dose and
variety of peptides that arrive
in your gut. You’ll drive
yourself crazy trying to figure
it out, but it is likely that
you will not undergo serious damage
from this occasional exposure.
Health and happiness,
Dr. Aron, JUNE
15,
2007 |
.
. . . . . . . .
. .
. . . . .
. . . . .
. . . . .
. . . . .
. . . . .
. . . . .
. . . . .
. . .
. . . . . . . .
|
What
is the link between celiac disease
and cancer?
|
There
is an increased risk of developing
lymphoma of the digestive tract
and the bloodstream in those who
have celiac disease and go undiagnosed
and do not eat a gluten-free diet,
or in those who have celiac disease,
and who do not stay on the diet.
If the initial biopsy used to make
the diagnosis was a Marsh III or
worse (Marsh I means no architectural
change to the villi; Marsh IV means
complete destruction of the villi),
then the risk is greater than the
rest of the population that does
not have celiac disease.
There is a very slightly increased
risk in developing other solid tumors
of the gut, such as colon cancer
or esophageal cancer, if one does
not adhere to the gluten-free diet.
If, at the time of diagnosis, the
biopsy is Marsh III or worse, you
should also get imaging of the rest
of the small intestine. The best
way for this is still the barium
swallow small bowel follow-through
test.
Health and happiness,
Dr. Aron, JUNE
1,
2007
|
|
|
|
| Ask
a Question
Fill
out the form or e-mail
us.
Your name will not be posted online.
If
you have an urgent issue, please contact
your physician. This form is not for
urgent or emergency situations.
. . . . . . . . . .
.
. . . . .
. . . . .
. . . . .
. . . . .
. . . . .
. . . . . .
|
|
