Question:

My question is: shouldn’t one of the doctors have done a blood test to check for signs of infection and other clues of  bacterial infection ? I was deathly ill when this first struck me, but have recovered to a point were I can function at 75% of my duties before this illness occurred, without antibiotic medication so far.

In my opinion, yes!  Bloodwork is a good starting point and can tell a lot about your condition.  In these days of managed care, you sometimes must demand the tests or they will not get done. Best of luck. — Richard Caccavale

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– Hide quoted text — Show quoted text – Reposting article removed by rogue canceller. Hi everyone, I have been suffering from some sort of gastrointestinal problems for 4 months now.  Symptoms are gas, bloating, lower abdominal pain, belching , very mild heartburn, lack of appetite and weight loss. I when to my primary care physician who asked a few questions and checked stool for blood: that was negative. He then gave me a referral to a gastroenterologist. The GI doc has done an endoscopy after an ultrasound scan showed slightly abnormal gallbladder, but no gallstones. Endoscopy showed no ulcers, but the doc said that there were "abnormal secretions" in stomach an gave my an Rx called Reglan. I can’t stand the stuff (headaches, dizzy, not thinking straight and it seems to make the symptoms worse) and will be calling him next week to inform him of this fact. My question is: shouldn’t one of the doctors have done a blood test to check for signs of infection and other clues of  bacterial infection ? I was deathly ill when this first struck me, but have recovered to a point were I can function at 75% of my duties before this illness occurred, without antibiotic medication so far. Am I off base here or are the doctors missing something by not checking my blood ? Thanks for any information. Bob

Bob,  Actually, it makes sense to do the least invasive test first followed by the more "invasive."  Thus, stool studies to look for Giardia antigen and occult blood would be early tests, then blood tests to check your liver function, glucose, protein levels and blood count, followed by endoscopy and finally biopsy.  I tend to agree with you…  If I were you, I’d pose the question to them directly! H2

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- Hide quoted text — Show quoted text – to a gastroenterologist. The GI doc has done an endoscopy after an ultrasound scan showed slightly abnormal gallbladder, but no gallstones. Endoscopy showed no ulcers, but the doc said that there were "abnormal secretions" All of your symptoms are consistent with undiagnosed celiac disease, aka gluten intolerance. However, none of the tests you list would detect it! An upper endoscopy was done, so are you implying the GI doc didn’t do a biopsy while the scope was there? That would be like tearing apart a car engine to find a problem and glossing over the spark plugs.

I agree. First for gluten intolerance the biopsy would have to be in the small intestine. I have no statistics, but I’m quite sure that biopsies are rarely done. At least there. I know nothing of possible biopsies in the stomach. Problem is, it is entirely controlled by a diet change, which isn’t profitable to the medical and pharmaceutical industries. So no one is out But why wouldn’t it be profitable for virtually the entire food industry to fund gene therapy research?

There is no reason to believe gene therapy would find a solution. If they did the research, they would bring attention as they were doing it and if everybody stopped eating wheat the food industry would be screwed. What else grows in the cool climates and arid soil that wheat grows in? Gluten-free rice requires irrigation. Most gluten-free grains grow in hotter climates. (The same could be said for the milk industry funding gene therapy research for lactose intolerance.)

Lactose is a maldigestion problem. They do fund research. They recently funded a study that tried to show that lactose intolerance was overblown and almost everybody could drink milk in moderate quantities. Again the same comments as above. Don.

Response:

to a gastroenterologist. The GI doc has done an endoscopy after an ultrasound scan showed slightly abnormal gallbladder, but no gallstones. Endoscopy showed no ulcers, but the doc said that there were "abnormal secretions" All of your symptoms are consistent with undiagnosed celiac disease, aka gluten intolerance. However, none of the tests you list would detect it!

An upper endoscopy was done, so are you implying the GI doc didn’t do a biopsy while the scope was there? That would be like tearing apart a car engine to find a problem and glossing over the spark plugs. Problem is, it is entirely controlled by a diet change, which isn’t profitable to the medical and pharmaceutical industries. So no one is out

But why wouldn’t it be profitable for virtually the entire food industry to fund gene therapy research? (The same could be said for the milk industry funding gene therapy research for lactose intolerance.) — http://www.fluxsoft.com/     ftp://ftp.fluxsoft.com

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Endoscopy showed no ulcers, but the doc said that there were "abnormal secretions" in stomach an gave my an Rx called Reglan.

Hi Bob, I wonder if the "abnormal secretions" are excessive histamine in the stomach? If so, that would sure fit with gluten intolerance. I don’t know enough about it to provide a comprehensive post, but Cooke & Holmes offer an interesting discussion of it in _COELIAC DISEASE_ 1984, Churhill Livingstone, New York. Apparently the histamine is produced in response to an allergen in the stomach (gluten). I’m sorry, that is all I remember about it. Best Wishes, Ron Hoggan

Response:

Reposting article removed by rogue canceller. Hi everyone, I have been suffering from some sort of gastrointestinal problems for 4 months now.  Symptoms are gas, bloating, lower abdominal pain, belching , very mild heartburn, lack of appetite and weight loss. I when to my primary care physician who asked a few questions and checked stool for blood: that was negative. He then gave me a referral to a gastroenterologist. The GI doc has done an endoscopy after an ultrasound scan showed slightly abnormal gallbladder, but no gallstones. Endoscopy showed no ulcers, but the doc said that there were "abnormal secretions" in stomach an gave my an Rx called Reglan. I can’t stand the stuff (headaches, dizzy, not thinking straight and it seems to make the symptoms worse) and will be calling him next week to inform him of this fact. My question is: shouldn’t one of the doctors have done a blood test to check for signs of infection and other clues of  bacterial infection ? I was deathly ill when this first struck me, but have recovered to a point were I can function at 75% of my duties before this illness occurred, without antibiotic medication so far. Am I off base here or are the doctors missing something by not checking my blood ? Thanks for any information. Bob

Response:

Hi everyone, I have been suffering from some sort of gastrointestinal problems for 4 months now.  Symptoms are gas, bloating, lower abdominal pain, belching , very mild heartburn, lack of appetite and weight loss. I when to my primary care physician who asked a few questions and checked stool for blood: that was negative. He then gave me a referral to a gastroenterologist. The GI doc has done an endoscopy after an ultrasound scan showed slightly abnormal gallbladder, but no gallstones. Endoscopy showed no ulcers, but the doc said that there were "abnormal secretions" in stomach an gave my an Rx called Reglan. I can’t stand the stuff (headaches, dizzy, not thinking straight and it seems to make the symptoms worse) and will be calling him next week to inform him of this fact. My question is: shouldn’t one of the doctors have done a blood test to check for signs of infection and other clues of  bacterial infection ? I was deathly ill when this first struck me, but have recovered to a point were I can function at 75% of my duties before this illness occurred, without antibiotic medication so far. Am I off base here or are the doctors missing something by not checking my blood ? Thanks for any information. Bob

Response:

I have been suffering from some sort of gastrointestinal problems for 4 months now.  Symptoms are gas, bloating, lower abdominal pain, belching , very mild heartburn, lack of appetite and weight loss. I when to my primary care physician who asked a few questions and checked stool for blood: that was negative. He then gave me a referral to a gastroenterologist. The GI doc has done an endoscopy after an ultrasound scan showed slightly abnormal gallbladder, but no gallstones. Endoscopy showed no ulcers, but the doc said that there were "abnormal secretions"

All of your symptoms are consistent with undiagnosed celiac disease, aka gluten intolerance. However, none of the tests you list would detect it! Problem is, it is entirely controlled by a diet change, which isn’t profitable to the medical and pharmaceutical industries. So no one is out there promoting any meds or treatments for it, or even promoting its existence, for that matter. You mention "slightly abnormal gallbladder". Gall bladder problems are frequently due to gluten problems. Here’s a relatively recently written article: Gall bladder disease or malfunction is often associated with celiac disease. It can cause pain in the upper right quadrant of the abdomen, just at the lowest rib on the right side. In one study of 1300 celiacs in Canada, 9% indicated that gall stones were the earliest presentation, sometimes followed by many years prior to correct diagnosis of their celiac disease. In another report, Dr. Kozlowska indicated that 13 of the 41 newly diagnosed celiacs she investigated were suffering from atresia, a condition which is a partial or complete blockage of the bile duct. CCK (cholecystokinin) is the hormone responsible for gall bladder contraction. The bulk of this hormone is produced in the duodenum. Active celiac disease would be likely, then, to cause a reduction or a cessation of duodenal production of CCK. A radiologist in Hungary is currently researching this problem. In private correspondence, one gastroenterologist reports having found (accidentally) a gallstone in a 12 year old girl who had active celiac disease. The 30% incidence of atresia among celiac children, as reported by Dr. Kozlowska, would suggest an even higher number among adults with active celiac disease. Given the low level of clinical suspicion for celiac disease in North America, it would not be at all surprising if a large portion of patients with gall bladder disease were suffering from occult celiac disease. Future research may reveal that gall stones and atresia are only symptoms of celiac disease. I did a Medline search on cck and celiac disease. I got 65 hits. Researchers repeatedly identified a connection between celiac disease and gall bladder malfunction with such comments as: "Thus the already impaired fat absorption in celiac sprue is magnified by the lack of bile delivery….."; and "We conclude that there is a reversible defect of gallbladder emptying and cholecystokinin release in celiac disease." and "Cholecystokinin (cck) release and gall bladder emptying in response to a fatty meal are completely abolished in coeliac disease." and "the abnormally decreased gallbladder contraction in coeliac patients is the result of endogenous cck secretion and not a lack of end-organ responsiveness to cck." There just isn’t much ambiguity there. If you’ve got celiac disease, you have gall bladder malfunction, of the sort that may well develop into atresia and gallstones. Upon receiving a diagnosis of gall bladder disease, whether gall stones or atresia, one might be wise to request a blood test for celiac disease. The anti-endomysial antibody test is currently the most reliable and available test. Now, given the low level of clinical suspicion for celiac disease, I anticipate the suggestion that absent gall bladder emptying, atresia, and gall stones might occur in the absence of celiac disease. I did another Medline search, and I can’t find a single study that has tested atresia patients or gallstone patients for celiac disease. My answer to the suggestion that gall bladder disease may occur in the absence of celiac disease is that there is no evidence to support such a contention. Considerable evidence exists, however, which points to celiac disease as a likely cause of gall bladder malfunction, atresia, or stones. As for childhood gallstones, there appears to be only one answer…. it is associated with celiac disease. A view that incorporates the association of gall bladder disease, and celiac disease, but does not preclude the above, has been expressed by Dr. Joseph Murray, of the University of Iowa, who is a gastroenterologist specializing in treating celiac disease. He believes there are several "triggers" that can activate Celiac disease in genetically susceptible people. One of them is: Surgery, particularly GI (gall bladder, etc.) In any case, the connection between celiac disease and gall bladder disease is well known.   More information is available at: The Gluten-Free Page:  http://www.panix.com/~donwiss/ I hope this is helpful. Ron Hoggan

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