Question Title: Confusion over Celiac Disease!

My husband suggested eating ordinary food, just to see how it wood affect me. I tried a variety of different foods, from cream cakes to pasta. To my surprise, I seemed to be ok.
There were no muscle spasms or visits to loo with the runs! Then I tried white bread and within a space of 2-3 hours I was in excrutiating pain, again.
I then tried brown bread, (with the main ingredients being, wheat flour and wheat gluten). For the past 2 weeks now, I have continually ate the brown bread.
Since then, I have had no spasms and any visits to the loo have actually been normal. ( which, since being diagnosed, I have not been able to do without discomfort and pain).

Naturally, you can see why I am confused. It only seems to be white bread and products made with same ingredients, that affect me.
When I was diagnosed, The specialst dealing with my condition at that time, took a biopsy from my stomach, through and endoscope and
I aslo had a colonoscopy. When the results came back, his exact diagnoses was as follows: THE RESULT OF THIS BIOPSY IS CONSISTENT WITH THE FINDINGS OF CELIAC DISEASE.

Now that all this has happened to me, I am confused as to wether my doctor's statement of CONSISTENT actually means, similar or definate.

Could someone please shed some light on this puzzle for me.
I have also been an insulin dependant diabetic for 20 years.

Any answers would be greatly appreciated.

Regards
Maureen.

Dear Maureen,

In order for the diagnosis of celiac disease to be made the following criteria must be met:
1) poor absorption of nutrients in the area of the small intestine which is affected
2) a characteristic microscopic appearance of the small intestine on biopsy
3) prompt clinical improvement following the withdrawal of certain cereal grains from the diet

Interestingly, the incidence of juvenile insulin requiring diabetes mellitus (type I) is increased in celiac sprue. Immune deficiency such as IgA deficiency is also associated with celiac disease.

The interaction of the water insoluble protein moiety (gluten) of certain cereal grains with the lining of the small intestine is crucial for the diagnosis of celiac sprue. It is the alcohol soluble protein component of these grains that are toxic. These substances are called prolamins and are the gliadins in wheat, secalins in rye and hordeins in barley. The toxicity of the wheat fractions depends upon the biochemical structure in food. For example, if the gliadin is not in its complete peptide (protein bond) form and broken down into simple amino acids, then the wheat fraction is no longer toxic. I am not sure how the various breads you are eating are processed, but this may explain why you are experiencing symptoms with certain types of food that contain gluten and not with others. Furthermore, there is considerable variation among patients with celiac disease in their ability to tolerate small amounts of toxic gluten.

Finally, there are blood tests which can also help suggest the diagnosis of celiac disease. Anti-gliadin antibodies and anti-endomysial antibodies, if positive, will help confirm this diagnosis. A normal repeat small intestinal biopsy after a gluten-free diet will help to confirm celiac disease as well. It should be kept in mind that it may take months for the small intestine to revert back to normal even with strict adherence to a gluten free diet. I hope you find this information helpful. Good luck to you.

This response is being provided for general informational purposes only and should not be considered medical advice or consultation. Always check with your personal physician when you have a question pertaining to your health.

If you would like to be seen at our institution please call 1-800-653-6568, our Referring Physicians’ Office and make an appointment to see Dr. Muszkat, one of our experts in Gastroenterology.

HFHSM.D.-ym
*Keywords: celiac disease, gluten free diet, gliadin, toxic wheat fractions