Monday, December 04, 2006

What tests should I ask the doctor for?

Go to the following website for in depth info:

A doctor may order one or more celiac disease tests, along with tests to evaluate the status and extent of a patient’s malnutrition and malabsorption. There are four autoantibodies that are related to celiac disease that can be measured. The doctor will often order an Anti-tissue Transglutaminase Antibody (tTG), IgA first to screen for celiac disease. If this test is positive, it is likely that the patient has celiac disease. The doctor may perform an intestinal biopsy to confirm that there is damage to the intestine. If the Anti-tTG is negative but the physician still suspects celiac disease, he may order other tests that include:
Anti-Gliadin Antibodies (AGA), IgG and IgA. These tests are often useful when testing young symptomatic children but they are found in fewer cases of celiac disease than Anti-tTG and they can also be positive in other diseases. AGA IgG and IgA are often ordered together so that their results can be compared. If one is positive, both should be – unless the patient has an IgA deficiency. They can be used to monitor dietary compliance.
Anti-Endomysial Antibodies (EMA), IgA. This test is being replaced by the Anti-tTG test as they both measure the autoantibodies causing the tissue damage associated with celiac disease. Anti-EMA is, however, still being ordered at this time by many physicians and may be used to monitor dietary compliance.
Anti-Reticulin Antibodies (ARA), IgA. Anti-ARA is not ordered as frequently as it once was as it is not as specific or sensitive as the other autoantibodies. It is found in about 60% of celiac disease patients and about 25% of patients with dermatitis herpetiformis.
tTG can also be used for monitoring dietary compliance.
These autoantibody tests are often ordered along with other tests to help determine the severity of the disease and the extent of a patient’s malnutrition, malabsorption, and organ involvement.

Other tests might include a:
CBC (complete blood count) to look for anemia
ESR (erythrocyte sedimentation rate) to evaluate inflammation
CRP (C-Reactive protein) to evaluate inflammation
CMP (complete metabolic panel) to determine electrolyte, protein, and calcium levels, and to verify the status of the kidney and liver
Vitamin D, E, and B12 to measure vitamin deficiencies
Stool fat, to help evaluate malabsorption
(by request!)

Lassitude (a term describing a feeling of tiredness, weakness or exhaustion)
Inanition (exhaustion, as from lack of nourishment)
IrritabilityFuzzy-mindedness after gluten ingestion
Severe Vitamin B deficiency
ADHD (all his life, but less of a problem in the last couple years)
Stomach pain (ranging from mild to severe, almost constant)
Sore throat (almost evey day)
White flecks on fingernails
Low hormones (cortisol)
Liver stress (the blood work showed liver problems, but that is all we know so far)
Aching joints
Shaking hands
Inability to concentrate

And these are the problems he has that may or may not be related to Celiac:
Chemical Poisoning (dont know what or how)
Heavy Metal Poisoning (Arsenic, probably from deck or swing set)
Internal Parasites
The dangers of not being tested for celiac:
In addition to the approximate 1 million Americans suffering from classical Celiac Disease, there are an equal number of individuals with silent or latent Celiac Disease who are unaware of their condition because they do not have the signs and symptoms typically associated with celiac disease. These individuals run the risk of developing full-blown celiac disease later in life and complications such as bowel cancer, infertility and autoimmune diseases, making proper and early diagnosis very important.

List of symptoms associated with Celiac Disease (also known as Celiac Sprue and Gluten Intolerance):
(I have highlited the symptoms that Mooky or other family members have, whether or not they have been diagnosed with CD.)
Lassitude (a term describing a feeling of tiredness, weakness or exhaustion)
Inanition (exhaustion, as from lack of nourishment)
Fatigue (often chronic)
Fuzzy-mindedness after gluten ingestion
Dental enamel defects (lots of dental cavities due to weak enamel)
General malnutrition with or without weightloss
Any problem associated with vitamin deficiencies
Irritable Bowel Syndrome
Lactose intolerance
Burning sensation in the throat
Abdominal pain and bloating
Borborygmi (audible bowel sounds)
Abdominal distention
Steatorrhea (fatty stools that float rather than sink)
Foul smelling stools
Bulky, greasy stools
Anemia (iron deficiency)
Hemorrhagic diathesis (bleeding disorder)
Osteoporosis/osteopenia (bone loss or thinning)
Gall Bladder problems
Bone pain (especially nocturnal)
White flecks on fingernails
Short stature (due to slow growth)
Rheumatoid arthritis
Arthralgia (pain in the joints)
Tetany (spasms and twitching of the muscles)
Parasthesia (abnormal or impaired skin sensation including burning, prickling, itching, or tingling)
Amenorrhea (absence of menstrual bleeding)
Delayed puberty
Cheilosis (inflammation, cracking and dryness of the lips)*
Angular cheilosis (specifically cracking in the corners of the lips)
Glossitis (swollen tongue)
Stomatitis (any form of inflammation or ulceration of the mouth, such as mouth ulcers, cold sores, thrush, etc.)
Purpura (purple or red spots on your skin caused by bleeding under the skin, more common in elderly)
Follicular hyperkeratosis (corns, calluses, plantar warts, psoriasis, nail fungus)
Atopic dermatitis (a tendency towards allergies and a predisposition to various allergic reactions)*
Scaly dermatitis (inflammation of the skin, includes dandruff and topical allergic reactions)Hyperpigmented dermatitis (can't find the definition, must have something to do with the color of the rash?)
Alopecia areata (loss or absence of hair, leaving the skin looking and feeling normal)
Edema (accumulation of serum-like fluid in the body tissues)
Ascites (accumulation of fluid in the peritoneal cavity-the space between the abdominal wall and the organs)
Selective IgA deficiency
Seizures, with or without occipital calcification
Hepatitis (inflammation of the liver, may be acute or chronic)
Dermatitis herpetiformis (skin rash characterized as intensely itchy skin eruptions like red bumps and blisters. Burning, stinging and itching is very bad. It appears in groups around the body, most often on the head, elbows, knees, and buttocks, much like the lesions of Herpes which is why the name is herpetiformis-meaning "like herpes". Must be diagnosed by a doctor. Only occurs in celiac patients.)
Liver disease
Xerophthalmia (an eye disorder which causes the conjunctiva and cornea to become abnormally dry)
Night blindness (inability to see well in dim light)
Thyroid disease
Unexplained neuropathic illnesses, including ataxia and peripheral neuropathy*Peripheral neuropathy (disease, inflammation and damage to the peripheral nerves, which connect the central nervous system to the sense organs, muscles, glands, and internal organs. Damage to sensory nerves may cause numbness, tingling, sensations of cold, or pain, often starting at the hands or feet and moving toward the body center. Damage to the nerves of the autonomic nervous system may lead to blurred vision, impaired or absent sweating, headaches, episodes of faintness associated with falls in blood pressure, disturbance of gastric, intestinal, bladder or sexual functioning, including incontinence and impotence. In some cases there is no obvious or detectable cause)*
Ataxia (incoordination and clumsiness, affecting balance and gait, limb or eye movements and/or speech, making one appear as if they were drunk)
DementiaDiabetes mellitus type 1
Sjogren's syndrome (eyes, mouth, and vagina become extremely dry)
Collagen disorders
Down syndrome
IgA neuropathy
Fibrosing alveolitis of the lung (body produces antibodies against its own lung tissue, creates a dry cough and breathing difficulty upon exertion)
Hyposplenism, with atrophy of the spleen (underactive spleen)
Pancreatitis (inflammation of the pancreas)
Lymphoma (any group of cancers in which the cells of the lymphoid tissue multiply unchecked)Leukopenia (abnormal decrease in white blood cells, often reducing immune system function)
Coagulopathy (blood clotting disorder)
Thrombocytosis (low blood platelets/damaged platelets, causing large amounts of bruises due to uncontrolled bleeding under the skin)
Melanosis (black or brown discoloration of the colon, usually due to chronic constipation)
Erythema nodosum (red-purple swellings on the legs and sometimes arms, with fever and joint pain)
In children:
Failure to thrive
Inability to concentrate
Emotional withdrawal or excessive dependence
Pale, malodorous, bulky stools
Frequent, foamy diarrhea
Wasted buttocks
Malnutrition:*With or without protuberant abdomen (with or without painful bloating)*
Muscle wasting of buttocks, thighs, and proximal arms*With or without diarrhea(as well as any number of the above diseases and disorders)
Additional information:
Reactions to ingestion of gluten can be immediate, or delayed for days, weeks or even months.
The amazing thing about celiac disease is that no two individuals who have it seem to have the same set of symptoms or reactions. A person might have several of the symptoms listed above, a few of them, one, or none. There are even cases in which obesity turned out to be a symptom of celiac disease. (In fact it is starting to be recognised that this is a VERY common symptom! There seem to be at least as many overweight Celiacs as there are underweight Celiacs.)