What to expect at the Gastroenterologist

Saturday, April 3, 2010

As many of you know, after suspecting I had a gluten intolerance I stopped eating gluten-containing foods last spring. We're coming up on a year now since I had a slice of baguette, or a real beer. Sigh. I digress.  So I finally made an appointment and saw my family doctor in ...December...yeah, that's right. My family doctor was hesitant to do any testing on his own and instead referred me to a gastroenterologist. My appointment was finally made, and I would have to wait until March 24.

The magic day came (and believe me, this is apparently not a long waiting list in comparison to most- long live "free" healthcare) so I totally prepared myself. I jotted down a history, what I had done since childhood to reduce my stomach pain (a constant in my life) and described the feelings that had intensified in recent years, my severe iron deficiency, etc. He interrupted me and asked if I'd been tested for Celiac; I said "just hang on- I'm getting to that". So I described having seen the naturopath and thinking after my strict elimination diet (which, I've gotta tell you, I'm due for again) that I may also have a gluten intolerance. As soon as I told him I'd gone off gluten, he sighed. This was expected. Let me give you one piece of advice: no matter how much it hurts, have the blood test and biopsy before you stop eating gluten. So he told me there was not that much we could do, given that I'd stopped eating gluten, but I told him I thought I'd probably contaminated my food so many times, there should be some residual tTG, IgA antibodies left- hopefully they'll be high enough to indicate a problem. In addition, I asked him to perform the genetic test for Celiac- just so I could rule it out as a possibility. Not that I still couldn't have an intolerance, but at least I would know that there is likely something else causing me problems- like milk.

I also asked him if he could test me for food allergies to milk, corn, wheat...some of the things I think I've isolated as being reactive to. He said no. He said they don't do that....that maybe I could see an allergist, maybe I could get a skin prick test done...but it wouldn't help me figure out intolerances. I showed him the IgG antibody test I had done. He told me this was not of any value- that the presence of an IgG antibody, did not actually indicate a correlation to any food intolerances. I suspected he would say that. He said "people come in here all the time with stuff like that, and it's meaningless". Well no s*&t Sherlock- if you offer no alternative, when people think they're eating something that makes them sick, they'll look to other methods to discover if it really IS x, y or z that is making them react. What's a girl to do?

I suppose (as much as it pains me to admit it) the only true way to figure out food intolerances is slowly, steadily, one food at a time, in an elimination diet. I have pretty much eliminated corn from my diet but every now and again if I have nachos or just a handful of corn chips, I don't feel well the next day. Do I really need a blood test of some kind to tell me that I'm reacting to corn? Probably not. I went away and had three cheese omelettes in 24 hours. I felt like death for a week. I don't really know if it was the cheese, the eggs or both, but do I now know that I can't eat cheese omelettes? Clearly.

Anyways, I should get my results back soon, come to think of it. The next day though, I actually went and saw "the boy's" doctor to figure out if we need to do anything for him. His doctor asked me what my heritage is- I told him I was 1/2 Scandinavian. He smiled and said "and what do we know about Scandinavians"? Aside from us being tall, blonde and exquisite conversationalists? Dunno. He said 80% of Scandinavian adults are lactose intolerant. Which is kind of funny because apparently some of the countries in that region have the highest dairy use. Hmmm...  Anyways, he suggested that we do a generalized blood draw on the boy, as we had never done one, and he would check for some indicator of allergenic activity. If it was positive (or high) it would be worthwhile sending him to an allergist. But I was to wait until my own tests came back, because if I were positive for IgA or Celiac, I should actually do the IgA test as well on the boy. The boy was growing increasingly freaked out at the possibility of a blood draw. That won't be a fun day. But we will wait until I know first.

The plan for the boy involved the use of Lactaid pills for a week (but still no dairy) then the reintroduction of dairy with doses of Lactaid. He is hopeful this will stem the tide of stomach pain complaints from my poor little boy. I hope so too...  I also bought the adult version of the enzyme for myself, and have used it a few times when I've had something with dairy. Let's just say, so far I'm not too impressed.

Last night I ate a whack load of those mini eggs from Cadbury at a friend's place. I discovered (after shovelling them in my gob of course) that of course there is milk in them (I only eat dark chocolate which does not have dairy in it now and had forgotten) and that there is some element, though not printed on the package, that is apparently not safe for Celiacs. I don't know this to be 100% accurate, but I was experiencing some wicked gut cramps about an hour after leaving their house so it of course seemed a great time to do a wee Google search and check on the safety of the food I had ALREADY consumed en masse. D'oh.

Okay, that's enough for today! I hope everyone is enjoying a lovely long weekend. It's summer-like here and we're going on a bike ride today.

Keep reading those labels. :)


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