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Question:

From Arizona, USA:

I have had type 1 diabetes for about two years, and after a year and a half my complaining about stomach pains my doctor checked for celiac disease. The test was higher than it should be, and I was sent to a gastroenterologist who did a scope and recently diagnosed acid reflux for which I now take medication. He did say that I don't currently have celiac disease but that I will probably develop it in a few years, and I was put on a gluten-free diet.

Is acid reflux common in people with diabetes? Can they tell if I will eventually develop celiac disease? A year ago, I had my appendix removed so could that have triggered something? I read that surgery can trigger celiac disease, is that true?

Answer:

I think that a biopsy is required to diagnose celiac disease, and one cannot tell by simply "just looking." Also, not all people with people with type 1 diabetes develop celiac disease. Therefore, based on your description, I do not feel that a "prophylactic" gluten free diet is justified. You should speak to the gastroenterologist and the other physicians involved in your care to confirm whether or not biopsies during the endoscopic procedure confirmed changes (or not) of celiac disease.

I am not aware that previous abdominal surgery triggers celiac disease or acid reflux disease. Acid reflux disease has been associated with a type of bacteria, however, called H. Pylorii.

DS

Additional comments from Dr. Donough O'Brien:

An appendectomy does not lead to celiac disease. Type I diabetes is a disorder of the immune system, and, in about 10% of cases, is linked to celiac disease which is also an autoimmune problem in what is now Autoimmune Polyglandular Syndrome Type II. Hypothyroidism is an even more common component of this disorder, and you should talk to your doctor about a TSH test for this.

In your case, I imagine that your blood test was positive for anti-glutamyl transferase antibodies, the specific test for celiac disease, but that the duodenal biopsy was still negative. In a sense therefore, you already have celiac disease in its very earliest form, and your doctor was right to put you on a gluten free diet firstly because this will prevent further problems in your upper small intestine but also because there is some evidence that even though the diet may be a nuisance it also prevents a certain kind of intestinal cancer called a lymphoma.

DOB

DTQ-20021216220054
Original posting 29 Apr 2003
Posted to Other Illnesses

  
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Last Updated: Tuesday April 06, 2010 15:09:46
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