Categorized: Post-Diagnosis Follow-Up

Will I have trouble absorbing vitamins with celiac disease once in remission?

Someone with celiac disease on strict gluten-free diet should absorb needed vitamins without the need for special supplements, unless there’s: Incomplete healing (persisting symptoms, clinical signs of malnutrition, an abnormal repeat biopsy); or Laboratory evidence of nutritional deficiencies (anemia, low bone mineral density, low cholesterol, low prealbumin, low iron, etc.). We do, however, recommend a… Read more »

(Updated .)

Hi I am a 49 year old male from the UK who was diagnosed with celiac disease 2 years ago and I have been coping with the change in diet quite well. What I do seem to have a problem with is oats, I buy gluten-free oats and gluten-free cookies with oats and I seem to react to them. I am a full time fire fighter and I also like to run marathons so I need to keep my health in tip top condition. My question really is if the avelin protein would show a positive reading on my TGA test? If it is just a GI reaction to the higher fibre, could this be overcome? As I think I may have a similar reaction to lentils too.

Oats are safe for more than 99% of celiac patients. There is however the extremely rare one who does react to oats. The fact that this gentleman also reacts to lentils seem to me a good reason to suspect his gut does not agree too much with fibers (or, to use a more fashionable and… Read more »

(Updated .)

Does the villous atrophy present differently at the lab or look the same? In other words, with persistent villous atrophy after a gluten free diet, would the biopsy confirm active celiac disease and/or another cause?

It depends on what the pathologist describes. Villous atrophy is important and well defined, but if in addition the pathologist for instance describes intense neutrophilic infiltration, this would point toward something like Crohn’s, or with eosinophils, this could be eosinophilic enteritis, and so on. In a few words: villous atrophy is only part of the… Read more »

(Updated .)

What is refractory sprue?

Refractory sprue is the term used when persistently damaged villi in the small intestine are not repaired after the gluten free diet has been successfully initiated and/or maintained, and other potential causes for the damage have been ruled out.

(Updated .)

In follow-up blood testing, why would tTG be negative and DGP be positive?

If the slightly positive test is the DGP-IgA, you can disregard this value, as it can be misleading. If the DGP-IgG is positive it probably means you’re ingesting small amounts of gluten, possibly from cross-contamination, which are raising antibodies but not enough to trigger a tTG or a mucosal response. Basically, in either case you… Read more »

(Updated .)

How often should follow-up testing occur?

New celiacs should receive follow-up testing twice in the first year after their diagnosis. The first appointment should occur 3-6 months after the diagnosis, and the second should occur after 1 year on a gluten-free diet. After that, a celiac should receive follow-up testing on a yearly basis. We recommend checking both tTG and DGP… Read more »

(Updated .)