Thursday, November 6, 2008

Here We Go Again!

Well, if nothing else, it was fun to see Dr. Carter, a gastroenterologist I saw regularly for a good five years, today.

He agreed with my internist that my declining ferritin levels (despite iron supplements of 100 mg per day) and the failure of my Vitamin D levels to increase sufficiently means he should look closer to see if I've got Celiac Disease even though the blood tests were negative.

So I'm scheduled for an endoscopy on Dec. 22. I could have gotten in 10 days sooner but figured since Scott has to take Christmas week off work anyway, I might as well adhere to his schedule and not make him take any more work off than he has to.

Dr. Carter also mentioned another possible problem that's similar to Celiac Disease in some ways. I didn't catch the name of it -- if he even said -- but essentially there's a chemical reaction that has to happen in the stomach for iron to be absorbed. So he says it's possible that that reaction isn't happening properly.

In both that and the case of Celiac Disease, he says blood tests can be normal and even the inside of the stomach and duadonum can look normal. He says only biopsies of both can definitely confirm or rule out both diseases.

Meanwhile, while he's in there, he can check whether I have any throat damage from my reflux, and see how the scar tissue in my stomach looks. And of course, rule out that there's anything percolating in there right now since I've been having some renewed stomach issues in recent months. (Probably because I can't stay away from ibuprofin all the time as I'm supposed to.)

So, no big deal, really. I've had about half a dozen endoscopies before and I'm a pro at them, unfortunately. I have my doubts that I'll end up with a helpful diagnosis at the end of it, but you never know. And the fact that he'll be able to check out my reflux issue and rule out that I have a new ulcer starting, I think it's worth going through the endoscopy.


Joan said...


Everything you wrote is true: many many people do not test positive by the celiac panel (if they don't also do genetic testing). The biopsy will tell if there is damage to the villi and is considered the gold-standard diagnosis.

Hang in there.


Aviva said...

Thanks, Joan! Yes, Dr. Carter used the same phrase -- "the gold standard" -- and I laughed when he did because I remembered you and another commenter using that terminology last time we were looking at Celiac Disease as a possible diagnosis.

Are you familiar with the other disease he mentioned that I didn't get the name to? It involves a chemical in the stomach that is necessary to absorb iron and some people don't produce that chemical for some reason. Wish I knew what it was called. He said it was related to Celiac Disease but different.

I swear, when I get healthy again, I might have to apply to med school or something so I can use the medical jargon I've been learning ... :) (Although I didn't do well at the jargon for this one since I missed the name completely.)