Do I have two different diseases?

[mle_ii]

Meaning is my Gluten Intollerance a separate disease from my Microscopic Colitis?

That said, I see how one might affect the other or even cause the other, but aren't they two separate entities?

One reason I ask is that some here have MC, yet don't have problems with gluten for one reason or another. The other reason is perhaps even if I get the gluten out of my diet and I have no other food intolerances there is still the disease of MC that I have which supposedly has no known cure.

Thanks,
Mike

[kate_ce1995]

I think that is a good way to look at it with the caviat that the gluten sensitivity likely triggered the MC. I believe my MC was triggered by ibuprofen use, although I was developing gluten sensitivity symptoms before the MC hit (the aches and pains). My chronic D went away with the reduced use of NSAIDs, which leads me to think biopsies might not show MC now, although when I ingest gluten more than once relatively consecutively, I do get a change in my stools from large, sinking Normans, to greasier, thinner, floaters. But its not what I'd call D.

Katy

[TendrTummy]

Mike,

Here's my take on it:

I was genetically predisposed to gluten sensitivity. Eventually I snapped and GOT gluten sensitivity one day. only THEN did my Microscopic Colitis symptoms appear. In fact, I've tested negative for Colitis since adopting the GF diet (by biopsy in colonoscopy). This doesn't mean I don't HAVE it, but it's certainly a good indicator that it might be in remission due to the diet, because obviously the places the doc biopsied the second time did not show signs of LC.

Anyway, my understanding, which I got from Dr. Fine and his associates, is that when you are sensitive to gluten, egg, corn, yeast, soy, milk, etc, and you ingest it, your antibodies attack it wherever it is in your digestive system. Most times, this would be your colon; however, my gall bladder was also involved, and has since been diseased and removed.

Now that I'm not ingesting my sensitivities anymore, my body is no longer attacking my colon or other digestive organs. (and we're talking from mouth to anus here - gums, throat, tongue, esophagus, stomach, intestines, rectum, gall bladder, kidneys, liver, anywhere the food GOES when digesting) And while I don't exactly FEEL great all the time, it might be either because I have other sensitivies yet to be identified, or that I'm still in a "healing" phase gut-wise.

That said, yes, Gluten Sensitivity is a separate entity from Microscopic Colitis; HOWEVER, they tend to run in the same groups because GS can cause MC. GS can also cause many other disorders and auto-immune disorders, such as migraines, insomnia, depression, anxiety, etc.

Christine

[tex]

Hi Mike,

I've always thought that the issue was a matter of semantics. IOW, in order to be officially classified as a victim of celiac sprue, you have to meet certain rigid test requirements. I've always felt that those requirements were arbitrarily set, which makes the definition of a diagnosis of celiac sprue an arguable issue, in my opinion. I've always felt that if it walks like a duck, quacks like a duck, etc., ....

Of course, on the other hand, a lot of diseases share common symptoms. If this were not the case, diagnosis would be rediculously simple. Unless/until the powers that be, decide to change the definition of celiac disease, you have microscopic colitis, and the gluten sensitivity is just a feature of the MC.

The fact of the matter is, though, it's very rare for someone with MC to not be gluten sensitive to some degree. In the final analysis, if we are only mildly sensitive, just how good we are at testing ourselves, and analyzing the results, usually determines whether or not we decide that we are, or are not, gluten sensitive. (Unless, of course, we send a stool sample for lab analysis).

Tex

[mle_ii]

Thanks for the feed back, both of you. :)

I'm curious where I can read what is actually going on physiologically in my gut with regards to MC and Gluten Intollerance.

I think I have a pretty good idea on the Gluten aspect. Antibodies are produced which attack the foreign invader (gluten protein). The production of antibodies causes inflamation or is part of the process of creating antibodies? The inflamation of the colon leads to diarrhea because water cannot be absorbed (or at least not as well), and anemia (and all its problems) due to the diarrhea.

[mle_ii]

Hi Mike,

I've always thought that the issue was a matter of semantics. IOW, in order to be officially classified as a victim of celiac sprue, you have to meet certain rigid test requirements. I've always felt that those requirements were arbitrarily set, which makes the definition of a diagnosis of celiac sprue an arguable issue, in my opinion. I've always felt that if it walks like a duck, quacks like a duck, etc., ....

Of course, on the other hand, a lot of diseases share common symptoms. If this were not the case, diagnosis would be rediculously simple. Unless/until the powers that be, decide to change the definition of celiac disease, you have microscopic colitis, and the gluten sensitivity is just a feature of the MC.

The fact of the matter is, though, it's very rare for someone with MC to not be gluten sensitive to some degree. In the final analysis, if we are only mildly sensitive, just how good we are at testing ourselves, and analyzing the results, usually determines whether or not we decide that we are, or are not, gluten sensitive. (Unless, of course, we send a stool sample for lab analysis).

Tex

I think you're right. I'm leaning more and more towards thinking I have CD, not just gluten intollerance, but the blood test doesn't show me as having it.

[moremuscle]

Hi Mike,

I don't blame you for wondering and being confused about these issues - it is confusing and I think we are all somewhat confused because we don't fit into the categories in the way that some people do. We DO fit into the category of people with MC, yes. But we don't meet the standard criteria for CD; however, we are undoubtedly sensitive to gluten just the same - we just don't necessarily have villus atrophy and/or test positive for antibodies in the blood test that is given.
The genes for gluten sensitivity and some other AI diseases are related and close to the genes that predispose for MC - this is why we tend to get more than just one "thing" when those genes are triggered to turn on. Are they the same disease or two different diseases? Well, in some ways I tend not to see gluten sensitivity or CD as a disease Our genes just program the immune system to recognize certain proteins as being "bad guys" - when we avoid the "bad guys" the immune system doesn't attack anything and we are well - not sick.

I think much of this debate boils down to who came first, the chicken or the egg?

I think it is easier for other people to relate to you if you say to them that you have CD - OK, then they think they know what it is and they don't try to stuff you with some gluten when you are not looking. They take you seriously. If you say, no you don't have CD but you are GS, they may simply think you are a bit of a hypochondriac.

Love,
Karen

[tex]

Mike,

Regarding your comments on water absorption in the colon, as related to MC: a lot of people don't realize this, but MC can cause a type of diarrhea known as secretory diarrhea, which is characterised by a reversal of the normal role of the colon. IOW, the colon actually releases copious amounts of water into the lumen, rather than to absorb it. This is what contributes to the surprising volume and urgency. It's the equivalent of an autoinduced enema. Presumably this reaction is designed to try to flush out the irritants, and to help protect the mucosal surface.


Karen,

You've got a good idea there. Since a few people have actually heard of CD, it's probably a lot easier and faster to make a convincing plea on that basis. I'm gonna try that, the next time it comes up.

Love,
Wayne

[mle_ii]

Mike,

Regarding your comments on water absorption in the colon, as related to MC: a lot of people don't realize this, but MC can cause a type of diarrhea known as secretory diarrhea, which is characterised by a reversal of the normal role of the colon. IOW, the colon actually releases copious amounts of water into the lumen, rather than to absorb it. This is what contributes to the surprising volume and urgency. It's the equivalent of an autoinduced enema. Presumably this reaction is designed to try to flush out the irritants, and to help protect the mucosal surface.

That was a rather interesting bit about the reverse water flow in the colon for MC, I had no idea about what that term meant. I should have looked it up. I wonder why it seems that I don't have this problem per se when others do. I get D but rarely now, and not as bad as the many times during the day that seem to plague folks here.

[mle_ii]

Back to CD, I saw this and it sounded familiar.

Untreated celiac disease can cause temporary lactose intolerance. Lactose is a sugar found in dairy products. To be digested it must be broken down by an enzyme called lactase. Lactase is produced on the tips of the villi in the small intestine. Since gluten damages the villi, it is common for untreated celiacs to have problems with milk and milk products. (Yogurt and cheese are less problematic since the cultures in them break down the lactose). A gluten-free diet will usually eliminate lactose intolerance. However, a number of adults (both celiacs and non-celiacs) are lactose intolerant even with a healthy small intestine; in that case a gluten-free diet will not eliminate lactose intolerance.

Celiacs often suffer from other food sensitivities. These may respond to a gluten-free diet--or they may not. Soy and MSG are examples of food products that many celiacs have trouble with. However, it should be noted that these other sensitivities, while troublesome, do not damage the villi. As far as we know, only gluten causes this damage.

[TendrTummy]

PostPosted: Wed Jul 06, 2005 9:49 pm Post subject:
Thanks for the feed back, both of you. :)

I'm curious where I can read what is actually going on physiologically in my gut with regards to MC and Gluten Intollerance.

Not sure how to use the quote feature.. so excuse me if this is messed up..

Mike,
I was told the physiology you described by one of my docs.. I dunno about documentation of it. I'll look around for that at work tomorrow (I google while I work), see what I can find, if anything..

Christine

[Jean]

Mike,

I think that MC, Celiac, Fibromyalgia, Arthritis, IBS, and all the other autoimmune diseases will someday be lumped together as one disease. I think this because I believe that the same thing is happening in each of these diseases, even though the symptoms present differently.

Jean

[Lucy]

Hi Mike,

Don't know that this will help you too much, but since my decades-long struggle with migraines left and never came back once off the gluten, I would have to assume that they were caused by immune reactivity to gluten.

This being the case, and since the first GI symptoms I can remember didn't come until at least a decade after I remember having migraines, I have to assume that I was gluten sensitive for a long, long time before I developed M.C./Celiac. There were other common non-GI symptoms which were long standing as well.

Think it would take a pretty sharp diagnostician to suspect gs by putting together some of these early non-GI symptoms, but then I doubt many of them would want to put someone on a gf diet if they didn't test positive on the blood test, so there ya have it.

Yours, Luce

[Polly]

Hi Mike,

I'll also take a stab at explaining our very complex diseases - it IS so confusing - no wonder we can't understand it.

Yes, there are two separate autoimmune-type diseases- MC and gluten sensitivity. But they are related by virtue of the fact that they are both directed by our HLA genes. In fact, probably most autoimmune (AI) diseases "travel" on these genes. So that when one HLA gene "turns on", others nearby can do the same.

Dr. Fine believes that the gluten sensitivity does not cause the MC.....rather, that it makes the MC worse. You might want to review his discussion of "microscopic colitis" at www.finerhealth.com again. He addresses the question of the difference between the two diseases.

Also, here is a major difference that many folks do not fully appreciate.
MC damages the LARGE intestine, while gluten sensitivity/celiac disease damages the SMALL intestine.

Hope this helps.

Love,

Polly

[TendrTummy]

Mike,

I looked into this a bit more, the physiology portion, and actually, I found a new website/laboratory for us.. http://www.biodia.com/test230.html.

On this page, it describes the physiology of the tests used to diagnose Celiac and GS, and it's actually very interesting! This paragraph in particular:

ANTI-TRANSGLUTAMINASE ANTIBODY, IgA : Human tissue transglutaminase is an enzyme-linked immunosorbent assay (ELISA) for the detection of IgA antibodies to tissue transglutaminase (endomysium) in human serum. Detection of these antibodies is an aid in diagnosis of certain gluten sensitive enteropathies such as celiac disease and dermatitis herpetiformis. Celiac disease and dermatitis herpetiformis, two recognized forms of gluten sensitive enteropathy (GSE) are characterized by chronic inflammation of the intestinal mucosa and flattening of the epithelium or positive “villous atrophy”. Intolerance to gluten (gliadin), the protein found primarily in grains such as wheat, rye and barley causes GSE. Patients with celiac disease may suffer from diarrhea, gastrointestinal problems, anemia, fatigue, psychiatric problems and other diverse side effects or they may be asymptomatic. Dermatitis herpetiformis is a skin disease associated with GSE. All GSE patients have an increased risk of lymphoma. A gluten-free diet controls GSE and associated risks.

I'm going to look more into this Dermatitis Herpetiformis stuff! inflammation of the derma which is the outter layer of skin, but I'm not sure what Herpetiformis means, and it says both are to do with enteropathy, which is a disease of the small intestine, so maybe it's inflammation of the outter layer of skin on your small intestine. Anyway, interesting to say the least. Unfortunately, I've been sofar unable to locate a clear description of the physiology of an IgA reaction.. I'll keep looking tho!!!

Oooh, here's another interesting paragraph:

Conditions Assessed
Conditions that may be assessed include celiac disease, sub-clinical gluten intolerance and overall immune system viability. Sequelae include maldigestion and malabsorption of proteins, carbohydrates, and fats, which in turn can lead to a variety of chronic degenerative disorders, including autoimmune, cardio vascular disease and cancer.

Kinda explains how celiac disease turns INTO issues like autoimmune disorders, like Fibromyalgia or hyperthyroidism. Also notable is that GS increases your risk of Lymphoma.

UPDATE -

Ok, I found another portion of that website that describes the physiology of an IgA reaction:
Physiology
A healthy adaptive immune system is able to readily distinguish self proteins from non-self proteins. Any protein that is non-self elicits an antibody response in someone with a healthy adaptive immune system. Under certain circumstances, via a mechanism called molecular mimicry (cross reactivity) the adaptive immune system can lose its ability to distinguish self from non-self, thus resulting in the production of antibodies to human tissues, enzymes and/or hormones. The immune system can cross over and create antibodies to human proteins for a variety of reasons some of which are related to long term chronic infections, excessive immune complexes (antigen complexes), TH2 dominance and a variety of other chronic stressors.

this was taken from: http://www.biodia.com/test_autoantibodies.html

Despite the lack of pictures, VERY interesting.

Christine