MICROSCOPIC COLITIS SUPPORT

I'm curious as to what tests should be done to test for food intolerances/allergies. I'm being referred to an allergist but have no idea what test he will want to do (skin vs blood).

I know people here have mentioned a stool sample test and a lab. I need to look into that some more.

Thank you!

Hi Karen,

The allergist will order blood tests designed to detect IgE (and maybe IgG) antibodies in the blood. If she or he does any skin tests those will be IgE tests. IgE tests are used to detect classic allergic reactions. (These are mast cell reactions where histamines and other inflammatory mediators are released to cause itching, swelling, redness, etc.). IgE antibodies are the ones that cause watery eyes, sneezing, itching, rash, etc., and in severe cases they can cause life-threatening anaphylactic reactions. IgG antibodies are simply markers of chronic IgE-based reactions. The skin tests are mostly useful for skin allergies, and have little value for most MC Patients.

Unfortunately, while many of us also have IgE antibody issues, these are not the cause of the intestinal inflammation associated with MC. The mechanism described in the medical literature as the classic cause of MC is T-cell promoted inflammation. T-cell activation can have many causes when the disease is initially triggered. But as the symptoms become chronic, this mode of inflammation is perpetuated by antibodies produced in response to food sensitivities within the digestive system. The proliferation of T-cell infiltration into the mucosal lining of the intestines is in response to IgA antibodies produced by the immune system in response to food sensitivities.

Because of that, and the absence of proper training in med school, most allergists aren't even aware of the fact that IgA antibodies promote intestinal inflammation. All they understand is IgE and IgG antibodies, because that's all they've studied. As a result, their testing methods are somewhat irrelevant to MC, though occasionally some of the foods that show positive test results will also show positive results when tested for IgA antibodies (in stool). But even if allergists tested for IgA antibodies (in blood), the antibodies are produced in the gut, not in the blood, so the blood level of IgA antibodies caused by food sensitivbities is so low that the tests are very unreliable due to lack of sensitivity.

For example, it often takes years for enough antibodies to build up in the blood to yield a positive celiac test result (based on IgA and IgG antibodies). By that time the patient has typically suffered from clinical symptoms for many months or years, and their intestine has accrued severe damage. But a stool test will detect the antibodies even before clinical symptoms appear. IOW, the stool tests are several orders of magnitude more sensitive, and they will detect celiac disease several years sooner (in most cases) than the classic celiac blood tests.

If you're interested in stool testing, here's a link to the basic information on the tests that most members (who order testing) order. Most order the combination of the A1 + C1 test panels. Some only order the A1 panel. The A1 panel tests for the 4 main food sensitivities, gluten, casein, soy, and eggs. The C1 panel tests for 11 additional foods that often cause problems.

https://www.enterolab.com/StaticPages/T ... #PanelA1C1

I hope that some of this is helpful.

Tex

A link to discussions about Enterolab testing
http://www.perskyfarms.com/phpBB2/viewforum.php?f=67

Discussions about why other food allergy testing (blood or skin) are not the best indicators for MC type reactions
http://www.perskyfarms.com/phpBB2/viewtopic.php?t=21227

Thank you Tex and Gabes! I found the test sub-forum shortly after I posted here. So much to read and consider.
Thanks! : )

Stools back to my lifetime “normal” in frequency/consistency before all hell broke loose w/ MC-L in 3/17!

EnteroLab Results:

Fat Malabsorption: Less than 300 which is normal
Anti-gliadin: 60 units (less than 10 is normal)
Anti-casein: 14 units (less than 10 is normal)
Anti-ovalbumin: 5 units (less than 10 is normal)
Anti-soy: 10 units (less than 10 is normal)
Mean value 11 Antigenic Foods: 10 units (less than 10 is normal)

0 reactivity: Beef, Chick, Pork, Tuna, Walnut, Cashew, White potato
+1: Corn, Rice, Almond
+2: Oat, Wheat
+3: Nothing
Anti-casein: 14 units (less than 10 is normal)

Currently: Moved from Gabes’ Level 1 Eating Plan to Level 2 @2 wks ago, adding foods suggested and using the 3-day methodology, and still GF. Daily use of rice, .75 oz cheddar cheese, and almond butter.

Questions on Lab results:

1) Peanut butter? Used up entire jar of natural p-butter w/ no problems. Currently using almond butter, but discontinue after lab results, move to cashew butter, right?
2) Quinoa?
3) Millet, once gut is healed so I can TRY seeds and nuts.
4) No almond flour for baking, use coconut flour, right?
5) Discontinue rice, cheddar cheese .75 oz, and almond butter, right?
6) No corn tortillas, right?

I was doing really well, but looks like I have to remove most things other than meats, eggs, veg and fruits. Feeling a little defeated...If possible, just simple “yes/no/maybe so” answers are enough. Thanks to those of you have time to respond!

Hi Linda,

You may not need to change anything. With a score of only 10 on the 11 other antigenic foods, those items in the +1 category may be OK. We all react to wheat and most of us react to oats, so you should avoid those.

Linda wrote:1) Peanut butter? Used up entire jar of natural p-butter w/ no problems. Currently using almond butter, but discontinue after lab results, move to cashew butter, right?

With soy at 10, you may or may not be able to tolerate peanut butter (it's a legume). Almond butter will probably be OK

Linda wrote:2) Quinoa?

Many of us react to quinoa.

Linda wrote:3) Millet, once gut is healed so I can TRY seeds and nuts.

Millet should be OK except that testing shows that a lot of the millet flour in supermarkets is cross-contaminated with gluten — it probably gets contaminated during the milling process.

Linda wrote:4) No almond flour for baking, use coconut flour, right

As noted above, almond flour may be OK, especially if you don't overdo it, or eat it every day.

Linda wrote:5) Discontinue rice, cheddar cheese .75 oz, and almond butter, right?

Yes on cheese, maybe on rice and almond butter. Rice and almond butter occasionally should be OK. If you eat them every day they might or might not cause any problems. You'll just have to determine this by how your body reacts, because the test results are borderline.

Linda wrote:6) No corn tortillas, right?

They may be OK, especially if you don't eat them often or in large amounts.

Tex

Hey, Tex -

Thanks SO much for responding so quickly! Husband and I were anxious to get the results...they were posted only 1 day after the lab received my specimen! VERY FAST! Then came that sinking feeling when I realized that +1 for Corn/Rice & +2 for Oat/Wheat meant basically removing ALL grains. With my lab results, is there a grain I could try?

Also, something I have been eating is causing a little negative change in my stool the last week. I checked my journal to see if I had something different. Now seeing the lab results, I’m thinking the culprits may be the rice and almond butter I had 2-4 times daily for 2 weeks. I will take your responses/suggestions and see if that changes positively. At least I can use eggs...greatful for that!

Just have to keep reminding myself that I actually have good lab results compare to SO many folks I have read on this site. AND I am SO blessed to have found this site so that I don’t feel alone on this journey, I can get TONS of info here, and am surrounded by many who have MC and provide SO much support to all of us!

HI Linda,

My results weren't nearly this nice, and I was able to rotate White rice (I used the minute rice in the red and white box) and since you seem to be able to have white potato you have options of using white, yellow, and red potato and then if you feel like rice you can have a portion of it, otherwise you don't need to eat it at all if you don't want to.

I also rotated and eat a little corn or products with corn in them, and I cook with almond milk, I do use a SILK non dairy creamer made with almond milk for my coffee, but there again, it is less than a 1/4 cup of it a day.

Your results are very good indeed! You can do this :-)

long story short, minimal grains and minimal flours is not a bad thing - if anything it is the best way to optimise healing and long term wellness!!

we just have to change our mindset and approach to eating / living life.

Gabes, I remember reading about your airlines eating pla and you used rice cakes. I was planning on doing that in Sept as we are taking a trans-Canadian train excursion lasting 19 days. Now, I have no idea what will work to take or buy while on that trip. W3 have already told them that my food has to be GF, but I’m guessing it might be as you experienced, salad, fresh fruit, etc, and I can’t eat any of that. Do you have any suggestions? I would love to hear from anyone who has some ideas given my test results under my profile flag. Thanks, in advance!

travel now i focus on protein...

eggs, avocado, safe meats.
pre make fritatta type thing with small amount of safe veges, eggs, safe meats. Freeze in portion size, can eat cold if need be

order extra boiled eggs with breakfast to take with you as snack
others here have used jerky cold meats

the most recent Microscopic Colitis Foundation newsletter had info/submissions about MC safe eating while travelling
we also have a travel section within the forum and this also contains lots of good ideas/suggestions

Hi Erica P-G,

Thanks for your suggestions, I had the same thoughts you mentioned, so I started reducting my intake of rice today. Switched from almond butter to cashew butter. Will use my corn tortillas sparingly, haven’t tried them at all yet. Also started my reduction today of almond milk, almond butter, and rice/almond crackers. Thanks for your ideas, I will certainly be looking for the pattern that works best for my gut health and will post how that goes.

Gabes, thanks for those suggestions! I will check out the travel ideas on the forum...didn’t realize that section existed, haven’t seen it. Will also try to find the newsletter you mentioned.

link to the MC foundation newsletter
http://www.microscopiccolitisfoundation ... etter.html

link to the travel section
https://perskyfarms.com/phpBB2/viewforum.php?f=62

Hi, Erica -

You were very specific in your post to me about using the minute rice. I use the regular cooked rice (Jasmine, long grain white, etc). Is the minute rice less likely to be an issue if I have a +1 lab rating for rice and don’t use it every day?