Hello everyone
I'm new here and have been reading all the fantastic information on this forum avidly for the last couple of months or so, as well as reading Wayne Persky's book.
Since the beginning of a (light) MC flare up last September (2021), I've been gluten and dairy free. Based on the recommendations of the book, I also went completely soy, egg, oat, rye and barley a couple of months ago. As a result, I was free of diarrhoea from a month ago, returning to my normal condition of constipation. On Friday I had a colonoscopy and have just received the result of the biopsies. The result: I am free of inflammation -- NO MICROSCOPIC COLITIS. This contrasts to a diagnosis of microscopic diagnosis five years ago. However, since then I have had another flare up as a result of the colonoscopy.
I also sent in a sample to Enterolab for testing and received the result on Thursday, which is below. It shows that I have (very) high levels of food sensitivities.
I would be so grateful if you could help me with the following questions:
1. How can the very high food sensitivities and flare ups be explained in the light of the biopsy results?
2. My mean value for antigenic foods is 49, which I believe is very high. How is this to be interpreted? What food plan is to be recommended in the light of this result (combined with the results for individual food sensitivities)?
3. I also suffer from migraine (over 40 years) and am following the recommendations on magnesium. So far with success - no migraine for a month! Will this help my constipation?
Thank you thank you thank you so much in advance for all the help, for this forum and for the great book!
Fecal Anti-gliadin IgA 38 Units (Normal Range is less than 10 Units)
Fecal Anti-casein (cow’s milk) IgA 35 Units (Normal Range is less than 10 Units)
Fecal Anti-ovalbumin (chicken egg) IgA 79 Units (Normal Range is less than 10 Units)
Fecal Anti-soy IgA 30 Units (Normal Range is less than 10 Units)
Mean Value 11 Antigenic Foods 49 Units (Normal Range is less than 10 Units)
While all of the foods tested can be immune-stimulating, the hierarchy of reactions detected were as follows:
Food to which there was no significant immunological reactivity:none; Food to which there was some immunological reactivity (1+): white potato; Food to which there was moderate immunological reactivity (2+): Corn, Rice, Pork, Beef, Tuna, Walnut, Almond; Food to which there was significant and/or the most immunological reactivity (3+): Oat, Chicken, Cashew
Within each class of foods to which you displayed multiple reactions, the hierarchy of those reactions detected were as follows:
Grains:
Grain toward which you displayed the most immunologic reactivity: Oat
Grain toward which you displayed intermediate immunologic reactivity: Corn
Grain toward which you displayed the least immunologic reactivity: Rice
Meats:
Meat toward which you displayed the most immunologic reactivity: Chicken
Meat toward which you were next most immunologically reactive: Pork
Meat toward which you displayed intermediate immunologic reactivity: Beef
Meat toward which you displayed the least immunologic reactivity: Tuna
Nuts:
Nut toward which you displayed the most immunologic reactivity: Cashew
Nut toward which you displayed intermediate immunologic reactivity: Walnut
Nut toward which you displayed the least immunologic reactivity: Almond
Helen
Enterolab and biopsy results - help!
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Re: Enterolab and biopsy results - help!
Thank you Helen for this post. I am also new to this group and look forward to the responses to your Enterolab results. I have many food sensitivities but I have never done the Enterolab testing and plan to do it soon. Being new I have nothing to offer but I look forward to the groups response to your post and hope that you find a way to balance. All the best, Laura
Diagnosed with CC, Hashimoto Thyroid, Costochondritis, psoriatic arthritis and psoriasis. Cannot eat gluten, dairy, nightshades, and high oxalate veggies.
Re: Enterolab and biopsy results - help!
Hello Helen,
Since this is your first post, welcome aboard. I'll try to answer your questions as best I can. There are a number of ways that a gastroenterologist can completely miss the markers of microscopic colitis (MC) when performing a colonoscopy, but most of them are due to either inexperience, or incompetence. To begin with, one must know how to look for MC in order to be able to find it. MC does not cause full coverage of the mucosal surface of the colon with inflammation. Instead, the inflammation appears as random scattered areas, on an otherwise normal mucosal surface. The inflammation can normally be seen through the scope as slightly darker pink patches of inflammation, scattered on an otherwise normal appearing lighter pink mucosal surface. But unless the doctor is aware of this characteristic, he or she will almost always overlook, or ignore the inflamed areas. For example, when my colonoscopy was done, over 20 years ago, I could easily see the areas of inflammation on the monitor screen, and I asked the doctor what those were. He simply shrugged them off as probably old sites of infection. MC wasn't even on his radar.
An inexperienced doctor often lucks out and happens to take biopsies from the right places by accident, but the bottom line is that, if the biopsy samples are not taken from inflamed areas, then MC will be missed in the diagnosis. Some doctors only take biopsies from certain areas of the colon, and thereby miss the inflamed areas. If they don't know what they're looking for, they need to take many biopsy samples from many areas of the colon from one end to the other. In cases where the MC is drug-induced, the left side colon tends to be more inflamed. But in most non-drug-induced cases, the Inflammation tends to be progressively more widespread at the proximal end (right, or upper end) of the colon, and in the terminal ilium.
MC is a lifetime disease, once it develops. When it's not active, colonic mucosal cellular homeostasis will eventually be reestablished, so that a colonoscopy will show no evidence of MC but I doubt that this was the case in your situation, since you had symptoms of active disease. Normally, it takes 5 to 10 years of healing, to reach cellular homeostasis. But whether the markers of MC show up under a microscopic examination of colonic biopsy samples, or not, the disease will typically become active again if we begin to eat gluten, or any of the other big four (casein, soy, chicken egg) food sensitivities (if our EnteroLab test results are positive for those respective foods).
Before you try to figure out a recovery diet, I suggest you read a newsletter published by the Microscopic Colitis Foundation, about a year ago. Newsletters are published monthly, and any of them can be downloaded for reading or printing. You can also sign up for an email subscription to the newsletter so that you don't miss any issues. Here's a direct link to the newsletter recommended above, for your convenience:
https://www.microscopiccolitisfoundatio ... 479987.pdf
With a score of 47 on the 11 other antigenic foods, it will probably be necessary to avoid all 2+ and 3+ foods. Traces may not be a problem, so avoiding them is not as important as it is with the "big four" food sensitivities, but they all should be generally avoided, at least until you've reached remission and healed for a while. This should get you started, and you can ask questions at any time. Published medical research shows that magnesium is a treatment for migraines, but most doctors seem to be oblivious of that fact, and they prefer to write prescriptions for medications that treat the symptoms, rather than treating the cause. And yes, constipation is a symptom of a chronic magnesium deficiency, so magnesium should help to relieve your constipation issues. Switching to magnesium citrate should further help to reduce constipation problems, since it has additional laxative properties, especially in higher doses.
Again, welcome to the group, and please feel free to ask any questions.
Tex
Since this is your first post, welcome aboard. I'll try to answer your questions as best I can. There are a number of ways that a gastroenterologist can completely miss the markers of microscopic colitis (MC) when performing a colonoscopy, but most of them are due to either inexperience, or incompetence. To begin with, one must know how to look for MC in order to be able to find it. MC does not cause full coverage of the mucosal surface of the colon with inflammation. Instead, the inflammation appears as random scattered areas, on an otherwise normal mucosal surface. The inflammation can normally be seen through the scope as slightly darker pink patches of inflammation, scattered on an otherwise normal appearing lighter pink mucosal surface. But unless the doctor is aware of this characteristic, he or she will almost always overlook, or ignore the inflamed areas. For example, when my colonoscopy was done, over 20 years ago, I could easily see the areas of inflammation on the monitor screen, and I asked the doctor what those were. He simply shrugged them off as probably old sites of infection. MC wasn't even on his radar.
An inexperienced doctor often lucks out and happens to take biopsies from the right places by accident, but the bottom line is that, if the biopsy samples are not taken from inflamed areas, then MC will be missed in the diagnosis. Some doctors only take biopsies from certain areas of the colon, and thereby miss the inflamed areas. If they don't know what they're looking for, they need to take many biopsy samples from many areas of the colon from one end to the other. In cases where the MC is drug-induced, the left side colon tends to be more inflamed. But in most non-drug-induced cases, the Inflammation tends to be progressively more widespread at the proximal end (right, or upper end) of the colon, and in the terminal ilium.
MC is a lifetime disease, once it develops. When it's not active, colonic mucosal cellular homeostasis will eventually be reestablished, so that a colonoscopy will show no evidence of MC but I doubt that this was the case in your situation, since you had symptoms of active disease. Normally, it takes 5 to 10 years of healing, to reach cellular homeostasis. But whether the markers of MC show up under a microscopic examination of colonic biopsy samples, or not, the disease will typically become active again if we begin to eat gluten, or any of the other big four (casein, soy, chicken egg) food sensitivities (if our EnteroLab test results are positive for those respective foods).
Before you try to figure out a recovery diet, I suggest you read a newsletter published by the Microscopic Colitis Foundation, about a year ago. Newsletters are published monthly, and any of them can be downloaded for reading or printing. You can also sign up for an email subscription to the newsletter so that you don't miss any issues. Here's a direct link to the newsletter recommended above, for your convenience:
https://www.microscopiccolitisfoundatio ... 479987.pdf
With a score of 47 on the 11 other antigenic foods, it will probably be necessary to avoid all 2+ and 3+ foods. Traces may not be a problem, so avoiding them is not as important as it is with the "big four" food sensitivities, but they all should be generally avoided, at least until you've reached remission and healed for a while. This should get you started, and you can ask questions at any time. Published medical research shows that magnesium is a treatment for migraines, but most doctors seem to be oblivious of that fact, and they prefer to write prescriptions for medications that treat the symptoms, rather than treating the cause. And yes, constipation is a symptom of a chronic magnesium deficiency, so magnesium should help to relieve your constipation issues. Switching to magnesium citrate should further help to reduce constipation problems, since it has additional laxative properties, especially in higher doses.
Again, welcome to the group, and please feel free to ask any questions.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
-
Helen Baumer
- Posts: 8
- Joined: Tue Apr 12, 2022 12:27 am
Re: Enterolab and biopsy results - help!
Hello Tex
Thank you very much for your long and helpful answer. I am very happy you say that my MC is definitely not healed since that is also my opinion. It is clear to me that I need to continue watching my diet very carefully for a long time.
I'm also happy that magnesium will help my constipation, although I would hesitate to switch to magnesium citrate. This has been prescribed to me by my neurologist (for migraine) more than once and each time it instantly gave me diarrhoea and I had to abandon it. That is why I have never taken magnesium up to now. Thanks to your excellent overview of different magnesium compounds I now understand why this approach failed. However, your route of using Doctor's Best Chelated Magnesium and upping the dose very gradually is working well for me.
I wonder if I could ask a couple more questions?
First, the newsletter you referred to is absolutely excellent; I had already read it from beginning to end very carefully, marking up the most relevant sections, and would therefore like to quote the following passage from the newsletter in connection with my results:
"If the overall score is significantly higher (in the 20s or 30s, for example), then probably all of the foods ranked as 1+, 2+, and 3+ should be avoided, at least during recovery. Only foods with a zero score should be considered to be safe."
Since my overall score (mean value 11 antigenic foods) is even higher than the 20s or 30s -- at 49 -- that would mean I should avoid White Potato, for which I had a 1+ score. However, in your reply you only recommended avoiding 2+ and 3+ foods. I'm wondering why. It would make a big difference to me if I could eat white potato and nightshades as they have been a significant part of my diet so far and have not caused any bad reactions.
Second, despite your comments about the biopsy results I still find them puzzling. As it happens, my gastroenterologist is very experienced and extremely capable, which is why I chose him. Also, he took great care when conducting the colonoscopy to take biopsies from a large number of different sites. Perhaps the only factor which may have caused him to miss any important sites is that, due to constipation, my colon was not completely clean and he was unable to access the lowest part of the ascending colon.
Finally, I'd like to take this opportunity of saying how much I appreciate and admire your wealth and depth of knowledge about microscopic colitis and matters closely and less closely related to it.
Thank you for your time and trouble.
Helen
Thank you very much for your long and helpful answer. I am very happy you say that my MC is definitely not healed since that is also my opinion. It is clear to me that I need to continue watching my diet very carefully for a long time.
I'm also happy that magnesium will help my constipation, although I would hesitate to switch to magnesium citrate. This has been prescribed to me by my neurologist (for migraine) more than once and each time it instantly gave me diarrhoea and I had to abandon it. That is why I have never taken magnesium up to now. Thanks to your excellent overview of different magnesium compounds I now understand why this approach failed. However, your route of using Doctor's Best Chelated Magnesium and upping the dose very gradually is working well for me.
I wonder if I could ask a couple more questions?
First, the newsletter you referred to is absolutely excellent; I had already read it from beginning to end very carefully, marking up the most relevant sections, and would therefore like to quote the following passage from the newsletter in connection with my results:
"If the overall score is significantly higher (in the 20s or 30s, for example), then probably all of the foods ranked as 1+, 2+, and 3+ should be avoided, at least during recovery. Only foods with a zero score should be considered to be safe."
Since my overall score (mean value 11 antigenic foods) is even higher than the 20s or 30s -- at 49 -- that would mean I should avoid White Potato, for which I had a 1+ score. However, in your reply you only recommended avoiding 2+ and 3+ foods. I'm wondering why. It would make a big difference to me if I could eat white potato and nightshades as they have been a significant part of my diet so far and have not caused any bad reactions.
Second, despite your comments about the biopsy results I still find them puzzling. As it happens, my gastroenterologist is very experienced and extremely capable, which is why I chose him. Also, he took great care when conducting the colonoscopy to take biopsies from a large number of different sites. Perhaps the only factor which may have caused him to miss any important sites is that, due to constipation, my colon was not completely clean and he was unable to access the lowest part of the ascending colon.
Finally, I'd like to take this opportunity of saying how much I appreciate and admire your wealth and depth of knowledge about microscopic colitis and matters closely and less closely related to it.
Thank you for your time and trouble.
Helen
Re: Enterolab and biopsy results - help!
The Nightshades are typically associated with arthritis symptoms, so if you have those symptoms, it might be best to avoid white potato. Otherwise very few of us ever have any problems with white potatoes. Colored potatoes (red, yellow, purple, etc.} primarily contain a different starch, and they're more easily digested. But if potatoes are problem, sweet potatoes are almost always a safe alternative.
It sounds as though your gastroenterologist is well qualified, so the problem with your diagnosis probably lies in the opinions handed down by the pathology lab. An official diagnosis of microscopic colitis requires a minimum of 20 intraepithelial lymphocytes (IELs) per 100 epithelial cells. Normal biopsies can show up to 10 IRLs. The area in between is undefined as far as most pathologists are concerned. However, that's the domain of paucicellular lymphocytic colitis. With paucicellular lymphocytic colitis, a patient displays the clinical symptoms of lymphocytic colitis, but they don't meet the diagnostic criteria because they have insufficient IELs in their biopsy samples. At least that's my best guess why you could have the symptoms of MC, with no official diagnosis.
Tex
It sounds as though your gastroenterologist is well qualified, so the problem with your diagnosis probably lies in the opinions handed down by the pathology lab. An official diagnosis of microscopic colitis requires a minimum of 20 intraepithelial lymphocytes (IELs) per 100 epithelial cells. Normal biopsies can show up to 10 IRLs. The area in between is undefined as far as most pathologists are concerned. However, that's the domain of paucicellular lymphocytic colitis. With paucicellular lymphocytic colitis, a patient displays the clinical symptoms of lymphocytic colitis, but they don't meet the diagnostic criteria because they have insufficient IELs in their biopsy samples. At least that's my best guess why you could have the symptoms of MC, with no official diagnosis.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
-
Helen Baumer
- Posts: 8
- Joined: Tue Apr 12, 2022 12:27 am
Re: Enterolab and biopsy results - help!
Dear Tex
I haven't got any problems with arthritis and it is so reassuring for me to know I can eat white potatoes and other nightshades without any qualms. Thank you!
Thank you too for your analysis of the reason why my biopsies might have produced a zero-MC result. I really appreciate your help and wish you all the best.
Helen
I haven't got any problems with arthritis and it is so reassuring for me to know I can eat white potatoes and other nightshades without any qualms. Thank you!
Thank you too for your analysis of the reason why my biopsies might have produced a zero-MC result. I really appreciate your help and wish you all the best.
Helen
Re: Enterolab and biopsy results - help!
Please remember what I said about digesting potatoes, because it's not impossible for them to cause problems for some of us. If they seem to cause digestive issues for you, try the red or yellow potatoes.
Tex
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.