CD SKILLS - A challenging diagnosis journey (Story form Romania)


My name is F. M. Ioana, I am a medical doctor, and also a celiac person. I was born in 1972 in the city of Oradea, and my childhood was marked by many respiratory tract infections, initially as pharyngitis, tonsillitis, and then, after the tonsillectomy at age 4, followed bronchitis, asthma and pneumonias. I followed desensitization therapy for aeroallergens, but besides this respiratory history, I was a normally developed child, of normal height, with a good nutritional status and without any other health issues. During my youth, everything went good, only having 2-3 colds a year.

In 2008, I had a viral gastroenteritis, which destabilized me for a long period. It was after this episode that I started having digestive symptoms. I started feeling tired, having modified, yellowish stools (2 to 4 a day), I was sometimes nauseous, or even vomiting, I had bloating, skin issues, hair loss, but without any weight loss or anemia. I received the diagnosis of irritable bowel and I was treated for this, without any other investigations apart from usual lab tests that were normal at that moment.

Still, the symptoms were not daily, and while I was on weight loss diets, thus not eating bread, these symptoms disappeared, and I was full of energy. Then I started thinking I could have celiac disease, but the burden of this diagnostic was too heavy to bear.

In 2013, besides the symptoms I already mentioned, accompanied by frequent hypoglycemia, I noticed a whitish lesion on my tongue. Judging by the way it looked, I thought it could be leukoplakia that is a premalignant lesion. I waited for 6 weeks to see how it evolves, and then I decided to see a doctor. I went to a professor at a Maxilla-facial surgery department in Cluj-Napoca, and he approved that the lesion was indeed leukoplakia, and advised me to see a gastroenterologist. Meanwhile, I had already done some immunological tests, and I discovered I had an IgA deficit. That is when I realized it had to be celiac disease, because the IgA deficit is associated with celiac disease. Within a week, I was hospitalized in an internal medicine unit in Cluj Napoca, where I had the intestinal biopsy done. Three weeks later, I had the histological confirmation for celiac disease. The antibodies anti-endomysium and anti-tissue transglutaminase (IgA) were negative, because I had the IgA deficit.

Therefore, in 2013 I started the gluten-free diet. I started studying the food processing technology, because at that time in Romania there were not many information available (ARIG was founded later). I accessed specialized websites in France to find data about gluten-free foods, but mostly about "hidden" gluten containing products. It happened many times to eat gluten-contaminated foods that I considered safe, or gluten containing drugs. Each of these "accidents" were followed by shorter or longer episodes of digestive symptoms, depending on how important the contamination was.

I am sure that if I had not been a doctor, the diagnosis of this disease would have taken even longer. I think that the diagnosis of irritable bowel should be established after a more thorough investigation of the digestive tract. It is for a good reason that French gastroenterologists say that 1 in 4 cases of irritable bowel is actually celiac disease.

Photo is symbolic; photo by Emma Simpson on Unsplash, the second photo: personal archive

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