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Doctors' Answers to "Frequently Asked Questions" - Gluten Intolerance
GI Problem requiring several drug therapies
Answer: I suspect strongly that you are experiencing biliary involvement from your Shogren's Syndrome. You need liver function checks and either a GI specialist or a Rheumatologist. This can be a serious problem called biliary cirrhosis and should be checked immediately.
Answer: Gluten intolerance is thought to be a genetic disorder. However, the severity varies widely and for some reason is not always seen in children, but manifests itself in adults as well. There are several HLA serotypes which are common in this disorder leading to the genetic theory. The reason that people have trouble with gluten digestion is not clear. However, biopsy of the small intestine shows a characteristic lesion. However, these are not specific. They can also be seen in other disorders (tropical sprue, lymphoma, gammaglobin disorders, etc.). Diarrhea is the most common symptom that patients complain of, accompanied by weight loss, bloating and greasy stools (float for example). Diagnosis depends on a biopsy as well as using a gluten free diet-demonstrating improvement. Treatment is a gluten free diet and occasionally steroids in the 20% or so who do not respond to the diet alone. Family counseling is helpful since 50% or so of her family will have the same problem. Weight gain is absolutely not a part of this diagnosis and would make me doubt her diagnosis.