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Enterolab and Uceris/Budesonide

 
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lsedels
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2017 Oct 23 - 1:53 AM




PostPosted: Wed Sep 03, 2014 1:30 pm    Post subject: Enterolab and Uceris/Budesonide Reply with quote

Still working on getting my Mom to take the Enterolab tests. She has been taking Uceris 9mg for about 2 months now and is thankfully doing very well. She asks whether having been on Uceris for 2 months will invalidate or somehow cause inaccurate or invalid results for the Enterolab tests.

Any opinions?
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tex
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Food Intolerances : Gluten, casein, soy, and avenin, (avenin is the prolamin in oats, which is equivalent to the gluten in wheat), beef, grapes, peanuts, cashews, almonds, (but nut butters seem OK except for peanuts), citric acid, chocolate, and agar.
Location: Central Texas

PostPosted: Wed Sep 03, 2014 2:11 pm    Post subject: Reply with quote

Hi Larry,

The simple answer is "yes". The more complex answer is "probably, but not necessarily". This is because treatment with budesonide in most forms will eventually suppress the immune system enough that antibody levels will begin to diminish. As a result, unless the patient has extremely high antibody levels to begin with (which can be the case if reactions have been going on for many years), after a few months of using Entocort, for example, virtually all antibody tests (including the stool tests at EnteroLab) will begin to yield false negative results because the antibody levels will have fallen to below the threshold at which a positive test result will be triggered.

At this point, it's not known whether Uceris will be any different in this respect than Entocort, but the odds are relatively high that it will show similar results, since the active ingredient in both medications is budesonide. Sorry that I can't provide a more definitive answer, but at this point in time, the answer mostly depends on her initial antibody levels.

Anti-gliadin antibodies have a half-life of 120 days, so the EnteroLab tests could probably reliably detect gluten sensitivity for at least 6 months or more after treatment with budesonide is begun. But the odds are much higher that antibodies to other foods might not be reliably detectable after several months of treatment.

Personally, I would be hesitant to spend the money on extensive testing at this point, because while any positive test results would be reliable, any negative results could not be trusted, since there is a good chance that they could be false negatives. If I were only interested in knowing whether or not gluten is a problem, I would go ahead and order an anti-gliadin antibody test, but testing for antibodies to other foods would be risky at best.

Tex
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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.
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lsedels
Adélie Penguin
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Joined: 18 Jul 2014

Posts: 53
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2017 Oct 23 - 1:53 AM




PostPosted: Wed Sep 03, 2014 2:16 pm    Post subject: Reply with quote

tex wrote:
Hi Larry,

The simple answer is "yes". The more complex answer is "probably, but not necessarily". This is because treatment with budesonide in most forms will eventually suppress the immune system enough that antibody levels will begin to diminish. As a result, unless the patient has extremely high antibody levels to begin with (which can be the case if reactions have been going on for many years), after a few months of using Entocort, for example, virtually all antibody tests (including the stool tests at EnteroLab) will begin to yield false negative results because the antibody levels will have fallen to below the threshold at which a positive test result will be triggered.

At this point, it's not known whether Uceris will be any different in this respect than Entocort, but the odds are relatively high that it will show similar results, since the active ingredient in both medications is budesonide. Sorry that I can't provide a more definitive answer, but at this point in time, the answer mostly depends on her initial antibody levels.

Personally, I would be hesitant to spend the money at this point, because while any positive test results would be reliable, any negative results could not be trusted, since there is a good chance that they could be false negatives.

Tex


Thank you for your honestly, Tex. If it were a less expensive test, I'd say let's do it anyway. Maybe we can pick and choose some individual tests for less money. Thanks again.
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Larry
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tex
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Joined: 24 May 2005

Posts: 30600
User's local time:
2017 Oct 23 - 1:53 AM


Food Intolerances : Gluten, casein, soy, and avenin, (avenin is the prolamin in oats, which is equivalent to the gluten in wheat), beef, grapes, peanuts, cashews, almonds, (but nut butters seem OK except for peanuts), citric acid, chocolate, and agar.
Location: Central Texas

PostPosted: Wed Sep 03, 2014 2:22 pm    Post subject: Reply with quote

Larry,

I was editing my post while you were writing, to add a remark about an individual test for antibodies to gluten, so please reread my post if you are interested in an individual test.

You're very welcome.

Tex
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cowboy

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.
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