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Tex or Polly, I have a question maybe you could answer

 
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IDreamInColor
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Location: Ohio

PostPosted: Tue Nov 23, 2010 5:13 pm    Post subject: Tex or Polly, I have a question maybe you could answer Reply with quote

Since my "anti -tissue transglutaminase IgA thru enterolab was negative and states that I'm not having an autoimmune reaction does that mean that MC is not always an autoimmune response, and that one can just have it for no good reason at all?

Second question. Is it ever possible for one to have a case of MC for a few months or so, and then one day all the symptoms leave and you never have it again? My GI doctos says that it probably has nothing to do with gluten (I strongly disagree with that), and it will eventually go away and all will be well. I've had potty problems now for years, and severely since August, if his theory was correct I should have been well by now.

I'm just having a bad day, and I think too much about it, how does one learn to just get over it and live with it.
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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: Tue Nov 23, 2010 7:12 pm    Post subject: Reply with quote

Hi,

IDreamInColor wrote:
Since my "anti -tissue transglutaminase IgA thru enterolab was negative and states that I'm not having an autoimmune reaction does that mean that MC is not always an autoimmune response, and that one can just have it for no good reason at all?


To be honest, I really don't know the answer to your questions, because I'm not aware of any research projects that have addressed this issue definitively, but maybe I just haven't come across them in the literature. My best guess on the two parts of your first question would be yes to the first part, and no to the second. Yes it's possible to have inflammation without an autoimmune reaction, but there is always a good, (valid), reason for the inflammation, and inflammation must be present for MC to exist, (by definition). Drug-induced MC, for example, does not involve an autoimmune reaction, (at least not initially), and presumably MC caused by other triggers probably does not necessarily involve an autoimmune component initially, but as I mentioned, that's strictly a guess. I would suspect that the auto immune issue tends to arise after a period of unresolved chronic inflammation. Of course, it could appear early on, if a patient already has pre-existing autoimmune issues. Again, though, I'm just guessing, based on the evidence. Maybe someone else has better information on this. shrug

IDreamInColor wrote:
Second question. Is it ever possible for one to have a case of MC for a few months or so, and then one day all the symptoms leave and you never have it again? My GI doctos says that it probably has nothing to do with gluten (I strongly disagree with that), and it will eventually go away and all will be well. I've had potty problems now for years, and severely since August, if his theory was correct I should have been well by now.


Yes indeed. Spontaneous remission does occasionally happen. According to some early research articles, (which are highly questionable), MC resolves without intervention, in as high as 80% of cases, after a mean period of approximately 38 months. Unfortunately, we don't see that happening among the members here, because many of us have had this disease for 10 years or more, and anytime we slip up on our treatment, we react. Where are all the patients who have experienced spontaneous remission, (if they exist)? shrug Why doesn't it happen to us?

We do have a couple of members who apparently enjoy fairly long periods of spontaneous remission, (often spanning months, and occasionally a year or more), sprinkled with occasional relapses, but personally, I'm not aware of anyone who has been able to enjoy long-term remission, with absolutely no dietary or drug intervention, that has lasted for more than a year or so, at best.

EXCEPT for some cases of MC that were/are drug-induced. When MC is caused by a drug, sometimes, if caught soon enough, just discontinuing the drug can bring lasting remission. We have a couple of members who discontinued certain drugs, at our suggestion, who promptly went into remission, and as far as I am aware, they are still in remission to this day. They were taking a PPI, that we believe caused their MC, and presumably, as long as they avoid that class of drugs, they should remain in remission.

I have a hunch that your doctors actually believe the misinformation in those old research articles, because in the medical field, once incorrect information is published, it seems to live forever. Rolling Eyes Here are links to abstracts of those old articles, if you want to read them yourself:

http://www.ncbi.nlm.nih.gov/pubmed/9824342

Here's the entire article, if you are interested:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC172...df/v043p00629.pdf

Here's a similar abstract, for CC:

http://www.ncbi.nlm.nih.gov/pubmed/8995938

Those articles sound good, don't they. Unfortunately, they're not worth the paper they were written on. Those articles were written back when MC was still "rare", because GI docs rarely took biopsies, so in those days, no one knew much about MC, (especially the authors of those articles. Laughing ). As the years have gone by, the articles describing long-term followups have become a lot less "ambitious". Here's one written in 2006, for example:

http://www.ncbi.nlm.nih.gov/pubmed/16981069?ord...l.Pubmed_RVDocSum

Notice that it doesn't even mention the possibility of resolution of symptoms without treatment - a far cry from the earlier articles.

I'm sorry you're having a bad day. I know it seems like it will last forever, but you shouldn't have to learn to just tough it out and live with it. If you continue to work at it, you will conquer it, and you will be able to look back on all this as if it were a bad dream. Living one day at a time, will get you there.

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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