Doctor insights on:
Celiac And Sma Stenosis
Variable Sx; slight: Celiac can have variable sx, incl gas, bloat, diarrhea, wt loss, rarely gain, constipation, joint aches and pains (often from vitamin d def), fatigue (often from iron def), osteoporosis, swallowing probl, rarely liver probl. Can get screened with blood testing, and/or genetic testing. Assoc with other autoimmune diseases such as ibd, psoriasis, rheum arth, lupus, type 1 diabetes, thyroid disease. ...Read more
Abd pain with eating. All GI tests normal. Diagnosed with MALS via aortagram. Back blood flow in SMA and celiac stenosis. Might surgery help?
MALS is: Characterized by abdominal pain attributed to compression of the celiac artery and possibly the celiac ganglia by the median arcuate ligament. The abdominal pain may be related to meals, may be accompanied by weight loss, and may be associated with an abdominal bruit. Treatment is generally surgical. Ref: https://en. Wikipedia. Org/wiki/Median_arcuate_ligament_syndrome ...Read more
Can stenosis return after celiac artery compression surgery? Pain nausea steatorrea back. Sma plaque also. Could ischemia be from SMA alone?
Complicated Question: Celiac artery compression syndrome (cacs) is the condition usually associated with the surgery you've described. Stenosis does not generally return after surgery for cacs. Chronic mesenteric ischemia can be from SMA stenosis in isolation, however, this would not include steatorrhea. With back pain, nausea, and steatorrhea I would consider pancreatitis or some other issue with the pancreas. ...Read more
33yf severe abd pain x6mon. Ct scans prominent soft tissue celiac region and distended duodenum sugestive of SMA syndrome. Type of dr should be seen?
Surgeon: After a thorough eval by your primary care doc, a general or vascular surgeon would be the type of doctor that would deal with this (if conservative therapy fails). Sma syndrome is rare and can be extremely serious so prompt attention is warranted. ...Read more
Confused Doppler u/s of SMA: Based on the velocities pre and postprandial there is evidence of significant stenosis greater than 70% at the level of the SMA proximally. But CT shows SMA axis is patent??? How is that possible? Next step?
Evaluating SMA: CT scan great overall study and can reveal bowel wall thickening and causes of ischemia. Infectious or autoimmune colitis (Ulcerative colitis) can mimic mesenteric ischemia. Pre and postprandial doppler ultrasound are effective in evaluating mesenteric flow after a meal but studies show it is not good at detecting venous causes of obstruction. MRI and angiography likely next steps. Good luck. ...Read more
Can a person put off surgery and not worry much about it if he/she were diagnosed with Celiac Artery Stenosis/90% Occlusion w/ little/no symptoms?
Why: Unfortunately, I can't see the point. You are looking at the main source of blood flow to digestive/absorptive organs. There is likely unusual outside blood flow or there would have more symptoms. If the flow does get blocked & the organs die from lack of adequate blood flow, the patient is likely to die a horrible death. You need your intestines like you need a heart. ...Read more
I had celiac artery compression syndrome surgery after the surgery a few weeks later had CT done still showed high grade stenosis of 80 percent?
Specific Study?: Was the study done in inspiration and expiration? Are your symptoms better? Poor blood flow to the GI system is incredibly painful and difficult to live with. If you feel better after surgery, it may just be some inflammation and/or an imaging artifact. If the pain persists, you need further testing with a dye study to look at the artery. Consult an interventional radiologist and your surgeon. ...Read more
My CTA shows that I have 50% celiac artery stenosis, what can cause this? History of open surgical AAA repair & endo repair of juxtarenal AAA
Artery Disease, aka: atherosclerosis, which by autopsy data going back ~8 decades in US, is present in 50% of population by age 7, yet within walls of arteries, arteries enlarge & openings remain same; thus no symptoms for decades until plaque ruptures induce clots which suddenly narrow opening or the enlargement becomes excessive resulting in aneurysms. Optimize NMR lipoprofile, HbA1c 5.0% & BP; study my answers. ...Read more
Had another ct scan for comparing adenoma size, it did enlarge. Also came back this, high-grade stenosis proximal celiac artery, what does that mean?
CT showed hook shaped celiac artery w/stenosis but patent likely due to ligament. Abd pain & nausea after meals. Cause of symptoms? GI tests normal.
Could be: It could be related but this needs to be discussed with your gastroenterologist. ...Read more
Abd pain x 4 months, nausea, Abd CT showed severe stenosis of celiac artery possibly by ligament. Referred to vasc surgeon who ordered aorta scan. Why?
Part of workup: To check on other big vessels in your body, wish you all the best in the treatment process ...Read more
Hook shaped celiac artery w/stenosis but patent d/t ligament. Yrs of abd pain&nausea after meals. No weight loss. GI tests normal. Surgery or live with it
Causes of colitis: Inflammation (infection, ischemic, ibd) of large intestine = colitis. Specifically, ischemic colitis occurs when there is decreased blood flow to the gut, due either to vasospasm (seldom recurrent) or stenosis/occlusion (frequently recurrent). Don't ignore the possibility of recurrence here--since transmural ischemia or mesenteric ischemia can be serious & often starts with "intestinal angina. ...Read more
CT showed hook shaped celiac artery w/stenosis but patent. Aorta US showed mild decrease in blood flow but patent. Abd pain & nausea after meals.
Causes of colitis: Inflammation (infection, ischemic, ibd) of large intestine = colitis. Specifically, ischemic colitis occurs when there is decreased blood flow to the gut, due either to vasospasm (seldom recurrent) or stenosis/occlusion (frequently recurrent). Don't ignore the possibility of recurrence here--since transmural ischemia or mesenteric ischemia can be serious & often starts with "intestinal angina." ...Read more
I was just diagnosed w/a 3.6 cm dilated ascending aorta in the hospital at 33. I have celiac artery stenosis, thoracic hemicord impingement & genetic celiac disease & hyperinsulinemia. I've been through 2 bariatric surgeries. Any of these connected?
I let my celiacs go untreated for quite some time now. I'm ready to tx it bc of bad sx. Aprox how long will it take for the s. Intestines to heal?
Weeks to months?: The clinical presentation of celiac disease varies from patient to patient with either typical intestinal symptoms (see earlier healthtap answers on this topic) or a host of atypical extraintestinal manifestations. Important complications include: malnutrition, osteoporosis, infertility, GI cancers. Up to 30% have persistent/recurrent symptoms, incomplete response, or refractory disease. ...Read more
Get tested: Your primary doc can order the blood screening tests that can identify the population at most risk for celiac disease. If this comes back positive s/he can refer you on to have confirmatory testing done through a gastroenterologist. If positive, you can reduce some of the gluten in your diet but should remain on some until the intestinal biopsy is done. ...Read more
Celiac Disease: Celiac disease (gluten-sensitive enteropathy) has three of the following features: villous atrophy; malabsorption, weight loss, or other signs of nutrient or vitamin deficiency; and resolution of the mucosal lesions and symptoms after withdrawal of gluten-containing foods (usually within a few weeks to months). Diarrhea, weight loss, and antibodies against gliadin ...Read more
Abdominal discomfort: Individuals with celiac disease can have a variety of different symptoms and may even be asymptomatic. Often it is associated with gastrointestinal distress including pale stools that are associated with non-specific diarrhea, cramping, and bloating. The diagnosis can only be made by a physician. If symptoms improve with a gluten free diet, the chances of having celiac disease are greater. ...Read more
Define "overcome": There is no "cure" yet for celiac. You learn to read labels & stay away from gluten.Some may need to stay away from non-gluten foods (specialized testing) when simple gluten exclusion is not helping. Some food additives (red#40 & others) can also trigger symptoms. You can live a good life but must always be on guard. Accidental exposures will occasionally set you back but you get better with time. ...Read more
It is known that celiac dz is associated w autoimmune diseases (antibodies against one's own tissues, eg diabetes-I).A letter in the Scandinavian Journal of Rheum in 2010 reported evidence of scleroderma-like activity in celiac disease. Raynaud's is found in cases of scleroderma, an auto-immune disease that causes scarring that can impede blood flow to fingers.
2010, Vol. 39, No. 5, Pages 438-43 ...Read more
Yes: Because celiac disease is hereditary, the disease occurs more often in certain ethnic/racial groups because more people in those groups carry the hla-dq2 and hla-dq8 genes that "cause" celiac disease. The genes are more common in persons from northern and western europe, but are uncommon in western pacific rim populations (china, japan). ...Read more
Constipation celiac: Celiac disease may have no GI symptoms, and may present with fatigue and anemia, bur classical symptoms are pale loose and greasy stools and weight loss, abdominal pain and cramps and distension, ulcers in the mouth. It can lead to lactose intolerance and may give symptoms of irritable bowel syndrome like constipation alternating with diarrhea, but it is not that common presentation. ...Read more
Yes: Celiac disease, especially if one has symptoms or small intestine inflammation/damage, does increase one's risk of small intestine cancer (adenocarcinoma, lymphoma). The increased risk may go to normal if one stays on a completely gluten free diet and stops having intestinal symptoms for many years. Celiac disease is not a risk factor for stomach cancer, according to the american cancer society. ...Read more
Antibody blood test: The definitive test is intestinal endoscopy with duodenal biopsy but screening for celiac disease aka gluten enteropathy is by a blood test for antibodies associated with the disease - ttg-a & ttg-g. Serum IgA is also obtained. If the patient has not been on gluten for a while antibody levels often fall into the normal range. ...Read more
Maybe unrelated...: Celiac disease (cd) is an immune-mediated enteropathy that inflames & destroys the lining of the small intestine--triggered in genetically-determined persons by dietary exposure to gluten (protein in wheat, barley, rye). Lots of immunologic & inflammatory symptoms can result. However, dizziness in a 56 year old lady can be serious, unrelated to cd, & deserves cardiovascular & neurologic work-up. ...Read more
Not really: Celiac disease is caused by antibodies, mainly of a class that is called iga, that destroy the lining of the small intestine (gut). Those antibodies are to several proteins in wheat and other cereals. Allergies are caused by antibodies of IgE class and they act in a different way. Celiac disease may be associated with a rash with blisters, called dermatitis herpetiformis (looks like herpes). ...Read more
Lots of things do: Your nausea may have little to do with the gut. Biliary ; pancreatic disease may be present. Gas/bloat syndrome? Consider "central" causes like: motion sickness, vertigo, migraine headache, brain problems (some very serious). Also, rule out infection (? Urinary tract), food poisoning, medication side effects, pregnancy, ; even stress. Yes, celiac disease may contribute, but best get checked. ...Read more
No: Autism is a complex neurobiological inherited disorder that is worsened by environmental toxins. Celiac disease is a digestive disorder that prevents absorption of gluten from the diet. There is no scientific evidence the two are related. Years ago, there was a flurry of thinking that malabsorption of gluten could lead to or worsen autism. This has been disproven. ...Read more
Not directly, but...: People who manage their diet to avoid gluten may risk becoming deficient in a variety of necessary nutrients. It's possible to learn how to have a varied, full range of foods, but it takes time and interest. Sun-sensitivity is a symptom of pellagra (a Niacin (vitamin b3) deficiency). It can be quite serious so eat tuna, salmon, or ground beef if you can, or snack on peanuts daily. ...Read more