665043 investigations agd february 2025 normal mucosal appearances judenal histology gastric heterotopia but no other significant pathological abnormality lymphoid aggregates in the lamina propria have a well developed villous architecture ogd november 2024 normal mucosal appearances histology very slight villous blunting but without significant crypt hyperplasia and tttg february 2025 negative anti endometrial antibodies igg and iga negative february 2025 hla dq to testing positive bloods december 2024 eosin is normal lft is normal full blackout normal hi hi laura hi my name is doctor rawl no no I'm 1 of the gastroenterology registrars you're clear of bed hi have I caught you at a reasonable time right yeah how how are you doing feel about the same tell me about your symptoms at the moment mhmm okay and so how often will these episodes these random episodes affect you every 3 weeks mhmm and that affect you for the whole day and and those those symptoms that affect you for the whole day will be next to the toilet mhmm I see fine so you build up the imodium but it you know doesn't affect things and do you associate it with any dietary changes gluten or anything like that mhmm have you yeah you're you had the last endoscopy in the february yeah so you've been gluten free since then but the symptoms haven't got better fine and do you have tummy pain along with that okay k and when's the last time you remember your bowels being normal for you years as far as you can remember or or or not that long mhmm mhmm mhmm mhmm but you still get the symptoms yeah okay we'll see and obviously your colonoscopy is quite reassuring there wasn't any worrying signs there there was that tiny polyp which we removed yeah then you had the the and the samples from that polyp didn't show anything worrying in that polyp and the samples from the rest of your: were very reassuring in terms of inflammation of the: causing the symptoms and then there's been this latest investigations for coeliac disease and certainly the biopsies it's a bit of a challenging 1 because the biopsies taken don't show coeliac disease at all and the other blood tests don't show coeliac disease but they do show that you're at risk of coeliac disease because of 1 of the genetic tests that we've done however nothing else points towards coeliac disease does that kind of make sense yeah fine so I don't think coeliac disease is causing your symptoms it certainly would be very uncommon for it to cause the episodic nature of your symptoms I think doing some different stool tests would be quite helpful because I still don't think we've really nailed the diagnosis for what's going on here and I can see you've had lots of tests in terms of upper and lower gi endoscopies and a ct scan I think checking your stool to look for whether there's any inflammation there or whether there's any problems with the pancreas could be quite helpful and and I think that in addition with some up to date blood tests would be would be a sensible investigation to do for the moment and then and take it from there with those results is that okay anything I've forgotten or any questions or anything like that okay I'll send you out a pots and a lay and a form for the stool test to look for the pancreas and I will book you the blood tests which you can have taken at windsor house which is just near derek and I'll write you with the results and then come back is that okay I'm sorry we haven't really got to the bottom of it but I hope we will with a few more tests yeah I'm sorry yeah okay alright I look forward to writing you the results when they come back alright talk to you soon bye bye