Lower right abdominal pain

by Steph
( Elsternwick, Victoria, Australia)

Hello. Since last June I have been having lower right abdominal pain on and off.

It all started with a virus and diarrhea. I was going 8-10 times per day. This went on for weeks and the only thing that seemed to help stop the diarrhea was going gluten free.

The gas, diarrhea and pain stopped. I couldn't tolerate the tiniest trace of gluten. After a few months and many tests for celiac and the celiac gene after completing the gluten challenge I have come up as negative for celiac.

Lately I seem to be able to tolerate small amounts of wheat and gluten without the diarrhea. Just this morning I had wheatbix but hours later- 10PM at night I am experiencing the lower right abdominal pain.

The Dr has ruled out anything else and the pain goes away. Could this be from a gluten intolerance?

Hello Steph,

Thanks for your query. You certainly have had more than your fair share of troubles with abdominal pain with this lurking uncertainty as per the possible cause.

May I clarify a few things?

  1. When you said you had tests for celiac gene, can you remember which test? Could it be specifically for the celiac gene or just a test for celiac generally.

    A negative testing for the HLA-DQ2 or HLA-DQ8 genes associated with gluten sensitivity or celiac disease is believed to completely rule out the possibility of such condition. So if this is what you had done, then you can be rest assured that you do not have celiac or gluten sensitivity.

  2. Can you please confirm that you live in a tropical climate? If you actually reside in Australia, did you make any foreign travel to South East Asia or Africa
    or indeed the Caribbeans in the last few months or years?

    The symptoms you are describing sounds very much like those seen in a condition called tropical sprue. This is where people develop abdominal cramps, diarrhoea and vomiting, bloating, excessive farting and irritability following an episode of infection - this could be viral, bacterial or protozoan.

    The exact cause of tropical sprue is not known, but the symptoms could so well mimic celiac disease, and after clearing for a while, the symptoms could come back, unannounced. Some patients have been known to harbor this condition and manifests as long as 5 to 10 years after their first contact with whatever is causing it...which we don't still know. What we do know is that if tropical sprue is suspected, tests like endoscopy of the small intestines, and blood test for vitamin B12, folic acid and iron levels as well as basic blood test may give a crude indication that something is not right - there is no exact confirmation test available yet.

    Trial of treatment with an antibiotic called tetracycline for at least 6 months and up to 12, is usually curative.

Is this something you want to look into and perhaps discuss with your family doctor?

In the main time, you may also want to take a look at our page here on celiac disease and see variants of this disease and other things apart from gluten that can trigger a reaction with abdominal pain and diarrhoea.

We always love to hear back from visitors on how things went and would be most grateful if you could update us with your findings.

Many thanks Steph, for using our free online resource on abdominal pain here.

With Best Wishes.

Dr Edema

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