As if dealing with Celiac disease is not enough I was continuing to have abdominal symptoms. I wasn't eating gluten. I had blood test to verify that there was no accidental contamination going on. Switched to lactose free dairy products - no improvement. My doctor recommended a breath test to rule out SIBO (Small intestinal bacterial overgrowth).
Symptoms may include abdominal pain, bloating, diahrrhea, heartburn. I seemed to get a acid reflux like taste in my mouth and some bloating.
In addition to celiac disease, other diseases that may lead to SIBO include diverticular disease, crohn's disease, alcohol abuse and liver disease.
The overgrowth of bacteria can lead to malabsorption. This can result in low levels of B12, iron and vitamin D. Low vitamin D can lead to inability to absorb calcium which can result in muscle twitching (which I was getting) and it can lead to osteoporosis.
The diagnosis can be made non-invasive with a hydrogen breath test.
For the test I had to fast overnight. After arriving I had to blow into a bag like this. Next, they gave me a sugar water drink. Every so often, I think it was every 10 minutes or so, I would have to blow into the bag again to give a sample. A time consuming test but pretty simple and non-invasive. I got a call about a week later with the results. My test was positive for bacterial overgrowth.
Treatment is with antibiotics. My physician recommended either doxycycline or rifamaxin (Xifaxan). Doxycycline is generic, cheap but can result in sunlight sensitivity while you are taking it. Xifaxan is more expense and not all insurances will cover it. I was able to get it covered and felt better after a few days.
Re-occurrence is common. I did have a relapse about six months later and took another round of antibiotics. So far so good - but time will tell.
I found a informative site by a woman who specializes in SIBO - www.siboinfo.com. You can also find some information at emedicine.medscape.
The Un-Gluten Guy