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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18676
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I am looking Doctor in Adelaide, South Australia who

Resolved Question:

I am looking for a Doctor in Adelaide, South Australia who can test me for food allergies.
30 years ago my son was tested and was found to be allergic to Wheat, Yeast, Beef, Milk, Eggs and sugar.
I am wondering if I am allergic to wheat because my abdomen is swollen, I have an enlarged benign prostate which I had surgery on 10 years ago and now needs further surgery. I am trying to find a cause for the enlarged abdomen. My local Doctor tells me "It's all about portion size." The rest of my body is quite slim. I weigh 85kg.
Many thanks for your help
Submitted: 2 years ago.
Category: Medical
Expert:  Dr. D. Love replied 2 years ago.
What other tests have been done?
Have you been tested for gluten sensitivity, which is not an allergy?
Customer: replied 2 years ago.

No, I have not been tested for gluten.

I have a psa of 2.8

Scan findings:

No renal calculi are seen. No hydronephrosis. No perinephric stranding seen. Exophytic renal cyst seen on the right interpolar region measuring 20mm and on the left lower pole measuring 30mm. Tprostateis enlarged measuring 45 x 50 x48mm. There is eccentric extension of the median lobe/basal thickening of the bladder noted towards the right. This should be assessed with ultrasound in the first instance. No bladder calculi seen.

The liver shows heterogeneous hypodensity in keeping with fatty change. Gallbladder shows a large calculus measuring 33m in the fundus and multiple small

calculi/milk of calcium seen in the fundus and the neck. No wall thickening or evidence of cholecystitis.

The pancreas, spleen and adrenal glands are unremarkable. The visualized bowel loops appear within normal limits. No free fluid seen in the pelvis.

No sinister bone lesion seen.

Impression

1. No CT evidence of urinary tract calculi.

2. Prostatomegaly with eccentric thickening of the bladder base which should be further assessed with an ultrasound as it is difficult to exclude whether this is from median lobe hypertrophy or a bladder base mass.

3. Uncomplicated cholelithiasis.

Expert:  Dr. D. Love replied 2 years ago.
Do you know whether liver blood tests are normal?
They almost certainly would have been checked, and I want to be certain that they are normal.
Customer: replied 2 years ago.

I am not aware that I have any liver blood tests. I am going to see my local G.P. today. I could ask him if the test has been done.

Expert:  Dr. D. Love replied 2 years ago.
Yes, it would be appropriate to be certain that liver blood tests were performed and normal. The fatty infiltration of the liver noted on the scan is usually not an issue, although it can cause inflammation of the liver in some people. Inflammation of the liver can affect liver function, and liver blood tests would be the best method for assessing liver inflammation and function. If the liver blood tests are normal, then the fatty infiltration of the liver would typically not cause the symptoms that you describe. It may cause a fullness in the right upper abdomen, but it typically would not cause enlargement of the entire abdomen.

As for food allergies, it is less common for food allergies to cause these symptoms or to present in someone of your age, although it can do so. For consideration of food allergies, it would be appropriate to be seen by an Allergist. There are several in Adelaide, including
Robert Heddle, Tiffany Hughes, & Pravin Hissaria, phone number (08) 8222 3471
***** *****, phone number (08) 8222 2953

In actuality, though, I see far more people with gluten sensitivity than a true wheat allergy. This is related to an autoimmune disorder of the gut, called celiac disease or celiac sprue. The testing for this does not require an Allergist, since it is not allergy mediated. The initial testing is by blood tests, which can be done by your primary care physician or a Gastroenterologist. The usual first test is an IgA TTG test (Immunoglobulin A anti-tissue transglutaminase antibody). Ideally, this testing should be done before completely eliminating gluten from the diet.

If I can provide any further information, please let me know.
Customer: replied 2 years ago.

Dear Doctor,

Thank you very much for your reply. I have just returned from a visit to my local G.P. He has told me that my Liver blood tests are all normal. He was adamant that I am not allergic to anything and that I must eat less and exercise more.

Several years ago I used to go to the gym and swim 2 or 3 times a week but always remained about 85kg.

Please advise me what foods contain gluten.

Many Thanks

David Kay

Expert:  Dr. D. Love replied 2 years ago.
Gluten is in wheat and related grains, such as barley and rye. We primarily encounter it in flour, but flour is used in many products beyond bread, such as a thickener for sauces and gravies, or a stabilizer for certain foods, such as ketchup. It is not necessarily present in every brand of certain foods, so it is necessary to read labels. It requires a significant amount of effort to eliminate all gluten from the diet.

See http://celiac.org/live-gluten-free/glutenfreediet/sources-of-gluten/ for a list of foods that do or may contain gluten.
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