First off....CONGRATS to you on being gluten free for 4 1/2 years! It's been about the same amount of time for me too. I was diagnosed in June/2003 with Celiac Disease when I was 38 years old. I had a painful flare up that sent me to the ER and they admitted me and ran many tests and procedures. I did go ahead with the endoscopy and biopsy which proved the diagnoses 100%. This flare up was my second one I had in a year. The first time I had a painful flare up, July/2002, I went to the ER but the ER doctor was ignorant and really wasn't interested in finding out what was wrong with me and brushed it off to being just a bladder infection.
Since my diagnoses, I have gotten worse and the doctors say I am ultra or severely sensitive to gluten from what they can see off the numerous tests done over the years. The damage in my small intestines have just been progressively getting worse. I have chronic abdomenal pain, diahreah, nausea, and vomiting, that can go from tolerable to severe at any time. In the beginning, I only had flare ups once to maybe three times in a year. I've noticed within the last 2 years it has progressed up to now having them once to three times in a month with the flare ups maybe lasting a day or up to over a week when severe.
This is also with being on a gluten free diet, checking all products I use that could have gluten in it such as toothpaste, mouth wash, etc., and even checking all medications I take with the manufactures to make sure they are gluten free AND if there is any possibility of their gluten free medications to have been cross contaminated with any other gluten containing products that they might make in their plant. I found out that gluten is used in many forms of medication and the only kind that doesn't have any gluten or chance of cross contamination are by injections.
Thankfully I have been working with a pain specialist and a GI doctor who (luckily) know what I am going through and specialize in this field. I've been seeing them for a few months so far and they have had me try a various of different medications to see which works better. Last time I was in the hospital the previous doctors were seriously thinking of putting me on IV meds for at home since they worked everytime I've been in the hospital ( and that they are 100% gluten free ). But I didn't want to have a central line or pic line put in. So my new doctors understand and we've been going through "trial and error" on the different medications to find something that will help me. In the hospital although, one medication I've noticed that always helped with my severe case of celiac has been Benadryl Inj. / 50mg. I noticed that when I used it at the same time with my other medications, I felt relief faster and better compared to not taking the Benadryl Inj. with my medications. Benadryl doesn't work by itself to relieve the discomfort only with my other medications. So I did some research and found out on Benadryl's FAQ web page it does state that OTHER uses for it is also as an antispasmatic as well as for a sleep aid, and nausia. It also went on saying it doesn't contain gluten but there is a chance for cross contamination. And since I can't take Benadryl in the form of tablets, capsules, or elixor ..... I found out you can get a prescription for it in a pre made injection pen of 50mg that comes in a package of ten ( I guess kinda like an epi pen ) and also it's available in vials ( like insulin for a diabetic). This to me doesn't sound too bad if given with the right combination of my other medications (with them being in gluten free pill form). So next time, I see my doctors this is our next thing we'll be trying. Hopefully this will work. It's seems better to take a shot of Benadryl now and then with a severe flare up ........ than having to take all my medications by injections in a central/pic line.
I don't think you're being unrealistic at all because I know that once someone is able to maintain and manage a gluten free regimen you will feel healed. Keeping it under control is the key to feeling better and getting back to a normal healthier life. I've read about this so many times and hearing how so many people have been able to do this regardless of how severe someone has the disease. I wish you all the best and good luck on your future test! I hope I'll be able to find a way to get mine under control soon so I can regain my life back as well.
I hope this has helped you in some way. Feel free to contact me if you have any questions.