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Diagnostic Challenges of Celiac Disease


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Gluten Challenge Testing

Slide 17

June 2010

Gluten-challenge testing requires adequate gluten intake for long enough to develop gut lesions. Four slices of whole wheat bread daily for 4 weeks usually suffices. However, it will make patients ill and they can become quite symptomatic. There are some patients who are delayed responders and if a patient has had no symptoms develop by 4 weeks, I will usually perform serology. If it becomes positive at that point, we’ll proceed to biopsy. If it’s negative we will wait longer, for both serology and histology change to occur. Typically, I will not wait longer than 6 months, however.

Gluten Challenge Testing


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