Gluten Challenge/ Test- Worried

[jasonD2]

I've been more or less gluten-free for 6 months after getting a slightly positive stool Ab result from Enterolab. I had bad constipation with thin stools, and since i stopped eating wheat I go pretty much every day and have bulkier stools.

My doctor doesnt think I have Celiacs cause all the intestinal workup he did on me initially does not indicate celiacs...absorption was fine and total stool IgA was in normal range. He thinks i might have an allergy or be intolerant. Thing is, Im concerned i might have it and he now wants to do the full Celiac Test Panel, but wants me to do a gluten challenge for up to a week and then run a bunch of tests. I'm really concerned about the effect this will have on my body but I also want to know once and for all. Any suggestions?

[MELINE]

I've been more or less gluten-free for 6 months after getting a slightly positive stool Ab result from Enterolab. I had bad constipation with thin stools, and since i stopped eating wheat I go pretty much every day and have bulkier stools.

My doctor doesnt think I have Celiacs cause all the intestinal workup he did on me initially does not indicate celiacs...absorption was fine and total stool IgA was in normal range. He thinks i might have an allergy or be intolerant. Thing is, Im concerned i might have it and he now wants to do the full Celiac Test Panel, but wants me to do a gluten challenge for up to a week and then run a bunch of tests. I'm really concerned about the effect this will have on my body but I also want to know once and for all. Any suggestions?

Hi

I did try the gluten challenge, I could not do it for more than 2 days. Impossible...But then I recovered in 3-4 days. No problem with that. If I were you I think I would give it a shot..Just to see. But that goes for me.

You can read this article:

How long do I need to be eating gluten before I am tested for celiac disease?

This is not an easy question to answer. Most people believe, or are told that they need to eat gluten for a few days (or up to a week) before a blood test or a biopsy, and this is incorrect. The true answer depends on how long the individual has been avoiding gluten. How much gluten to eat depends on the age of the individual who is being tested. The information provided here is a general rule, there are many specifics that come into play, so its best to talk with a knowledgable physician about your particular situation.

First: If a patient has avoided gluten for six to 12 months (or more) it is advisable to consider an HLA gene test before a gluten challenge. The HLA gene test will help determine if the patient is even in the risk group for celiac disease. (Only 1/3 of the US population have the genes for celiac disease.) After 6-12 months, it can be difficult to obtain a diagnosis of celiac disease after a gluten challenge, which is why this step is advisable.

Patients who have been on a gluten free diet for less than six months can consider a gluten challenge under a physician's supervision. A challenge would typically require an adult or a child to eat some gluten for four to eight weeks. For some, a twelve week challenge could be required but no challenge should last more than 12 weeks in children. The patient would eat a specified amount of gluten every day.

Many patients are concerned about participating in a challenge. Medical research shows that a limited challenge of this sort provides a greater medical benefit when it leads to a correct diagnosis of celiac disease. The challenge would need to be maintained if a positive antibody test result is received, because the biopsy procedure also depends on the presence of an autoimmune response.

For children, eating a saltine cracker each day would be enough gluten to conduct a challenge and for adults, a slice of bread a day would be adequate. The challenge would need to occur for six to eight weeks before the test in order for it to be accurate. Accordingly, we will not be able to register individuals for the screening who cannot meet this criteria, should they wish to be tested after following the diet.

[CeliBelli]

....Thing is, Im concerned i might have it and he now wants to do the full Celiac Test Panel, but wants me to do a gluten challenge for up to a week and then run a bunch of tests. I'm really concerned about the effect this will have on my body but I also want to know once and for all. Any suggestions?

I agree with Meline. Although it is hard to do a gluten challenge, a week is not a long challenge period. If I were you, I'd try it, since it is necessary to be in a full gluten reaction to get accurate test results. Remember, too, that the gold standard for diagnosis is endoscopic biopsy, and all the best research recommends doing this while on gluten.