Gluten Challenge - How Much And How Long?

[CMG]

Hi. Like many who post in this area, I'm new here.

I have been "gluten-light", as I like to call it, for over a year. I know I feel better when I exclude gluten from my diet and we are gluten free at home. I just don't worry so much about what I eat outside of our house, so once a week or so I'll end up having pizza or pasta.

I recently had a positive celiac gene test - DQ2 heterodimer.

Now, I would like to have testing done to find out whether I actually have celiac. My question is, for how long will I have to include gluten in my diet and how much each day for blood tests and biopsies to be accurate?

[MELINE]

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.

I don't remember the source. I just had it saved as a word document in my pc.

Meline

[CMG]

Thank you for the information Meline.

I do have a positive HLA test, so I think gluten challenge and testing is the right next step. I have an appointment with a GI doc next week.

[MELINE]

good luck then!

Meline