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How Long Should A Gluten Challenge Be?

Defkid

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Defkid Rookie
Defkid
Posted

Hi

Has anyone in this forum gone on a gluten challenge, gotten tested and had a positive result? Just wondering how long I should stick to the challenge before getting tested.

If it comes back negative, I'd rather believe that I don't have celiac, than wonder if I just didn't stick out the challenge long enough.

How much gluten containing food should I be eating

Thanks

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one more mile Contributor
one more mile
Posted

I do not understand your question. What is a gluten challenge?

happygirl Collaborator
happygirl
Posted
Hi

Has anyone in this forum gone on a gluten challenge, gotten tested and had a positive result? Just wondering how long I should stick to the challenge before getting tested.

If it comes back negative, I'd rather believe that I don't have celiac, than wonder if I just didn't stick out the challenge long enough.

How much gluten containing food should I be eating

Thanks

In Dr. Peter Green's book Celiac Disease: A Hidden Epidemic, he states:

"Results of all the tests will return to normal on a gluten-free diet. Therefore, a gluten challenge which consists of eating gluten foods for anywhere from one to three months - is often needed in order to confirm a diagnosis of celiac disease. A gluten challenge involves a biopsy, not blood tests, after a period of eating gluten." (p. 52)

"There is no uniform standard for what a gluten challenge involves." (p. 53)

"We arbitrarily use a standard set by Michael Marsh, MD, from England.....and say that a gluten challenge consists of eating about four slices of bread/day for a month. ....if people are tolerationg the gluten well, we would prefer that they remain on gluten for at least three months before having a biopsy. This will reduce the chances that the biopsy result will not be definitive." (p. 53)

maile Newbie
maile
Posted
In Dr. Peter Green's book Celiac Disease: A Hidden Epidemic, he states:

"Results of all the tests will return to normal on a gluten-free diet. Therefore, a gluten challenge which consists of eating gluten-free foods for anywhere from one to three months - is often needed in order to confirm a diagnosis of celiac disease. A gluten challenge involves a biopsy, not blood tests, after a period of eating gluten." (p. 52)

"There is no uniform standard for what a gluten challenge involves." (p. 53)

"We arbitrarily use a standard set by Michael Marsh, MD, from England.....and say that a gluten challenge consists of eating about four slices of bread/day for a month. ....if people are tolerationg the gluten well, we would prefer that they remain on gluten for at least three months before having a biopsy. This will reduce the chances that the biopsy result will not be definitive." (p. 53)

um not to be snarky but shouldn't that be "consists of eating gluten foods" ? (I bet you're like me, my fingers and brain have to consciously drop the word free when writing gluten B) )

Katea Rookie
Katea
Posted

Hi, I saw a gartroenterologist this week and he said a recent study shows that 4 slices of bread a day are required for at least 4 weeks before a biopsy. So 10 more days to go for me and I will be tested :D . I am not sure if this same rule applies to blood tests also.

happygirl Collaborator
happygirl
Posted

edited.

JustCan Explorer
JustCan
Posted

Hi...I did a gluten challenge for a month and ate roughly four slices of bread a day but some of it was in the form of pasta, crackers, etc. By the end of the month, I felt like I was going to die (couldn't go to work, falling asleep by 7pm at night, extreme stomach pain, etc). But, my biopsy came back negative with no "conclusive" signs of celiac. My doc said to definitely continue the gluten-free diet since gluten obviously caused major problems for me. So, either a month of a gluten challenge wasn't enough to do damage or the pathologist just couldn't see it. But, had I known then what I know now, I never would have done the gluten challenge since I already knew I was healthy on a gluten-free diet instead of sick like I'd been my whole life. Anyway, best of luck to you!

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  • 2 months later...
Crayons574 Contributor
Crayons574
Posted

JustCan-----

I have been gluten-free for a year and considering doing the gluten challenge to hopefully result celiac or not (Is it bad I am secretly hoping I will be positive Celiac so everything will make since?) However, I'm afraid to go through all this trouble of temporarily messing up my stomach again with the gluten challenge to have the test results come back negative. I don't know the answer to your question, but I saw that it was dated back in March. I was wondering if you have heard any other information on if you are gluten intolerant or if you are celiac and didn't do the gluten challenge for long enough? How long did you do the gluten challenge for?

Serversymptoms Contributor
Serversymptoms
Posted

Since I'm seeing my doctor tomorrow, I've been having gluten once or twice, or maybe even three times a week. So my test results/ allergy test ( if I get one) can be more accurate.... on whether I'm celiac or not. Like me ( and today) I consumed gluten and I think my health, appearance etc... took a worst toll... and these are part of my symtoms. So consume gluten once a week ( if your really curious/ anxious) and see what happens.

  • 1 month later...
Crayons574 Contributor
Crayons574
Posted

my gastro said 3 pieces of bread for 3 months.

pdx.lila Rookie
pdx.lila
Posted

I'm also curious about this. I've been virtually gluten free for about a year but because I've been getting sicker I finally saw a GI doctor yesterday. He was an idiot and told me that blood tests for celiac are almost 100% accurate and that I couldn't have it because I'm not underweight. Anyway,he also told me that i didn't have to be eating gluten before I had an endoscopy. I'd still like to find out if it's all celiac (I have very clear symptoms but blood tests are negative) but I'm terrified of eating gluten again-I feel completely unable to function. I have a endoscopy schedule for next week and I'm wondering if I ate gluten between now and then if that would be enough to show up on a biopsy?

I'm not sure if it's worth it to fill like poop for the next 3-4 weeks because I eat gluten for a week just to find out if I for sure have Celiac...I figure if something else shows up in the biopsy,then we can look in to that,but if nothing shows up I'll assume it's celiac...

tarnalberry Community Regular
tarnalberry
Posted
Since I'm seeing my doctor tomorrow, I've been having gluten once or twice, or maybe even three times a week. So my test results/ allergy test ( if I get one) can be more accurate.... on whether I'm celiac or not. Like me ( and today) I consumed gluten and I think my health, appearance etc... took a worst toll... and these are part of my symtoms. So consume gluten once a week ( if your really curious/ anxious) and see what happens.

Tests are unlikely to be accurate with that little gluten. :(

bagelbabe Newbie
bagelbabe
Posted
I'm also curious about this. I've been virtually gluten free for about a year but because I've been getting sicker I finally saw a GI doctor yesterday. He was an idiot and told me that blood tests for celiac are almost 100% accurate and that I couldn't have it because I'm not underweight. Anyway,he also told me that i didn't have to be eating gluten before I had an endoscopy. I'd still like to find out if it's all celiac (I have very clear symptoms but blood tests are negative) but I'm terrified of eating gluten again-I feel completely unable to function. I have a endoscopy schedule for next week and I'm wondering if I ate gluten between now and then if that would be enough to show up on a biopsy?

I'm not sure if it's worth it to fill like poop for the next 3-4 weeks because I eat gluten for a week just to find out if I for sure have Celiac...I figure if something else shows up in the biopsy,then we can look in to that,but if nothing shows up I'll assume it's celiac...

I feel your pain, I have been there, I am in the same boat right now, I was diagnosed 2yrs ago roughly by a Doc that did the full panel plus genetic risk factor, I came back negative for the antibodies test, High Risk Category based on genetic flags found, and he diagnosed me with Iga defficency which he based his diagnosis on for the reason my antibody test came back negative for celiac. So b/c I feel if you have a life long commitment to following a rigourous and restricted diet/ lifestyle, I had a second and a third opinion. they both said, that I was not Iga defficent which would cancel out the first doctors reason for diagnosing me right? Yeah I am at a high risk and had symptoms yada yada yada, but also I have been pretty much gluten free before I was even tested the first time, and was strictly gluten-free after diagnosis. SO it stands that I really don't have a celiac diagnosis afterall, I m starting from scratch, and contimplating a rough month ahead for peace of mind for me and my family since they are in the same gluten-free household as of now, I am terrified as well of eating a crumb of gluten, I have more anxiety about it than anything, But at the end of it all hopefully I should have something solid to stand on. IF you don't you will always wonder, and think about it , its exhausting reading everything, shampoo, makeup , vitamins, medications, it never goes away, so a month of uncomfortable stuff might be worth it to you to have that true answer. I wish there was another way, but I don't think there is, I have been gluten-free for 2 yrs now, and it sucks, not just not eating bread and such, just the worry, the being left out, or just always having to read every stinkin thing, I mean I might and you might just be sensitive to it at the end of it which is much better than worrying about a single crumb contaminating your food, SO thats what Im hoping for, I am hoping for a difinitive negative no doubt about it answer! then I can make my own choices, and live my own life!

  • 1 month later...
sapila Newbie
sapila
Posted
I'm also curious about this. I've been virtually gluten free for about a year but because I've been getting sicker I finally saw a GI doctor yesterday. He was an idiot and told me that blood tests for celiac are almost 100% accurate and that I couldn't have it because I'm not underweight. Anyway,he also told me that i didn't have to be eating gluten before I had an endoscopy. I'd still like to find out if it's all celiac (I have very clear symptoms but blood tests are negative) but I'm terrified of eating gluten again-I feel completely unable to function. I have a endoscopy schedule for next week and I'm wondering if I ate gluten between now and then if that would be enough to show up on a biopsy?

I'm not sure if it's worth it to fill like poop for the next 3-4 weeks because I eat gluten for a week just to find out if I for sure have Celiac...I figure if something else shows up in the biopsy,then we can look in to that,but if nothing shows up I'll assume it's celiac...

I found a doc who didn't seem to know much about Celiac, but he told me the shortest time period for a gluten challenge, so I went with him anyway.

I couldn't even make it through the whole 2 weeks he told me to eat gluten because I got so severely dehydrated and couldn't go into work any longer. It was horrible.

I am an incredibly cheap person, but after that experience and the struggle to get my body back to normal afterwards, I wish I would have just paid the $320 or so out of pocket for the genetic test from Prometheus. I'm cheap, but my health is so much worse now as I'm still recovering.

Also, I just found this interesting tid-bit about length of time at Open Original Shared Link for a research study into Celiac testing sensitivity at different gluten consumption levels:

"Because of this many individuals who present for evaluation of possible celiac disease but who are already on a gluten free diet cannot be tested accurately as there is currently no way of differentiating between healthy individuals and individuals with well treated celiac disease. The standard practice in such cases is to perform a 'Gluten Challenge' whereby the patient eats the equivalent of 2 slices of bread per day for six to eight weeks before returning for evaluation with serologic testing and endoscopy with duodenal biopsy. The use of the gluten challenge in clinical practice is limited by patient symptoms and resistance to such a long test period, after which it may take a number of weeks for the intestine to heal and the symptoms to resolve. Autoantibodies to tissue transglutaminase or antibodies to deamidated gliadin, while being excellent tools to predict celiac disease in patients who have been on a long-term gluten containing diet, display low sensitivities to detect short-term and/or recent gluten exposure."

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