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Gluten Challenge Question


WMO

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WMO Newbie

Hi there,

I just have a question or two about doing a gluten challenge.

My son (age 2 - will be 3 in March) had months of diarrhea, as well as some excema to his face off and on. I decided to try to remove gluten from his diet to see what would happen. Although it didn't completely "fix" his diarrhea, I noticed a significant improvement. He went from 2-3 diarrhea or loose BM's per day to 1, maybe 2 BM's, that ranged from loose to firm (no diarrhea). His excema seemed to flare up every evening, but maybe that was the yogurt he got (I thought it was gluten free, but found out later it might not have been). After 2 1/2 weeks being gluten free, I took him to the doctor who wants to test him for celiac. He wanted me to put him back on a regular diet for 7-10 days and then get the tests done. I expected that all of his symptoms would come back... but other than a few times of diarrhea, his BM's have been mostly better than even while we were doing gluten-free! And his face hasn't been too bad either. I find him to be easily irritable (which had improved while gluten-free) - but other than that, his symptoms are minimal. Could he still have celiac even though is GI symptoms don't seem as bad? Anyone else have a similar experience or can offer some thoughts on this? Thanks!


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eatmeat4good Enthusiast

If your child has Celiac and you were really good at avoiding gluten, then the antibodies may have calmed down. The reaction time can be delayed. They used to think children outgrew Celiac for this reason. Later they learned that was not the case. The irritability would be consistent with the neurological reactions of Celiac. Symptoms can change over time, but your post indicates that your child has all the three categories of Celiac symptoms...Gastrointestinal, Dermatological, and Neurological. If the test is negative you should continue to keep this in mind since 7 to 10 days may not be enough time for his antibodies to become reactive enough to test positive on the tests.

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    • par18
      Thanks for the reply. 
    • Scott Adams
      What you’re describing is actually very common, and unfortunately the timing of the biopsy likely explains the confusion. Yes, it is absolutely possible for the small intestine to heal enough in three months on a strict gluten-free diet to produce a normal or near-normal biopsy, especially when damage was mild to begin with. In contrast, celiac antibodies can stay elevated for many months or even years after gluten removal, so persistently high antibody levels alongside the celiac genes and clear nutrient deficiencies strongly point to celiac disease, even if you don’t feel symptoms. Many people with celiac are asymptomatic but still develop iron and vitamin deficiencies and silent intestinal damage. The lack of immediate symptoms makes it harder emotionally, but it doesn’t mean gluten isn’t harming you. Most specialists would consider this a case of celiac disease with a false-negative biopsy due to early healing rather than “something else,” and staying consistently gluten-free is what protects you long-term—even when your body doesn’t protest right away.
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      Yes, I meant if you had celiac disease but went gluten-free before screening, your results would end up false-negative. As @trents mentioned, this can also happen when a total IGA test isn't done.
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