I searched the last few questions to see if my questions had already been asked and answered but didn't find a similiar question. I am sorry if I overlooked a similiar question. My questions: 1. Are all reactions to gluten that cause GI side effects (like bloating and diarrhea) auto-immune mediated? Or is it possible to have a reaction that isn't an auto-immune and all you have to do is reduce your gluten intake to be symptom free rather than going 100% gluten free like Celiac disease requires? 2. Is it possible to have Celiac disease and have a high tolerance to gluten so that an occasional bagel or slice of pizza causes no reaction other than possibly a bit of bloating? Can one's reaction to gluten be periodic - one day no reaction but trying gluten a couple of weeks later does cause sudden, painless diarrhea. 3. Is there a typical time frame that diarrhea related to an auto-immune reaction to gluten occurs in? Is it typically immediately after eating gluten, say within 30 minutes? Can it be 24 hours later? I am trying to figure out my own symptoms and diagnosis. I am a doctor, an internist, but I was amazed at how little I actually knew about the practical aspects of celiac disease when I started having symptoms myself. I have done extensive reading into the disease and now know more than some gastroenterologists that I know. But there are certain topics that are not explained in the medical literature - such as the timing of the dirrhea and whether the symptoms can be sporadic. So I was hoping someone on the forum might be able to shed some light. Finally, does anyone know of a good GI doc in the triad area of NC? My blood work was negative, so I want to find a doctor willing to persue a biopsy even with negative antibody levels rather than treat me like a hypochondriac. Thanks so much!