It's important to remain on a normal, gluten-containing diet before being tested for celiac disease. Keep in mind that going gluten-free before being tested for celiac disease can prevent diagnosis. If you cut gluten out of your diet before undergoing testing, your body will begin to heal and tests will be unreliable. However, people who have already adopted the gluten-free diet without having been tested for celiac disease can undergo a "gluten challenge" in order to receive accurate test results.
A gluten challenge is when you intentionally eat gluten to see if your body produces the antibodies that indicate celiac disease. An expert celiac physician can advise you how to undertake a gluten challenge. He or she will recommend the best about of gluten. (Typically its three to 10 grams per day, and two grams is roughly equivalent to a slice of bread.) Although there is research underway to drastically shorten the duration, currently the challenge would usually be done for six to eight weeks, followed by a biopsy of the small bowel, which is done by endoscopy. However, recent findings suggest that if you are having too many symptoms and cannot tolerate a full six to eight weeks of a daily challenge, it is still worthwhile to have a biopsy after as little as two weeks on one. That would then be combined with celiac antibody testing two to four weeks after the challenge ends.
The gluten challenge now requires eating less gluten over a shorter time frame than in years past. When beginning a gluten challenge:
- You will be asked to begin to eat gluten again. The gluten challenge will last up to eight weeks;
- You will need to eat a three to 10 grams of gluten per day, and two grams is roughly equivalent to a slice of bread.
While the gluten challenge may sound risky, it is accepted within the medical community. However, you should be closely monitored by a doctor skilled in celiac disease if taking on the challenge. If you have specific concerns, it is always best to ask your doctor for further guidance.