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It is easily the most common diagnostic dilemma that I am put in is
seeing someone who went on gluten free diet for several months felt
better then decided they wanted medical confirmation of the diagnosis.
They go to a doctor and get biopsies or the serologic blood tests which
come out normal.  They are then told they don't have it and subsequently
get sick on gluten .

It is then hard to get permission from the insurance company to go back
in to get the biopsies again.

THE STATE OF THE DIET IS CRUCIAL TO THE TIMING AND INTERPRETATION OF THE
BIOPSIES OR THE BLOOD TESTS WHEN LOOKING FOR CELIAC DISEASE!!
EXCLUSION OF GLUTEN FROM THE DIET CAN MASK BOTH THE BIOPSY RESULTS AND
THE BLOOD TESTS RESULTS!!!

sorry for shouting but my professional frustration reflects your
personal frustration with the lack of familiarity with celiac disease in
the USA.

I am happy to discuss my experience in dealing with these issues with
any MD who maybe not as familiar with celiac disease

Joseph A. Murray MD
Coordinator, Celiac Disease Clinic
Associate Professor of Medicine,
University of Iowa
IA 52242