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The necessity for a biopsy to diagnose celiac disease is currently
without an alternative.  The risk of a biopsy when carried out by a well
qualified physician is extremely low.  The issue of whether a patient
needs to be on a gluten challenge is one that needs to be discussed with
the doctor beforehand.  How much gluten, for how long and when to do the
biopsy should all be discussed well ahead of the biopsy. Please bring up
the topic if the doctor does not mention it. I agree that the decision is
the patients in all matters related to their health.   the doctor has to
agree to do something if he feels that it is reasonable and indicated. At
a recent meeting meeting in Baltimore it was agreed by all the
professional participants that a biopsy isa required to make the
diagnosis of celiac disease.
Not medical advice
Joe Murray