<<Disclaimer: Verify this information before applying it to your situation.>> I have read several postings from members who have gone off gluten before diagnosis, and are now facing the dilemma of how to get diagnosed, not wanting to resume a diet containing gluten. (It is important NOT to go off gluten before diagnosis, but we have learned of many people through our support group who were not given this information, or did not choose to follow this advice.) Could rectal gluten challenge be an answer for them? Michael Marsh, M.D., in speaking to the last annual GIG conference (Videotape available from GIG), presented Rectal Gluten Challenge as a preferable method of diagnosis for CD. He stated that Rectal Gluten Challenge is "relatively fast... easier to analyze...can be given to any age group... is useful in diagnosing latent gluten sensitivity, and can be used if the patient has been on a recent gluten-free diet." He stated that an ordinary syringe is used, containing gluten in the tube. Gluten is discharged into the proximal rectum. The patient is dismissed and returns four hours later, for a rectal biopsy. If there is gluten sensitivity, there will be an increase of T-cells in the rectal mucosa.. A before and after count of T-cells is done, and it is determined by this count if there is gluten sensitivity. According to Dr. Marsh, in a blind study, all those with intestinal biopsy proven CD were ID'd correctly with gluten sensitivity, and all the disease controls were identified correctly, as not showing gluten sensitivity. This information was taken from the videotape mentioned above. Now the question is: Is diagnosis by rectal challenge accepted as valid anywhere in the United States?. Is anyone doing it? Is there anything in the literature to support Dr. Marsh's study? Is diagnosis by rectal challenge reliable for those who are gluten-free? This sounds, to a non-medical person like me, like a safer, more comfortable, surer means of diagnosis for everyone, but I'd like more information. Sue Goldstein Westchester County, NY Celiac Support Group