<<Disclaimer: Verify this information before applying it to your situation.>> In reply to the message about nontropical sprue in the tropics which I just accidentally deleted; I am not a medical person but have read that tropical sprue responds to antibiotics where nontropical sprue responds to the gluten free diet. As I understand it both conditions, when seen on biopsy, look similar enough to fool even some experts. The reason for the gluten challenge and second biopsy is to distinguish celiac disease from other diseases such as tropical sprue. Tropical sprue can be chronic. I have read it several places but have so much information that I would have to read a week to find it. One article is entitled, "Chronic tropical sprue and pernicious anaemia in a young indian man"; Proceedings of the Royal Society of Medicine; 67(10); 1021-2; October 1974. I have one article that compares tropical and nontropical sprue. Another article that may be of interest is, "Adult Coeliac Disease in Tropics"; British Medical Journal ; 1966; 2; 1230-2. It says, in part, "Seven cases of adult coeliac disease occurring in tropical regions are reported with clinical, biochemical, radiological, and histopathological data, suggesting that, even though gluten-sensitivity is a relatively uncommon cause of primary malabsorption syndromes in the tropics, it is not entirely absent." The two articles mentioned here are fairly old. They are the ones I quoted simply because the titles were self explanatory. Except for the articles written prior to the realization that the gluten free diet was effective, most of the information in the older articles seem to still be accepted as fact. I have a copy of an article from 1944 discussing, among other things, the bones problems with non tropical sprue. The spelling "Coeliac" was the old way of spelling celiac for those who didn't already know. I see posts from people asking if such and such is connected to sprue and have, somewhere, information dealing with it. One day I hope to have it indexed in such a way as to quickly look up what I want. Sorry to be so long. Brenda