<<Disclaimer: Verify this information before applying it to your situation.>> I have read a book called "Coeliac Disease", written by W T Cooke and G K T Holmes, published in 1984. They discuss jejunal muscosal changes in patients with celiac disease who were in remission on a gluten free diet, when a normal diet is resumed. And I quote "Indeed, it has been claimed that if changes have not occurred in three months, [flattened villi occurring] the diagnosis is incorrect. There is evidence, however, that this view is wrong and that the time for a flat muscosa to develop may take months or even years." [on a gluten diet] They also state the time needed varies by individual. Please keep in mind the intestines can heal quickly in some individuals. I have read that anywhere from 6 months - 2 years on a gluten free diet could completely heal the villi based on the age of the patient and the degree of damage at the time of onset. This means that a gluten diet can be commenced without no apparent symptoms for some individuals until the damage begins again. This could take months or years. Meanwhile, the risk of intestinal lymphoma exists for those that are celiac. My mother and two of her sisters died of intestinal lymphoma, so I take the cancer risk quite seriously. Eating gluten would be like playing with fire for me. I will never go back to eating gluten again even if the HMO doesn't change their mind on the diagnosis. (It is currently a gluten sensitivity, but not celiac based on tests that were improperly performed--which is why the diagnosis is under appeal.) There is no proof that it will not eventually completely flatten the villi after many years eating gluten. My villi were all clumped together in my biopsy. But no one told me this until I viewed the biopsy for myself. I want people to be aware also, that some doctors are looking only for flat villi, not an increase in lymphocytes. We all need to be actively involved in our diagnosis process. I would encourage anyone with a negative biopsy after being gluten free to verify with the pathologist what he or she was looking for when he or she read the biopsy. View the biopsy yourself and compare it to pictures in books. The book I mentioned above have some excellent photographs of biopsies which you can compare them with. Ask the pathologist whether he/she was aware that this test was on a challenge of [so many weeks or months]and not on someone who had been eating gluten for years? Also tell them how long you were gluten free. Ask them at this point if they have to experience and skill to read this type of biopsy. My pathologist admitted he did not, which is why he recommened the appeal. This kind of information needs to be provided to the pathologist to insure that they were aware of all the circumstances of the case. My gasenterologist assured me that the pathologist would be informed of my case, I found out that this was not true at all. So we need to find out everything for ourselves, rather than trust the system. I am still waiting on my appeal of diagnosis with my HMO. If anyone would like to read about my experience, my home page is listed below. Abigail --- [log in to unmask] Homepage: http://www.geocities.com/HotSprings/Spa/4003/ Join the Monday night Celiac chats from 8PM - 10PM ET and the celiac forum at: http://www.medsupport.org