<<Disclaimer: Verify this information before applying it to your situation.>> I agree with Jim Lyles when he said that biopsies are necessary. There are other diseases that need to be ruled out. In my case I really can't call it "gold" standard. When I had my first biopsy I was told that it was a "low positive". It read "Partial Villous Atrophy, Focally Increased Interepithelial Lymphocytes, and Mild Crypt Hyperplasia". I brought the results to another Gastroenterologist and he read it as neg. He did a chalenge biopsy (I only lasted 3 or 4 days back on gluten) and the results were neg. I went for a third opinion and was told that because of my symptoms he felt I had Celiac. My mother at that time had just been diagnosed with D.H.(with proven biopsy). I still recommend that people have the biopsy. It can at times be very hard staying on a gluten-free diet when you are not 100% sure of the diagnosis. Ginny