Diagnosis of celiac disease should be firmly established before commencing treatment with a gluten-free diet for several reasons.
The gluten-free diet is a lifelong and tedious commitment that should not be taken lightly. It is more costly than a normal diet and has significant social implications for dining out.
Patients with irritable bowel syndrome may experience improvements in bloating, abdominal pain, and diarrhea with a gluten-free diet. These patients may be misdiagnosed as having celiac disease. Without confirmation of celiac disease by small intestinal biopsy, they may be unnecessarily committed to lifelong gluten restriction.
A gluten-free diet can lower blood antibody levels and allow the small intestine to lose the typical appearance of celiac disease, complicating subsequent efforts at making a firm diagnosis of celiac disease.
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