I’ve decided to do a small mini-series on the website called FAQ. These are questions that I often see asked or have a bit of confusion surrounding the topic. If you have a question or topic you think I should do an article on you can leave a comment below or email me.
Today’s topic is going to surround the gluten challenge. Focusing on when and why a gluten challenge is necessary, what is involved and explaining a few misconceptions that surround and have been developed by the challenge.
So, What is A Gluten Challenge?
Let’s start by discussing the specifics. Firstly, a gluten challenge is only required if you have eliminated gluten in your diet prior to receiving your formal diagnosis. I’ll be covering why a formal diagnosis is important in another article, however this excerpt gives you a little insight.
“By obtaining a proper diagnosis, you can be assured that your symptoms are caused by coeliac disease (and should therefore improve once the gluten free diet is established) and not by another more sinister condition.” – Coeliac Aus
If you haven’t eliminated gluten yet, DO NOT remove it from your diet. Continue eating gluten as usual until your biopsy has been completed. You must be consuming gluten to receive accurate testing results. If you have removed gluten from your diet, then the gluten challenge must be undertaken for 6 weeks prior to testing. During this time you must meet the recommended daily gluten intake to ensure that you can be accurately diagnosed. The recommended intake differs from Children to Adults but both must undergo the full 6 weeks.
The recommended gluten intake for adults is four slices of a wheat-based bread each day. For children the recommendation is for two slices of a wheat-based bread. This can easily be achieved with a sandwich for lunch and perhaps some toast. Often I see people curious about what else they could eat instead of a wheat-based bread, so here are a few equivalent options.
- One half of another bread-based item – Roll, Muffin, Crumpet, Danish, Crossaint (Naturally these need to be wheat based)
- A half serve of a wheat based pasta – For me 1 serve is usually about 1 cup cooked.
- A single Weetbix
- 1 Packet of Two Minute Noodles
- A Serve of Savoury Crackers – Saladas and so on
- 1 Serve of a wheat based sweet biscuit
- 2 Servings of a savoury biscuit (Ritz)
- 1/2 a serve of a wheat based cereal
Please note that oats cannot count towards your gluten challenge. For more information see Are you the One in Five and the Coeliac Australian Statement.
Gluten Challenge Misconception
A big misconception I see thrown around is that, if we need to eat so much gluten to show damage during the biopsy, then a crumb or cross contamination obviously can’t hurt us. During the gluten challenge it is important to include as much gluten as possible for the set period of time. This is to guarantee a correct diagnosis for most people.
During the procedure, the specialist will take small samples of your intestinal lining for the diagnosis of Coeliac Disease. These small samples are only a portion of your intestines and therefore it is possible that there is no damage in that area. Completing the gluten challenge provides the opportunity for internal damage to be in a wider area within the intestines and will be more likely found during the biopsy. In short words, a crumb or cross contamination can provide damage to the villi, however it may not be on distributed enough to be picked up via the scope and biopsy.
Follow Up Scope
Another question I see a lot is when someone needs to go in for a follow up scope. This question is often, do I need to eat gluten again? The answer is No. You do not need to consume gluten after your diagnosis. Definitely do not consume gluten after your diagnosis. The follow up scope is to check your progress regarding to healing and following a gluten free diet. Follow up scopes are recommended to be set for 12 to 24 months after your initial diagnosis, as the healing process takes time.
I hope that this has cleared up a few things regarding the gluten challenge. As further questions come to light, this article will be updated.
If you are going through a gluten challenge, stay strong, get some rest and drink plenty of water. It will be over soon.
Until Next Time;
Ashlee; The Aussie Coeliac.
All information regarding to this topic has been obtained via Coeliac Australia. I do not claim to be a medical expert and strongly recommend using the official information from Coeliac Australia. For more information see the diagnosis page on their website.