Q: I want to know about the diagnosis of coeliac disease. I know that it is important to keep eating wheat before the blood test for it to work, but does the same apply to before the biopsy? I want to give up wheat, but I am afraid that if I do a biopsy it will be pointless because the intestine would be healed. For how long does one have to go gluten free before the intestine starts healing?

A:To confirm coeliac disease (CD) three major steps are taken. Firstly, a thorough physical examination is conducted, including a series of blood tests, sometimes referred to as the Celiac Blood Panel. Secondly, a duodenal biopsy is performed with multiple samples from multiple locations in the small intestine. And thirdly, the gluten-free diet is implemented. When the patient shows a positive response to the diet - symptoms subside and the small intestine returns to its normal, healthy state - the diagnosis of CD is confirmed. The diagnosis of coeliac disease is complete when the health of the patient improves following implementation of the gluten-free (GF) diet. When gluten is removed from the diet, most of the damage that was done to the small intestine (the jejunum) is repaired. It takes only three to six days for the intestinal lining (the mucosa) to show improvement. Within three to six months, most symptoms subside as the mucosa returns to its normal (or nearly normal) state.