What is the recommended dietary action upon symptom identification of suspected celiac disease?

• A. Gluten Needs to Remain in the Diet Until After Serology Testing and Biopsy Are Completed
• B. Gluten Should Be Eliminated Immediately
• C. Gluten-Free Diet Should Be Started Immediately
• D. Diet Should Be Continued as Is Until Testing

Answer: (A)

Accurate diagnosis of suspected celiac disease relies on keeping gluten in the diet during initial testing. Serology (such as tTG IgA and EMA) and a confirmatory small bowel biopsy depend on ongoing gluten exposure to reflect the true disease state. If gluten is eliminated before testing, results can become falsely negative or less definitive, delaying diagnosis and appropriate management. Therefore, maintain the patient’s usual gluten intake until serology and biopsy are completed, then implement a gluten-free diet if the diagnosis is confirmed. Eliminating gluten prematurely can obscure the diagnosis and complicate future treatment.