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The test may be performed in people with suspected gluten-related disorders in very specific occasions and under medical supervision, for example in people who had started a gluten-free diet without performing duodenal biopsy. [1] [2] [3] Gluten challenge is discouraged before the age of 5 years and during pubertal growth. [4]
The gluten-free diet has become popular in the United States and other countries. [3] Clinicians worldwide have been challenged by an increasing number of people who do not have celiac disease nor wheat allergy, with digestive or extra-digestive symptoms which improved after removing wheat / gluten from the diet.
In addition to gluten withdrawal, some people need to follow a low-FODMAPs diet or avoid consumption of commercial gluten-free products, which are usually rich in preservatives and additives (such as sulfites, glutamates, nitrates and benzoates) and might have a role in triggering functional gastrointestinal symptoms. [118]
Researchers think people's sensitivity issues aren't always with gluten — they could be linked to fructan.
Though oats are gluten-free, some people with celiac disease have an adverse immune reaction to the proteins in oats and need to avoid the grain. 3. Worst: Ener-G Multigrain Loaf (With Brown Rice)
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The degree of gluten cross contamination tolerated by people with non-celiac gluten sensitivity is not clear but there is some evidence that they can present with symptoms even after consumption of small amounts. [37] Sporadic accidental contaminations with gluten can reactivate movement disorders associated with non-celiac gluten sensitivity. [72]
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