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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]
A trial of gluten reintroduction to observe any reaction after one to two years of strict gluten-free diet might be performed. [6] A strict gluten-free diet is effective in most of the neurological disorders associated with NCGS, ameliorating or even resolving the symptoms. It should be started as soon as possible to improve the prognosis. [1]
Theoretically, a trial of gluten reintroduction to observe reaction after 1–2 years of strict gluten-free diet might be advisable. [37] Approximately one-third of persons with NCGS continue having symptoms despite gluten withdrawal. This may be due to diagnostic error, poor dietary compliance, or other reasons.
Gluten bears an innate response peptide (IRP) found on α-9 gliadin, at positions 31–43 and on α-3, 4, 5, 8, and 11 gliadins. The IRP lies within a 25 amino-acid long region that is resistant to pancreatic proteases. The 25mer is also resistant to brush border membrane peptidases of the small intestine in coeliacs. [3]
Stimulus–response (S–R) compatibility is the degree to which a person's perception of the world is compatible with the required action. S–R compatibility has been described as the "naturalness" of the association between a stimulus and its response, such as a left-oriented stimulus requiring a response from the left side of the body.
Gluten-free" is defined as 20 parts per million of gluten or less and "very low gluten" is 100 parts per million of gluten or less; only foods with cereal ingredients processed to remove gluten can claim "very low gluten" on labels. [89]
This time can be manipulated experimentally to determine its effects on other dependent measures such as reaction time or brain activity. [2] For an example of the application of stimulus-onset asynchrony, see psychological refractory period. Figure 1. Time diagram for a trial in a psychological experiment.
This condition is known as refractory coeliac disease (RCD), defined as malabsorption due to gluten-related enteropathy (villous atrophy or elevated intraepitheal lymphocytes) after initial or subsequent failure of a strict gluten-free diet (usually 1 year) and after exclusion of any disorder mimicking coeliac disease. [106] [107]