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For people eating a gluten-free diet who are unable to perform an oral gluten challenge, an alternative to identify a possible celiac disease is an in vitro gliadin challenge of small bowel biopsies, but this test is available only at selected specialized tertiary-care centers. [5]
It is excluded when there are normal levels of serum IgE antibodies to gluten proteins and wheat fractions, and no skin reaction to prick tests for wheat allergy. [6] Nevertheless, these tests are not always completely reliable. [11] If an allergic reaction can not be clearly identified, the diagnosis should be confirmed by food provocation ...
Food intolerance is a detrimental reaction, often delayed, to a food, beverage, food additive, or compound found in foods that produces symptoms in one or more body organs and systems, but generally refers to reactions other than food allergy. Food hypersensitivity is used to refer broadly to both food intolerances and food allergies.
Food allergy is principally diagnosed by careful history and examination. When reactions occur immediately after certain food ingestion then diagnosis is straight forward and can be documented by using carefully performed tests such as the skin prick test and the radioallergosorbent test RAST to detect specific IgE antibodies to specific food proteins and aero-allergens.
Gastrointestinal symptoms of wheat allergy are similar to those of coeliac disease and non-celiac gluten sensitivity, but there is a different interval between exposure to wheat and onset of symptoms. Wheat allergy has a fast onset (from minutes to hours) after the consumption of food containing wheat and could be anaphylaxis. [15] [45]
The NHS is free at the point of use for the patient though there are charges associated with eye tests, dental care, prescriptions, and many aspects of personal care. The NHS provides the major part of healthcare in England, including primary care , in-patient care , long-term healthcare , ophthalmology and dentistry .
An NHS trust is an organisational unit within the National Health Services of England and Wales, generally serving either a geographical area or a specialised function (such as an ambulance service). In any particular location there may be several trusts involved in the different aspects of providing healthcare to the local population.
The diagnostic test, when used, is similar to that used to diagnose lactose intolerance. It is called a hydrogen breath test and is the method currently used for a clinical diagnosis. Nevertheless, some authors argue this test is not an appropriate diagnostic tool, because a negative result does not exclude a positive response to fructose ...
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