Q. After many years of digestive problems, I decided to go gluten-free and have felt much better. Does this mean I need to go gluten-free for the rest of my life? Is there any diagnostic test other than if you feel better, stay gluten-free?

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A. Robert M. Russell, MD, emeritus professor at Tufts Friedman School, replies: You may in fact have a disease called celiac disease which results in an intestinal sensitivity and intolerance to gluten, but you wont know for sure until you have a blood test done to detect specific diagnostic antibodies in your circulation (anti-endomysial or anti-tissue transglutaminase). The presence of these antibodies is approximately 95% sensitive and 95% specific for the diagnosis of celiac disease. If you have celiac disease, you will need to follow a gluten-restricted diet for the rest of your life. Thus, it is worth knowing for sure whether or not you have the disease. In the meantime, if you are feeling better on the diet, by all means continue to stay on it.

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