Non-celiac gluten sensitivity not yet universally adopted. For people on a gluten-free diet who are unable to perform an oral gluten challenge, an alternative to identify possible celiac disease is an in vitro gliadin challenge of small bowel biopsies; this test is only available at selected specialized tertiary-care centers. After exclusion of celiac disease and wheat allergy, the subsequent step for diagnosis and treatment of NCGS is to start a strict gluten-free diet (GFD) to assess if symptoms improve or resolve completely. This may occur within days to weeks of starting a GFD, but improvement may also be due to a non-specific, placebo
Rye bread "Lactobacillus" "sourdough" cultures lowers bread pH, facilitating growth of an acid-tolerant yeast strain, and helping gelatinize starches in the dough matrix. The byproduct of this approach is lighter breads. In areas where high-gluten hard wheat is readily available the need for a complex polyculture of bacteria and yeast can often be reduced or removed by adding a large proportion of hard wheat flour to the rye flour. Its added gluten compensates for amylase activity on the starch in the dough, allowing the bread to retain its structure as it bakes. The "deli rye" tradition in the United States is based