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 upon this mixing of grains. Use of high-gluten wheat flour also makes possible multigrain breads, such as the "rye and Indian" bread of the American colonies, which combined rye and wheat with cornmeal in one loaf. Rye bread contains phenolic acids and ferulic acid dehydrodimers. Pure rye bread contains only rye flour, without any wheat. German-style pumpernickel, a dark, dense, and close-textured loaf, is made from crushed or ground whole rye grains, usually without wheat flour, baked for long periods at low temperature in a covered tin. Rye and wheat flours are often used to produce a rye bread with