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
Gluten-free diet food bearing the claim in its labelling may not contain: Any food product that inherently does not contain gluten may use a gluten-free label where any unavoidable presence of gluten in the food bearing the claim in its labelling is below 20 ppm gluten. Gluten-free diet A gluten-free diet (GFD) is a diet that strictly excludes gluten, a mixture of proteins found in wheat and related grains, including barley, rye, oat, and all their species and hybrids (such as spelt, kamut, and triticale). The inclusion of oats in a gluten-free diet remains controversial, and may depend on the oat cultivar