Question

A 40-year-old with celiac disease on a gluten-free diet has persistent symptoms; tTG-IgA is normal. What is the next step?

Accepted Answer

Assess for hidden gluten exposure and consider a repeat biopsy.

Answer

Assume refractory disease and start steroids.

Answer

Start biologic therapy.

Answer

Begin a low-FODMAP diet only.

Answer

Stop all follow-up.

Practice question

A 40-year-old with celiac disease on a gluten-free diet has persistent symptoms; tTG-IgA is normal. What is the next step?