Response to challenge may be delayed in rare cases up to in rare case 14 years. Gluten is gradually introduced, starting with one wheat cracker, and increasing to 3 slices of whole wheat bread a day. The dose should be high enough to produce symptoms but hopefully not so severe as to require hospitalization. It must be made certain that the patient will not have an anaphylactic response- if a concern should be done in a hospital setting. Many don't want to do the gluten challenge as it will make them sick or they don't truly follow the instructions of the challenge.
Potential problem is non compliance with taking gluten back into diet.
Grief reaction to the loss of gluten-containing foods. Can change bowel habit just by mal digesting a lot of wheat. Can be a lactose intolerance issue. Colons are meant to have bacteria and is important to maintain colonic health. Gluten to a celiac is protein found in wheat, barley, rye, oats, spelt and kamut and wheat like grains.