id	author	title	date	pages	extension	mime	words	sentences	flesch	summary	cache	txt
cord-274189-mrrctuxt	Freeman, Hugh James	REVIEW: Adult Celiac Disease and the Severe “Flat” Small Bowel Biopsy Lesion	2004		.txt	text/plain	5330	274	37	Even a normal small bowel biopsy may be useful, in most instances, to exclude structural small bowel causes of diarrhea, particularly those with diffuse and severe changes in the proximal small intestine, such as classic celiac disease. Repeated biopsies from the same proximal small intestinal sites after only a few weeks on a strict gluten-free diet may not be sufficient to show a convincing histologic response, even if the patient is clinically improved (i.e., resolution of diarrhea and weight gain). Recently, even strongly positive tissue transglutaminase antibody assays were recorded using a commercially available test kit in patients with no other disease detected and entirely normal small bowel biopsies (17) as well as in a patient with a severe flat lesion not histologically responsive to gluten restriction (17) . Demonstration of histologic improvement in these gluten-induced changes in the small intestinal mucosa with a gluten-free diet in patients with latent celiac disease was also documented (23, 47) .	./cache/cord-274189-mrrctuxt.txt	./txt/cord-274189-mrrctuxt.txt