Even though I don’t think the biopsy is as reliable as it is made out, having one is better than not having one by a long chalk! A report I read on FoodsMatter suggests that many people with coeliac symptoms in the US are not even getting a biopsy check, which is just plain daft.
One interesting reason put forward is that coeliac is thought to be a Caucasian disease so many people from non-Caucasian backgrounds are assumed unlikely coeliac candidates and are not tested because of that.
In addition, this summary also suggests that even those in the US who are diagnosed coeliac aren’t followed up correctly to review their progress, nor given the support they need to be successful with a gluten free diet. How can we possibly say that a gluten free diet works if we don’t follow up…?