Gastroenterology and Hepatologymiddle twist
A 29-year-old woman asks whether she has coeliac disease. For three years she had bloating, loose stools and tiredness; four months ago she removed gluten from her diet on a friend's advice and feels "like a different person". Her ferritin is 9 µg/L (30–300). A tissue transglutaminase IgA antibody test requested last week is negative with a normal total IgA. She says she is very reluctant to eat gluten again because her symptoms were so disabling, but wants to know definitively whether she needs to avoid it for life.
Which one of the following is the most appropriate next step?