True or False: You should always deworm before starting a diet trial for suspected food-responsive enteropathy.

• A. Not applicable
• B. Not sure
• C. False
• D. True

Answer: (D)

Confronting suspected food-responsive enteropathy, you want to isolate the diet as the variable affecting the gut. Parasites are a common mimic of chronic GI disease and can cause diarrhea and other signs similar to a dietary issue. If a parasite is present and not treated, it can confound the diet trial—either masking a true dietary response or giving the impression that the diet isn’t helping when the parasite is actually driving the symptoms. Deworming beforehand helps ensure that any observed improvement or lack thereof truly reflects the diet, not an untreated parasitic infection. Since fecal tests can miss some parasites, proactively deworming is a prudent step to clarify the cause of symptoms before evaluating a diet trial. True.