What is the primary diagnostic approach for suspected food-responsive enteropathy?

• A. Measure fecal fat
• B. Do fecal culture
• C. Rule out other underlying causes
• D. Perform GI biopsy

Answer: (C)

Food-responsive enteropathy is diagnosed primarily by ruling out other underlying causes of chronic GI signs. Because symptoms overlap with infections, parasitic diseases, pancreatic issues, inflammatory bowel disease, and malabsorption, you don’t conclude FRE from symptoms alone—you systematically test for and exclude these conditions first. If the workup is unremarkable and the patient improves on an elimination diet, FRE becomes the most likely explanation. Tests like fecal fat measurement, fecal culture, or GI biopsy can provide helpful information or rule in/out specific diseases, but they aren’t the initial approach when FRE is suspected.