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Participants kept a diary and collected urine samples for 10\u00a0days and stools on days 4\u201010. \u2018Doggie bags\u2019 containing \u00bc portions of foods consumed were saved during the first 7\u00a0days. Gluten in food, stool and urine was quantified using A1\/G12 ELISA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen participants with CD (12 female; age 21\u201070\u00a0years) and three participants on a gluten\u2010containing diet enrolled and completed the study. Twelve out of 18 CD participants had a median 2.1\u00a0mg gluten per exposure (range 0.2 to &gt;80\u00a0mg). Most exposures were asymptomatic and unsuspected. There was high intra\u2010individual variability in the interval between gluten ingestion and excretion. Participants were generally unable to identify the food.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Gluten exposure on a GFD is common, intermittent, and usually silent. Excretion kinetics are highly variable among individuals. The amount of gluten varied widely, but was typically in the milligram range, which was 10\u2010100 times less than consumed by those on an unrestricted diet. These findings suggest that a strict GFD is difficult to attain, and specific exposures are difficult to detect due to variable time course of excretion.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.16075","type":"journal-article","created":{"date-parts":[[2021,1,15]],"date-time":"2021-01-15T18:46:09Z","timestamp":1610736369000},"page":"1469-1479","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Exposure sources, amounts and time course of gluten ingestion and excretion in patients with coeliac disease on a gluten\u2010free diet"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3615-1666","authenticated-orcid":false,"given":"Jocelyn A.","family":"Silvester","sequence":"first","affiliation":[{"name":"Harvard Medical School Celiac Research Program Boston MA USA"},{"name":"Boston Children's Hospital Boston MA USA"},{"name":"Beth Israel Deaconess Medical Center Boston MA USA"},{"name":"Rady Faculty of Health Sciences Max Rady College of Medicine University of Manitoba Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4982-273X","authenticated-orcid":false,"given":"Isabel","family":"Comino","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy University of Seville Seville Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa N.","family":"Rigaux","sequence":"additional","affiliation":[{"name":"St Boniface Hospital Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Segura","sequence":"additional","affiliation":[{"name":"Faculty of Pharmacy University of Seville Seville Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy H.","family":"Green","sequence":"additional","affiliation":[{"name":"St Boniface Hospital Winnipeg MB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angel","family":"Cebolla","sequence":"additional","affiliation":[{"name":"Biomedal S.L. 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