We would like to congratulate Mooney et al1 on their excellent study of ultra-short celiac disease (CD) and add some notes in support of their findings. In the last 15 years we have encouraged our colleagues to take 2 biopsies from the duodenal bulb (D1) as well as 4 from the descending duodenum (D2). Our experience corroborates the findings of Mooney’s study, namely, that a significantly greater chance of detecting CD and—in many cases—the association with lower levels of tTGA or EMA titers. Interestingly our experience suggests that this is true in adults but even more so in the pediatric setting.