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      Frequently Asked Questions About Celiac Disease   04/07/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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    ARTHRITIS AND CELIAC DISEASE


    admin

    Arthritis may be an allergic response to materials in the food supply. Diet revision may be helpful in reducing the activity of inflammatory arthritis and in some instances may halt the progression of the disease. There are many patterns of arthritis. A group of related joint and connective disorders have been called rheumatic diseases. All these diseases are immune-mediated, and all are expressions of inflammation in connective tissues. Inflammation damages joints and surrounding tissues resulting in loss of function and deformities. Variations in the patterns of these diseases reflect the many possibilities for immune damage to disturb and distort structure and function. Severity ranges from mildly painful, chronic activity to drastic, disabling disease. Rheumatoid arthritis, often severe and disabling, is the dominant rheumatic disease that can attack all joints in the body.


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    Rheumatoid arthritis is often considered to be an autoimmune disease. Our idea is that no disease is just internally generated and must involve outside contributions. Arthritis is often associated with inflammatory bowel disease. The mechanisms of food allergy link abnormal Gastrointestinal Tract (GIT) function with immune attacks on connective tissue. In all arthritic patients, normal GIT function should be rigorously sought by adaptive dietary adjustments.

    Simple allergic arthritis is a definite entity that is often not recognized as a food allergy. Typically, a dramatic, acute, and painful swelling develops in one or more joints asymmetrically. Eating a food, either an unusual food eaten for the first time or sometimes a regular food eaten in excess usually brings on the joint inflammation. This presentation is similar to and often confused with gout. Any food can cause allergic arthritis. Staple foods such as milk, eggs, and wheat (rye, oats, barley), coffee, beef, pork, and food additives are the most common food triggers. Carinini and Brostroff reviewed the concepts of and evidence for food-induced arthritis. They stated:

    Despite an increasing interest in food allergy and the conviction of innumerable patients with joint disease that certain foods exacerbate their symptoms, relatively little scientific attention has been paid to this relationship. Abnormalities of the gastrointestinal tract are commonly found in rheumatic disease...Support for an intestinal origin of antigens comes from studies of patients whose joint symptoms have improved on the avoidance of certain foods antigens, and become worse on consuming them. These have included patients with both intermittent symptoms, palindromic rheumatism and more chronic disease.

    In another study, 33 of 45 patients with rheumatoid arthritis improved significantly on a hypoallergenic diet. The authors concluded: Increasing numbers of scientific studies suggest that dietary manipulation may help at least some rheumatoid patients and perhaps the greatest need now is for more careful and well-designed research so that preconceptions may be put aside and role of diet, as a specific or even a nonspecific adjunctive therapy, may be determined.

    Unfortunately, dairy products, wheat and its close relatives, oats, barley, and rye, have proved to be a major problem in the diets of our patients. There are many possible reasons for cereal grains to become pathogenic. Hypersensitivity mechanisms triggered by grain proteins, collectively called Gluten, are the likely cause of the illnesses related to intake of cereal grains. Gluten is a mixture of individual proteins classified in two groups, the Prolamines and the Glutelins. The prolamine fraction of gluten concerns us the most when grain intolerance is suspected. The prolamine, Gliadin, seems to be a problem in celiac disease; gliadin antibodies are commonly found in the immune complexes associated with this disease. Recently marketed grains, spelt and kamut, are wheat variants (despite claims to the contrary) and are likely to cause problems similar to other wheat varieties.

    A wheat gluten mechanism has been studied in rheumatoid arthritis patients. The clinical observation is that wheat ingestion is followed within hours by increased joint swelling and pain. Little and his colleagues studied the mechanism, as it developed sequentially following gluten ingestion. Dr. Parke and colleagues concurred with this explanation of the gut-arthritis link in their report of three patients with celiac disease and rheumatoid arthritis. The mechanism involves several stages:

    • GIT must be permeable to antigenic proteins or peptide fragments, derived from digested gluten.
    • The food antigens appear in the blood stream and are bound by a specific antibody (probably of IgA or IgG, not IgE class), forming an antigen-antibody complex, a circulating immune complex (CIC).
    • The antigen-antibody complex then activates the rest of the immune response, beginning with the release of mediators - serotonin is released from the blood platelets.
    • Serotonin release causes symptoms as it circulates in the blood stream and enhances the deposition of CICs in joint tissues.

    Once in the joint, the immune complexes activate complement, which in turn damages cells and activates inflammation. More inflammation results in more pain, swelling, stiffness, and loss of mobility.

    Arthritis is usually treated with salicylates or related anti-inflammatory drugs generally referred to as NSAIDs. These drugs alleviate the terrible pain of active arthritis but do not favorably affect the outcome of the disease. All anti-arthritic medication can produce asthma or chronic rhinitis and a variety of allergic skin rashes. Gastrointestinal surface irritation, bleeding, and ulceration are routine problems of anti-arthritic medication.

    The first attack of joint swelling and pain should be treated as an urgent problem to be solved. Inflammation may damage joints. Often NSAIDs and physiotherapy are the only treatments prescribed and inflammation is given every opportunity to ravage tissues. We have seen countless patients, just treated with NSAIDs, who progressed rapidly to a severe disabling disease, often with poor pain control. In unlucky patients, severe deformities of joints accumulate in the first few months of a severe attack. There is a trend to recommend more aggressive treatments, using drugs that impair the immune response. The best drug is prednisone, but it is seldom used because it has long-term side effects which scare both physicians and patients. Prednisone is often a magic drug that relieves terrible pain and suffering often in the first 48 hours of therapy. Beyond prednisone, there is a grab bag of immune suppressant drugs to treat arthritis-chloroquine, penicillamine, gold and methotrexate have emerged as the favored drug therapies. All these drugs have impressive side effects and great potential for toxicity.

    Our preference is to try to stop the inflammatory activity as soon as possible with diet revision. All inflammation is likened to a fire. You get out the fire-extinguishers and go to work. No matter what pattern the immune attack assumes, our standard defense can be tried first. The Core Program method of diet revision is used. Food is replaced with an elemental nutrient formula, ENFood, for a clearing period of 10 to 20 days. Prednisone and/or NSAIDs are drug options during the clearing period and then the dosage is reduced after pain and swelling have subsided. Improvement is followed by slow food reintroduction (see Core Program). Each returning food is carefully screened for arthritis- triggering effects. You hope that food allergy caused the problem and that food control can be successful controlling the disease in the long- term. Nothing is lost by taking this approach and complete control of the disease can sometimes be obtained. If strict food control proves to be inadequate, then other drug treatments can be instituted.

    End Notes/Sources:

    • Carinini C, Brostroff J. Gut and joint disease. Annals of Allergy 1985;55:624-625.
    • Darlington et al. Lancet Feb 1 1986;236-238.
    • Keiffer M et al. Wheat gliadin fractions and other cereal antigens reactive with antibodies in the sera of of celiac patients. Clin Exp Immunol 1982;50:651-60.
    • Little C, Stewart AG, Fennesy MR. Platelet serotonin release in rheumatoid arthritis: a study in food intolerant patients. Lancet 1983;297-9.
    • Parke AI et al. Celiac disease and rheumatoid arthritis.
    • Annals of Rheum Dis 1984;43:378-380.
    • Voorneveld CR, Rubin LA Disease-modifying antirheumatic drugs: early use is better. Medicine North Amer. Oct 1991 3177-3184.

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    Guest Nelda Fletcher

    Posted

    My daughter suffers from celiac and rheumatoid arthritis, and I read anything I can on this subject. She has recently changed rheumatologists, and this doctor suspects that her arthritis is food-related. When she was diagnosed 13 years ago, there was no information on this connection, so I'm grateful that this is being studied!

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    Guest liz thornber

    Posted

    Good article, where can I get information on the core plan in your article, as I have celiac disease and chronic arthritis?

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    Guest jennifer

    Posted

    After countless doctors visits with little help I have come to the conclusion that I most likely have celiac disease. I have taken myself off gluten while my new rheumatologist confirms this diagnosis. While conducting my own research I have found that many celiacs have a low B12 level causing anemia and many of the problems associated with celiacs. I have been taking 100% Himylain goji juice (no I do not sell it) and have experienced great relief from the symptoms. It is expensive but it has been well worth the cost. I suggest anyone with joint and muscle pain to try it. I have tried some of the less expensive generic brands but the don't seem to work. It is amazing the roller coaster ride I have been on for the last year and I am so thankful that there is so much information available on the internet. If not for the web I think I would still be in a great deal of pain and not able to function from day to day.

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    Well done!!! As a person with personal and hereditary Celiac and Rheumatoid Arthritis and as a professional who often assists others with these conditions via homeopathy & diet I know the info out there well. Yours is the best, most comprehensive article I've seen. Wish you would suggest seeing a qualified alternative practitioner - homeopath, ND, herbalist... whatever a person feels will help them best, in addition to diet. Best, Ellen

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    Guest Oliver Mendez

    Posted

    Good article! I'm celiac and I didn't know that arthritis was related to this...thanks.

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    Guest Anna Dzondzua

    Posted

    Great article, thank You very much for this. I'll send it to my son's rheumatologist. Pity that in our country celiac is completely ignored...

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    Guest Helen

    Posted

    I found out that I have the celiac disease three years ago. I watch my diet carefully to avoid gluten. Last fall after being on a trip in which I walked allot, I had pain in my knees. I didn't know that it had anything to do with the celiac disease. In March I took another trip in which I walked a lot. My knees have been hurting allot. I'm going to the doctor tomorrow. I'm glad I read this article - I'm going to print it and show him. Thanks!

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    Guest Kathy

    Posted

    I have celiac and thought I was doing well on my diet until joint pain in my hands, elbows, knees and feet slowly joined in about six months ago. Good to read this info.

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    Guest Kung Fu Man

    Posted

    Firstly, great article. I have been suffering for about 2.5 years now and the medical system failed me. I have done a lot of self research and thanks to articles like this I have learned that my pain (knees, elbows, ankles, wrists, shortness of breath, bloating etc.) is due to my diet. I have eliminated dairy, soy, gluten and eggs in the past week or so and I am feeling a lot of relief. I am planning to take a food intolerance test soon to confirm. Thanks again and best wishes to all.

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    Guest Patricia Coxhead

    Posted

    What an excellent article. I have been diagnosed with Palindromic Rheumatism and it is now under control with eliminating Gluten from my diet.

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    Guest Stewart Edgington

    Posted

    About one year ago I developed psoriatic arthritis. I pointed this out to my internist who insisted that I just was having discomfort with osteoarthritis. I pointed to all the appropriate symptoms and correlations and so she looked it up and asked one more question. Then she said, 'oh, you have psoriatic arthritis.' I was sent to a rheumatologist who wanted to put me on methotrexate. I have type I diabetes and did not feel I needed any addition suppression of my immune system. Then I a new client came into my office. She is a widow whose husband had had rheumatoid arthritis. She is a widow because of the methotrexate. I have two sisters with full blown celiac disease. So I consulted a naturopathic doctor. She suggested several possibilities including an auto immune response to gluten. I tried going gluten free and my symptoms have decreased by about 90%. Any time I have inadvertently consumed even a tiny amount of gluten the arthritis returns. Then this past Sunday I decided to test a single beer. Alas, the symptoms returned severely for two days and only now, 5 days latter am I approaching becoming symptom free again. I suspect there are other things I should eliminate but gluten seem to be the monster for me.

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    Guest rob secker

    Posted

    Very helpful...I have just been diagnosed with Celaic and after two days gluten free my joint pain has improved greatly

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    Guest Paul R. Dierks

    Posted

    Anyone with passion cannot be ignored for a noble effort. You all will soon learn my name. Sheer genetic dietary evolution and genetic markers do not lie. The riddle is solved. My apologies if I offend the Vegans, but we are evolved carnivore. Not omnivore. We eat herbivore and fish. Without these accurate proteins, we as a species will suffer. This will no longer be hidden.With just the 2 markers of DQ2 and 8 make up nearly 40% of the USA. They now have at least 10 markers that are known gluten intolerant. DQ1 through 9 and a possible HLA A24. The only thing that can kill me is glutonite!Any nutritionist will tell you, mimic the diet of the bear, only add potato and rice! Follow the diet of your evolutionary origins. Paul R. Dierks. Proud celiac!

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    Guest Linda

    Posted

    I am finding that diet is such an important factor in solving health issues. I have become lactose intolerant in my middle years. I have found that my three children are all lactose sensitive. Two of my brother's children have been recently diagnosed with celiac disease. My sister who helped our family identify our lactose issues has gone gluten free. I am seeing that there may be more than dairy issues with me as I hit my funny bone in the summer and now 7 months later I still have 'tennis elbow'. After reading this article I will be watching carefully to see what happens to my elbow pain as I cut out the gluten.

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    Guest Christie

    Posted

    I was diagnosed with psoriatic arthritis two years ago. I was in so much pain and suffered for 18 months. I am was on Enbrel and Methrotrexate. They helped but did not do enough. I soon realized I also had Candida and went on a strict diet - no sugars, no gluten for 6 months. Alas, the pain went away, my chronic fatigue disappeared! I got my life back! In the past 3 months, I have added just a little bit of sugar back - mostly in the form of fructose. I also experimented with bringing back the gluten and every time I did the aches and the flair-ups came back. No doctor ever told me to consider eliminating gluten to help my arthritis during the first 18 months of misery! Cutting out the gluten and the night shade vegetables (which I did too) has been life changing! Anyone with arthritis needs to give it a try. This is a great article. I wish I had read it 2 years ago.

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    Guest merryweather

    Posted

    Taking proteolytic enzymes, such as Wobenzym, or serrapeptase or nattokinase can also help eliminate unwanted protein fragments and circulating immune complexes. There has been quite a lot of research into this. People suffer less pain after taking proteolytic enzymes instead of NSAIDs for these conditions. I can testify to this from personal experience. I have a little arthritis in one hand and am now trying a bread-free experiment to see if this helps.

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    Guest bill

    Posted

    Specific Carbohydrate Diet -- Check in out -- It works -- Whole food diet -- No gluten, no grains, no sugars, no starches. Eat whole, natural meats, vegetables and fruits.

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    Guest Linda

    Posted

    It was February since I came upon this article for my severe elbow pain. With in 3-4 days of changing my diet, my pain was 90% better.

    I had been suffering for 7 months and came upon this article in the night when I could not sleep because of the pain. I painted my daughter's room on President's Day and didn't think till the next day that my elbow didn't hurt. In addition I had what I called a brain fog where I was so scattered and forgetful that I thought I was in the early stages of memory loss. I was anxious and worried more than I use to be. Now I seem to have more clarity again. I did not test high on a blood test for celiac yet still had symptoms. The last thing I wanted to do was change my diet especially after being told by my sister that I might have some concerns. Her blood test was insignificant as well but had high numbers on a stool test. She changed her 4 year old son's diet as he had very aggressive behavior. He is now a pleasant yet still active child after finding additional corn, soy, sugar and additive triggers in addition to gluten and lactose.

    I know I keep going on but there is more. In March we found that I am pregnant! An unexpected blessing! I am 45 and our youngest is 7 years old. We have been relying on 'timing' for birth control and all of the sudden I change my diet and I'm pregnant. I do have a history of endometriosis, which is inflammatory. I have been sensitive to wheat in my previous pregnancies but never thought to exclude it from my diet. I usually vomit the first 3-4 months of pregnancy with a revisit to pukesville about every two weeks until delivery. I have not thrown up even once. Just lucky? I'm not going back to gluten to test it. It's not worth the health risks to me or the baby. I'm also interested to see if this baby will be a 10lb or 10lb + like my last two. Lots of speculation on my part but the results cannot be ignored.

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    Guest mayra

    Posted

    My daughter suffers from celiac and rheumatoid arthritis, and I read anything I can on this subject. She has recently changed rheumatologists, and this doctor suspects that her arthritis is food-related. When she was diagnosed 13 years ago, there was no information on this connection, so I'm grateful that this is being studied!

    was her RA food-related? i didn't even know that excisted. thank you.

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    Taking proteolytic enzymes, such as Wobenzym, or serrapeptase or nattokinase can also help eliminate unwanted protein fragments and circulating immune complexes. There has been quite a lot of research into this. People suffer less pain after taking proteolytic enzymes instead of NSAIDs for these conditions. I can testify to this from personal experience. I have a little arthritis in one hand and am now trying a bread-free experiment to see if this helps.

    Did this regime help you? I have severe RA and now after being on Enbrel and Methotrexate for over a year am looking for another answer besides these toxic drugs. Also, I have had severe cramping the past 4 months and am trying an experiment today. Please let me know how it helped you.

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    I was diagnosed with psoriatic arthritis two years ago. I was in so much pain and suffered for 18 months. I am was on Enbrel and Methrotrexate. They helped but did not do enough. I soon realized I also had Candida and went on a strict diet - no sugars, no gluten for 6 months. Alas, the pain went away, my chronic fatigue disappeared! I got my life back! In the past 3 months, I have added just a little bit of sugar back - mostly in the form of fructose. I also experimented with bringing back the gluten and every time I did the aches and the flair-ups came back. No doctor ever told me to consider eliminating gluten to help my arthritis during the first 18 months of misery! Cutting out the gluten and the night shade vegetables (which I did too) has been life changing! Anyone with arthritis needs to give it a try. This is a great article. I wish I had read it 2 years ago.

    Is the nightshade thing an absolute???

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    Guest Michelle

    Posted

    Did this regime help you? I have severe RA and now after being on Enbrel and Methotrexate for over a year am looking for another answer besides these toxic drugs. Also, I have had severe cramping the past 4 months and am trying an experiment today. Please let me know how it helped you.

    I've had severe RA from the onset, nearly nine years ago. I've been on nearly every drug out there for RA, most recently a combo of Enbrel and Mobic, which worked amazingly. I'd been told repeatedly that stress contributes greatly to the severity of RA, but didn't really believe it much, till I switched jobs nearly a year ago. Since then I have been able to slowly go off of the Enbrel, while adding Omega-3's to help control the symptoms. It worked great until about a month ago (month 5 of no Enbrel). I have also had severe allergies most of my life, I broke out with a serious rash yesterday and have an appointment with my PCP later today. I'm planning to ask about a correlation with celiac or other food allergy. I have a good friend who was diagnosed with celiac about two years ago, and hadn't known about it before then, but after researching it have wondered if maybe that's been my problem all along. Does anyone know if an elevated SED rate is linked to celiac?

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    Guest Mechal Sobel

    Posted

    I think this is a fine article. The notes mention an article by Gail Darlington, however I strongly recommend Darlington's book DIET AND ARTHRITIS: A COMPREHENSIVE GUIDE TO CONTROLLING ARTHRITIS THROUGH DIET. Darlington details the way in which to test your reactions to foods, and build a healthy individualized diet, a way that proved very successful for me.

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    Guest George D.M.

    Posted

    Excellent information, great site.

    Oats, kidney bean and Beer flares up my joint pain. I will have stiff finger and palm, starts with left hand first and then right foot. If we keep off these items then there will be no pain.

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    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764

    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

    BIOPSY
    Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide.

    WHY A GLUTEN-FREE DIET?
    Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. 
    A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years.
    For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease.
    WHAT ABOUT ENZYMES, VACCINES, ETC.?
    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center

    Jefferson Adams
    Celiac.com 04/17/2018 - Could the holy grail of gluten-free food lie in special strains of wheat that lack “bad glutens” that trigger the celiac disease, but include the “good glutens” that make bread and other products chewy, spongey and delicious? Such products would include all of the good things about wheat, but none of the bad things that might trigger celiac disease.
    A team of researchers in Spain is creating strains of wheat that lack the “bad glutens” that trigger the autoimmune disorder celiac disease. The team, based at the Institute for Sustainable Agriculture in Cordoba, Spain, is making use of the new and highly effective CRISPR gene editing to eliminate the majority of the gliadins in wheat.
    Gliadins are the gluten proteins that trigger the majority of symptoms for people with celiac disease.
    As part of their efforts, the team has conducted a small study on 20 people with “gluten sensitivity.” That study showed that test subjects can tolerate bread made with this special wheat, says team member Francisco Barro. However, the team has yet to publish the results.
    Clearly, more comprehensive testing would be needed to determine if such a product is safely tolerated by people with celiac disease. Still, with these efforts, along with efforts to develop vaccines, enzymes, and other treatments making steady progress, we are living in exciting times for people with celiac disease.
    It is entirely conceivable that in the not-so-distant future we will see safe, viable treatments for celiac disease that do not require a strict gluten-free diet.
    Read more at Digitaltrends.com , and at Newscientist.com