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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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    MAN'S FALL IN SHOWER LEADS TO CELIAC DIAGNOSIS


    Jefferson Adams

    Celiac.com 07/22/2016 - You think you have a crazy celiac disease diagnosis story? Try this one. When a college student fell and struck his shoulder while showering, he went to the emergency treatment center.


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    There, in addition to shoulder pain from the fall, he complained of numbness in his feet, along with general weakness and fatigue in the preceding few weeks. Blood tests showed the man had mild anemia, prompting the doctor to check his vitamin B-12 level, which was also low. This was puzzling.

    The patient was a 20-year-old, seemingly healthy Asian man, whose omnivorous diet should have provided enough B-12 to sustain normal blood levels. That meant that the next likely cause was poor B-12 absorption through the stomach or intestines.

    Besides pernicious anemia, which is marked by the absence of a protein in the stomach, the most frequent causes of B-12 malabsorption include celiac disease, HIV, chronic inflammation of the pancreas and even a type of tapeworm infection. The man's youth and general good health seems to rule out pernicious anemia.

    Although he had adhered to a more typical Chinese diet that was heavy on fish and rice, he had recently been eating a lot of pizza. Pizza means gluten. Lots of gluten. So could he have celiac disease?

    Although most commonly associated with some sort of gastrointestinal distress, such as diarrhea or abdominal cramping, celiac disease can have other symptoms, such as fatigue and numbness of extremities. Celiac often interferes with the gut's ability to absorb vitamin B-12.

    Ultimately, the patient met with a gastroenterologist who diagnosed celiac disease. The patient saw his B-12 levels return to normal when he began a gluten-free diet. The numbness has also improved.

    So, remember, celiac disease can have some vague and confusing symptoms that will usually improve significantly with a gluten-free diet.

    Have a wild celiac disease diagnosis story of your own?

    Source:


    Image Caption: Photo: CC--Chris Violette
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    Guest Joanne

    Posted

    He was lucky it was caught early. I went without a diagnosis for years. Multiple doctors saying it was in my head . This guy does not know how lucky he is. I'm permanently disabled from late stage diagnosis.

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    Guest Geoff

    Posted

    Joanne, Agreed! I have had numbness in my left foot pad for 30 years which was undiagnosed and has now affected my balance somewhat, however not even close to where I would consider myself disabled. Very slow progress - luckily. I recently found that I have celiac disease and have been on a gluten-free diet for over 6 months. I hope this will arrest the PN progress but I have no illusions that the diet might reverse it.

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    admin
    I have a big issue with what I believe to be a misleading headline in a recent joint press release by Domino's Pizza and the National Foundation for Celiac Awareness (NFCA)...here is the headline:
    "Domino’s Pizza Becomes First National Pizza Delivery Chain to Offer Gluten Free Crust"
    When you read the release further, starting at the 5th paragraph, which many people will never get to, it says:
    "While Domino’s new Gluten Free Crust is appropriate for those with mild gluten sensitivity, Domino’s and the NFCA do not recommend it for those with celiac disease. Domino’s and the NFCA found that while the crust is certified as gluten free, current store operations at Domino’s cannot guarantee that each handcrafted pizza will be completely free from gluten."
    So my question is this: How can the NFCA, a national organization dedicated to supporting celiacs, actually get behind this? Domino's is obviously a big corporation that has decided it wants to cash in and profit on the new gluten-free gold rush, but they cleary don't want to spend the money that it would take to make their pizzas truely gluten-free, and safe for celiacs.
    The Designations area of the NFCA's web site begins with: "Restaurants that complete GREAT Kitchens earn a designation based on their ability to meet gluten-free needs and avoid cross-contamination with gluten."  Just below this it describes their "Green Designation" and its "Amber Designation," and describes its Amber Designation as follows: "This level requires ingredient verification and basic training of wait staff and managers. Kitchen practices may vary with this designation, level one of the tier system, meaning those with celiac disease and non-celiac gluten sensitivity should ask questions and exercise judgment when dining at an establishment with an Amber Designation. Domino's has earned this designation."  So how has Domino's met "gluten-free needs and avoid cross-contamination with gluten"?
    Also, I think any celiac who watches the video Domino's made for this release will find it a bit scary...the same ovens, pizza scoopers, topping areas, etc., as where they make their regular gluten pizzas.
    I would exclude Domino's as an advertiser on Celiac.com based on this release.
    Some might think that the NFCA has sold out here. I invite them to respond using the comment field below, and I invite you to respond.
     
    Also, there is a lively discussion going on in our forum on this topic.  
    Here is the original press release:
    ANN ARBOR, Mich., May 7, 2012 – Domino's Pizza is responding to the needs of choice consumers, today launching a Gluten Free Crust available in all of its nearly 5,000 U.S. stores and becoming the first national pizza delivery chain to offer such a product.
    Domino’s Pizza (NYSE: DPZ) consulted with the National Foundation for Celiac Awareness (NFCA) to ensure its products and team member training meet the standards of the foundation’s GREAT Kitchens Amber Designation. NFCA’s GREAT Kitchens is an official credentialing program that has expanded to include restaurants offering gluten free products with varying kitchen practices, therefore suitable for those with gluten sensitivity under the Amber Designation.
    Domino’s new Gluten Free Crust provides a great-tasting option for consumers who previously could not enjoy pizza from the recognized world leader in pizza delivery because of sensitivity to gluten – a protein found in wheat, rye and barley.
    “Many of our customers have asked for a gluten free crust, and Domino’s is excited to offer a product to customers with mild gluten sensitivity – as well as partner with the NFCA, which has been instrumental to our learning more about how to take this step,” said J. Patrick Doyle, Domino’s Pizza president and CEO. “The prevalence of gluten sensitivity has become a real issue with significant impact on consumer choice, and we want to be a part of the solution. Now, the whole group can enjoy Domino’s with the addition of our new Gluten Free Crust.”
    While Domino’s new Gluten Free Crust is appropriate for those with mild gluten sensitivity, Domino’s and the NFCA do not recommend it for those with celiac disease. Domino’s and the NFCA found that while the crust is certified as gluten free, current store operations at Domino’s cannot guarantee that each handcrafted pizza will be completely free from gluten.
    “The NFCA is thrilled that Domino’s Pizza has developed a product that will improve the quality of life for many of the estimated 18 million Americans who are gluten sensitive,” said Alice Bast, NFCA founder and president. “Not only is Domino’s Gluten Free Crust a huge win for much of the gluten free community who can now get pizza delivered to their door, it’s also delicious. Customers aren’t going to believe they’re eating a pizza made on a gluten free crust when they try it. And the variety of fresh toppings that are available is a giant leap ahead.”
    In an effort to remain open and informative about Domino’s Gluten Free Crust, Domino’s has created a video on YouTube that allows customers to decide whether this product is suitable for their diet, found here: www.youtube.com/user/dominosvids.
    “Offering Domino’s Gluten Free Crust is a big step for us, and we wanted to make sure we were doing it right,” said Doyle. “Domino’s is doing that by partnering with experts at the NFCA and by empowering the gluten sensitive community with the information they need.”
    Domino’s new Gluten Free Crust is available in stores across the U.S. in a small, 10-inch size only, and prices vary by store.
    Domino’s pizza made with a Gluten Free Crust is prepared in a common kitchen with the risk of gluten exposure. The National Foundation for Celiac Awareness supports the availability of Domino’s Gluten Free Crust, but cannot recommend the pizza for customers with celiac disease. Customers with gluten sensitivities should exercise judgment in consuming this pizza.
    About Domino’s Pizza®
    Founded in 1960, Domino's Pizza is the recognized world leader in pizza delivery.  Domino’s is listed on the NYSE under the symbol “DPZ.”  As of the first quarter of 2012, through its global footprint primarily made up of locally-owned and operated franchises, Domino’s operated a network of 9,810 franchised and Company-owned stores in the United States and over 70 international markets.  During the first quarter of 2012, Domino’s had global retail sales of nearly $1.7 billion, comprised of over $830 million domestically and nearly $855 million internationally.  Domino's Pizza had global retail sales of over $6.9 billion in 2011, comprised of over $3.4 billion domestically and over $3.5 billion internationally. In May 2011, Pizza Today named Domino’s its “Chain of the Year” for the second straight year – making the company a three-time overall winner, and the first pizza delivery company to receive the honor in back-to-back years.  In 2011, Domino’s was ranked #1 in Forbes Magazine’s “Top 20 Franchises for the Money” list.  
     

    Jefferson Adams
    Celiac.com 06/01/2012 - Even as gluten-free bread continue to rise, sales of traditional wheat-based bread are falling across the globe.
    According to Paul Hetherington, a 20 year veteran of the Baking Association of Canada, the plunge is driven by numerous factors, including recent dietary shifts away from wheat and toward gluten-free diets by people who are not adverse to gluten.
    One example, major Canadian baked goods manufacturer, Maple Leaf Foods Inc., recently reported first quarter adjusted earnings of just 11¢ per share, down from 18¢ last year, and well below the 16.8¢ predicted by analysts.
    Maple Leaf president and CEO, Michael McCain, says that the decline was due to a 73% drop in adjusted first quarter earnings by the company's Bakery Products Group, which fell from $12.2-million in 2011 to $3.3-million this year.
    McCain said that his company is experiencing a fate shared across the industry as “fundamental bread consumption is down.”
    Maple Leaf’s net earnings decreased to $800,000 compared with $10.5 million last year, as the company’s adjusted operated earnings dropped 20% to $40.5 million.
    To counter the trend, Maple Leaf plans marketing initiatives to grow sales and to focus on the health benefits of bread and target growth categories, such as English muffins and bagels, he said. The company also expects to benefit from lower commodity costs, including wheat, to improve margins later in the year.
    Source:
    http://business.financialpost.com/2012/05/02/bread-sales-take-a-beating-as-more-consumers-go-gluten-free/

    Courtney Buchanan
    Celiac.com 01/21/2013 - At the end of a long day of class and meetings, Morgan Hembarsky loved to come home to her four roommates eagerly awaiting her to cook their weekly meal together. Immediately when she walked through the door the most important thing to talk about was food, conversation could wait. Was it pasta with marinara and veggies or chicken Parmesan with warm rolls night? "We try to have dinner together at least once a week to catch up," said Hembarsky, a senior at Lehigh University.
    The women sat down to a warm meal together and gossiped about their Lehigh University professors' bad jokes and the new romantic comedy in nearby Lehigh Valley theaters. Cooking and chatting: a girl's perfect way to unwind at the end of the day. But days of cooking with her roommates are gone. Early in the fall of 2011 after months of stomach pain, Hembarsky visited a doctor and received the answer to her suffering.
    The culprit, celiac disease, which is a condition in which one's body cannot digest gluten and eating it damages the small intestine. Because many of the foods Hembarsky and her friends often used to make contained gluten, like pasta and bread, that meant no more pasta nights with her friends. In October 2011 she gave up foods with gluten, the killer protein found in many grains and flours. Being diagnosed with celiac forced a change to the social calendar. "It's something you learn to live with and you learn what healthy decision you need to make," said Hembarsky. Hembarsky is not alone. For many celiacs in Bethlehem, social opportunities are hindered by dietary restrictions such as not being able to eat a hamburger bun or drink beer at a tailgate because they have gluten. Instead of going out with friends, they cook individualized meals at home. Now with more people being diagnosed as gluten-intolerant or celiac – in fact one out of 133 people in the United States is affected by celiac disease, according to the celiac disease Foundation – the choices of where to buy groceries and whether one should go to a restaurant taking the chance of feeling like a burden are at the forefront of people's minds.
    Take Tabitha Echavarria, a senior at Lehigh University, who was diagnosed with celiac last July 1. "The biggest change in my life has been taking charge of my diet," said Echavarria. "I know 100 percent of the ingredients of everything I eat because I most likely made it from scratch. I never eat anything without asking what is in it. " Echavarria said senior year of high school she experienced persistent migraines, numb feet, chest pain and stomach aches – symptoms that other celiacs often suffer as well. After constantly changing her diet hoping to find the trigger to the pain and receiving negative blood tests, she visited every doctor she could find. "The previous year I had cut out bread from my diet ‘cause I knew something was wrong," said Echavarria. "Then eventually I just really couldn't eat ever and went to like every different doctor available to figure it out. " Now on a Friday night when her rugby teammates go out to hibachi or Sal's starving for a delicious meal, Echavarria makes herself dinner beforehand so she can still tag along to the restaurant. Going to meals with friends is no longer about the eating, it's about the company. While Echavarria still goes out to restaurants for the social aspect, other celiacs avoid eating out as much as possible.
    Three weeks ago, Andrew Bench was sitting at his desk at King, Spry, Herman, Freund & Faul Law Firm in Bethlehem, Pa. , with a stomach ache when he decided to stop eating out as much as possible because of the potential cross contamination. He said many restaurants in the Lehigh Valley have cross contamination even though the waiters told him that the kitchens were being careful. Flash back to when he was diagnosed as celiac a year ago. He described the feeling as a concussion mixed with sinus pressure. Cross contamination could result in the same thing, or worse. Bench recommends Tapas on Main on North Side as a safe gluten-free option. Echavarria likes Red Robin for their protein-style burgers and La Lupita for the corn-based options while Hembarsky prefers salads at Bravo and sushi at Asian Bistro.
    While restaurants are introducing gluten-free menus, Bench said that one slip-up in the kitchen can mean hours of stomach pain. Echavarria recalled getting sick after ordering eggs, a naturally gluten-free dish, at a restaurant. Later she found out that the eggs had pancake batter in them. Restaurants may not think about the danger to celiacs by adding gluten to a naturally gluten-free food. "I think what I am most looking forward to in the future is restaurant activism," said Echavarria. "I would just like to have the option of eating with my friends knowing I'm not going to get sick or that I'm not annoying the people that work there. "The Lehigh Valley is embracing the gluten-free movement, slowly but surely.
    Wegmans, Giant Food and ShopRite have gluten-free aisles that provide a wide range of options. As he was giving granola samples at Wegmans, Calvin Virgillo, operations and sales at The Granola Factory, recognized a need for gluten-free, nut-free granola, which will be available in 2013. "It doesn't matter how good our granolas if there are people who won't buy it because they're gluten free or have a nut allergy," said Virgillo. With increasing options of places to purchase groceries and dine out, the community is recognizing the gap for this niche market of gluten-free consumers. A day will come when gluten-free diners won't have to worry about missing out on social life because of their diets. Until then, Hembarsky must deal with biting into a dry, hard piece of bread and baking her own treats when she wants to socialize with her roommates. "I think bread is the hardest to be gluten-free because it [the gluten-free version] doesn't taste like bread, but a majority of them aren't that great and they come frozen," said Hembarsky. "But everything else, I feel like you don't have to sacrifice at all. "

    Jefferson Adams
    Celiac.com 05/16/2013 - As more Americans then ever are looking to either reduce the amount of gluten in their diets or to eliminate it entirely, many nutritionists are saying that cutting gluten carelessly can be unnecessary and unhealthy, while others are pointing out that it is likely a waste of money for those who do not suffer from celiac disease or gluten intolerance.
    In a recent poll by market-research company NDP Group, one in three adults said they were looking to cut down or eliminate gluten from their diets. Those are the highest numbers since NDP began asking the question in 2009. In fact, in 2012, TIME magazine put the gluten-free movement at #2 on its top 10 list of food trends.
    Current estimates put the number of Americans with celiac disease (diagnosed or not) at about 3 million. Other studies indicate that as many as many as one in 16 Americans may have a less-severe sensitivity to gluten that can trigger gastrointestinal symptoms.
    For people with celiac disease or gluten-sensitivity, avoiding gluten is not merely beneficial, it is necessary for good health. For everyone else, though, avoiding gluten is unnecessary, provides questionable benefit, and can increase food costs substantially.
    One thing to remember, is that junk food is junk food, whether is contains gluten or not. Many people who do not have celiac disease or gluten-sensitivity, and who feel better after cutting gluten out of their diet, are really benefiting simply because they have eliminated junk foods and/or breaded, fried foods from their diet, not because they have a problem eating gluten.
    On the other hand, many others who do not have celiac disease or gluten-sensitivity, and who simply replace junky, processed foods with gluten-free versions are gaining little or no benefit, and are, in fact, spending money unnecessarily. That's because gluten-free foods usually cost more than their gluten-containing counterparts.
    How much more? When researchers from Dalhousie Medical School at Dalhousie University in Canada compared prices for 56 standard grocery items with similar gluten-free items, they found that the gluten-free products cost about 2½ times more than the gluten-containing versions.
    With more and more food manufacturers producing more and more gluten-free products, the gluten-free market in the United States is projected to grow from $4.2 billion last year to $6.6 billion by 2017.
    But that still doesn't add up to the NPD Group’s finding that 29% of Americans are trying to avoid gluten. The numbers suggest that many consumers are staying away from gluten simply because it’s trendy to do so.
    It is likely true that many people are following gluten-free diets unnecessarily, but it is also true that many more people with celiac disease and gluten sensitivity remain undiagnosed, and the exact nature of those conditions needs to be better understood to know who will fully benefit from a gluten-free diet. In the meantime, look for the gluten-free market to grow, and look for much of that growth to be driven by people without an official diagnosis that actually requires a gluten-free diet.
    Source:
    http://business.time.com/2013/03/13/why-were-wasting-billions-on-gluten-free-food/

  • Recent Articles

    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    fdfworld.com

    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