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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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    HIGH RATES OF MICROSCOPIC COLITIS IN CELIAC DISEASE, ESPECIALLY AMONG MIDDLE AGED WOMEN


    Jefferson Adams

    Celiac.com 07/27/2011 - Based on associations made between microscopic colitis and celiac disease in scientific literature, but limited population-based data, a team of researchers set out to assess rates of microscopic colitis in celiac disease.


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    The research team included M. Stewart, C. N. Andrews, S. Urbanski, P. L. Beck, and M. Storr. They were looking to better understand how these two diseases might be connected, and to identify any factors that might cause them to occur together.

    This led them to conduct a population-based review of all people diagnosed with celiac disease and microscopic colitis in a large Canadian medical center over a 5-year period.

    To do that, they searched endoscopy and pathology databases to find all diagnosis made for celiac disease and microscopic colitis within the Calgary Health Region between 2004 and 2008.

    To get accurate results, they made sure to standardize age and gender data from their study with 2006 Canadian Census data.

    They then used standardized incidence ratios (SIR) to figure out how often the two disease occur together.

    In the study population, they found, over a five-year period, 763 patients diagnosed with celiac disease, and 1106 diagnosed with microscopic colitis.

    In the general population, the standard rates of celiac disease ran from 10.4 to 15.7 per 100,000 people, while the standard rates of microscopic colitis ran from 16.9 to 26.2 per 100,000 people.

    The study team found 40 patients with both celiac disease and microscopic colitis, 21 of whom were females aged 40–60 years.

    In the celiac disease group, microscopic colitis occurred at an annual rate of 11.4 per 1000 cases of celiac disease with an overall SIR of 52.7.

    These findings showed a strong association between microscopic colitis and celiac disease. In fact, the diseases occurred together in the study population at rates of about 50-times those expected in the general population.

    One prominent finding was that middle-aged women suffered especially high rates of celiac disease together with microscopic colitis.

    Therefore, the team recommends that middle-aged women with celiac disease and persistent diarrhea undergo lower endoscopy with biopsies to check for microscopic colitis.

    Source:


    Image Caption: New study on microscopic colitis and celiac disease.
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    When I first went gluten-free 8 years ago I read about this strong correlation between MC and gluten sensitivity on Dr. Kenneth Fine's Intestinal Health website. One can be gluten sensitive even if one does not have the genes for celiac disease or if tests for celiac disease are negative.

     

    Since I cannot post a link to a website you can find this info by Googling "Intestinal Health Institute"

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    Guest Judy Santos

    Posted

    I found this very interesting. I have been trying to convince my GI doc of this for two years now. I was diagnosed with MC in 2009. I had to beg him to test me for celiac disease. A year later he reluctantly agreed. Blood test off the charts. positive for celiac disease Confirmed (like It needed to be?) with endoscopy. I have a follow up appointment Monday. I will be taking this article for him. Maybe this can help someone else. I think not only should celiac disease patients be tested for MC but visa versa like me.

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    It doesn't say anything about what you do if you have it or any links to more information about microscopic colitis. So far, nothing works for me, but I'm still looking for more information about it.

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    I have celiac disease, and I had already been on a strict gluten-free diet for years before I developed MC. The GI doctor suspected maybe I was somehow consuming gluten without knowing - the symptoms were so similar - but biopsies confirmed that it was MC alone. (This also shows that it can develop in people with celiac disease even when celiac disease-related inflammation is not active.)

     

    A long list of things can trigger MC, especially medications; all NSAIDs (Advil, aspirin, etc.) and all SSRIs (many common antidepressants) have been linked to it. I'm very glad more studies are being published on this, and I hope more focus is placed on identifying triggers & causes.

     

    I also hope more doctors will consider this as a possibility even if the patient is not in the "typical" age/gender group - I was diagnosed with MC when I was 21.

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    Good information. Who has developed the "perfect" diet for both (I have both)? Why do we have to push this information on "specialists"? I am tired of being treated like I am stupid and then I am correct. I have also developed such a cough, I know it is food allergies. Ideas?

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    Guest cavouta

    Posted

    I have had severe digestive system issues...ulcerative colitis most of my adult life. My ability to digest and absorb foods properly to get the nutritional benefit was greatly diminished. I knew nothing would be "quick fix", since I had been digestive compromised for so many years.

     

    It turns out, my intestinal bacteria were probably totally out of whack from all the trauma and medications my digestive system had endured over all these years. I researched and decided on the Lady Soma Fiber Cleanse - I ordered online after being recommended by my GP. When I received these, I immediately started taking them. I did feel a little dizzy after but I know this response just means the Deep Immune is doing its job, killing off bad bacteria and replacing it with good bacteria.

     

    After my body finished dumping all those toxins, I STARTED FEELING BETTER THAN I HAVE FOR YEARS! I will continue to use Lady Soma's Fiber Cleanse It is probably a good addition for everyone's general health, but it can also be life changing for some people like me.

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    admin

    Am J Gastroenterol 2000;95:2154-2156,2285-2295.
    Celiac.com 10/14/2000 - According to new research done by Dr. Andrew J. Wakefield, of the Royal Free and University College Medical School, in London (published in the September issue of the American Journal of Gastroenterology) children with developmental disorders seem to be at risk of developing a unique type of inflammatory bowel disease (IBD). This newly discovered type lacks the typical features seen in Crohns disease and ulcerative colitis.
    The researchers studied 60 children with developmental disorders (50 had autism, five had Aspergers syndrome, two had disintegrative disorder, one had attention deficit hyperactivity disorder, one had schizophrenia and one had dyslexia.) whose ages ranged from 3 to 16 years old to compare the clinical and histologic features against 37 developmentally normal controls who underwent evaluation for possible IBD.
    According to Dr. Wakefield and colleagues The combination of ileocolonic lymphoid nodular hyperplasia and colitis in children with developmental disorders distinguished them from developmentally normal children with similar symptoms (including abdominal pain and constipation) in whom lymphoid nodular hyperplasia and histopathological change were uncommon. They emphasize that their finding are consistent with those of other recent case studies, and that in their study inflammatory changes were detected in the upper gastrointestinal tract that were unique in children with autism and IBD, compared with developmentally normal children with IBD.
    Further, there is accumulating evidence of a specific type of enterocolitis in autism that makes it tempting to suggest that a gut-brain interaction is involved in the pathogenesis of what many researchers are now calling autistic enterocolitis. The detection of opioid peptides of dietary origin in the urine of some of the affected children further supports this theory. The team emphasizes that further studies and more evidence is needed to establish a direct link between an inflamed gut and the brain in those with autism.

    Destiny Stone
    Celiac.com 03/24/2010 - Celiac disease is a permanent intolerance to gluten ingestion, which is predisposed in individuals with human leukocyte antigen  (HLA ) and DQ2 or DQ8 haplotype. Celiac is an autoimmune disease and  there has been mounting evidence indicating a substantial connection between celiac and other autoimmune disorders such as, autoimmune thyroiditis and diabetes mellitus type 1.  Additionally, recent evidence has surfaced correlating a relationship between celiac and inflammatory bowel disease (IBD).
    An Italian study was designed to research  a gene commonly associated with celiac disease known as MYO IXB, which was recently found to be mutated in IBD patients as well. Additionally, the chromosome 4q27 region is also associated with celiac disease and other autoimmune diseases, and predisposes patients to ulcerative colitis, indicating a common genetic code for these diseases. Although, other IBD risk factors were not found to be candidate genes for celiac disease.
    Italian patients with IBD were tested for celiac disease and their results were lower than expected, and  lower than compared with the general population. celiac disease was found to be more prevalent in patients with ulcerative colitis than in those with Crohn's disease. Ulcerative colitis is typically isolated to the colon and is not present in the small intestine. However, there have been reports of diffuse duodenitis in ulcerative colitis patients which is sometimes mistaken for celiac disease.  The gastroduodenal association with Crohn's disease varies from 30% to 80% of patients.
    Celiac disease and inflammatory bowel are not related, they are merely two diseases that sometimes cross the same path. While the prevalence of celiac disease in Italian IBD patients was typically low indicating no close relationship between celiac disease and inflammatory bowl disease, the mutual relationship of these diseases lies in the fact that patients with both conditions frequently share a history of iron-deficient anemia.  It is thus important for patients that are unresponsive to treatments for IBD and are prone to incessant anemia, to also test for celiac disease.

    Source:

    Science Direct

    Jefferson Adams
    Celiac.com 02/27/2012 - The relationship between celiac disease and inflammatory bowel disease has not been well documented. One study that hasn't gotten too much attention was published in 2008. To get a better idea regarding any connection, a team of researchers studied rates of celiac disease in patients with inflammatory bowel disease, along with the rates of inflammatory bowel disease in patients with celiac disease.
    The research team included J.S. Leeds, B.S. Höroldt, R. Sidhu, A.D. Hopper, K. Robinson, B. Toulson, L. Dixon, A.J. Lobo, M.E. McAlindon, D.P. Hurlstone, and D.S. Sanders. They are affiliated with the Gastroenterology and Liver Unit of Royal Hallamshire Hospital in Sheffield, UK. 
    The team recruited patients from clinics specializing in inflammatory bowel disease and celiac disease, along with control subjects from the local population. They then tested subjects for Antigliadins, endomysial, tissue transglutaminase antibodies and total IgA levels. They offered duodenal biopsy to patients with positive antibodies. The team reviewed colonoscopy and biopsy data for celiac patients.
    In all, the team assessed 305 patients with celiac disease, 354 patients with IBD, and 601 healthy control subjects. The IBD group included 154 patients with ulcerative colitis (UC), 173 with Crohn's disease, 18 with indeterminate colitis, and nine cases of microscopic colitis. Forty-seven patients showed positive antibodies, while three patients showed villous atrophy upon biopsy.
    All three patients with villous atrophy showed positive anti-tissue transglutaminase antibodies, but only two tested positive for endomysial antibody (EMA). Ten celiac patients had IBD (5 UC and 5 lymphocytic colitis). Five control subjects had celiac disease, while two had IBD (1 Crohn's disease and 1 UC). Stepwise multiple logistic regression showed that only antibody positivity was a factor (p<0.0001).
    The results showed that people with celiac disease had IBD at rates ten times higher than the control group (odds ratio 9.98, 95% CI 2.8-45.9, p=0.0006), while patients with IBD had celiac disease at about the same rates control subjects (odds ratio 1.02, 95% CI, 0.24-4.29, p=1.0).
    Source:

    Scand J Gastroenterol. 2008;43(10):1279-80

    Jefferson Adams
    Celiac.com 11/28/2012 - A team of researchers recently set out to determine whether childhood antianaerobic antibiotic exposure is associated with the development of inflammatory bowel disease (IBD). Their findings show that children who are treated with antianaerobic antibiotics face a significantly higher risk of developing IBD.
    The team included Matthew P. Kronman, MD, MSCE, Theoklis E. Zaoutis, MD, MSCE, Kevin Haynes, PharmD, MSCE, Rui Feng, PhD, and Susan E. Coffin, MD, MPH.They are affiliated variously with the Division of Infectious Diseases, Seattle Children’s Hospital at the University of Washington in Seattle, Washington, the Division of Infectious Diseases at The Children’s Hospital of Philadelphia, and the Department of Biostatistics and Epidemiology, the Center for Clinical Epidemiology and Biostatistics at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania. The team's findings appear in the 24 September issue of Pediatrics.
    To get a better picture regarding use of antibiotics on children and a possible connection to IBD, the team conducted a retrospective cohort study using data from 464 UK ambulatory practices in The Health Improvement Network.
    The study looked at all children in the network with 2 or more years of follow-up from 1994 to 2009. The team screened and excluded anyone with previous IBD. They then cataloged all antibiotic prescriptions used by all children in the study. Finally, they tracked the children's data from practice enrollment and IBD development, practice de-registration, 19 years of age, or death.
    Their defined study parameters included the following antianaerobic antibiotics: penicillin, amoxicillin, ampicillin, penicillin/β-lactamase inhibitor combinations, tetracyclines, clindamycin, metronidazole, cefoxitin, carbapenems, and oral vancomycin.
    Their study looked at 1,072,426 children for a total of 6.6 million person-years of follow-up. Of those children, 748 developed IBD. Children treated with antianaerobic antibiotics had nearly 1.52 cases of IBD per ten-thousand person years, while those who were not given antibiotics saw just 0.83 cases per ten-thousand person-years; for an 84% relative risk differential.
    Antibiotic exposure throughout childhood was associated with the development of IBD, but this relationship decreased with increasing age at exposure. That is, the longer doctors waited to give children antibiotics, the more the risk of iBD went down.
    Children treated with antibiotics before 1 year of age showed an adjusted hazard ratio of 5.51 (95% confidence interval [CI]: 1.66–18.28), while that decreased to 2.62 (95% CI: 1.61–4.25) for children first treated at 5 years old, and to 1.57 (95% CI: 1.35–1.84) for those first treated at 15 years of age. Overall, each course of antibiotics increased the IBD hazard by 6% (4%–8%).
    The study showed that children who received two or more antibiotic courses were more highly likely to develop IBD than those who received 1 to 2 courses, with adjusted hazard ratios of 4.77 (95% CI: 2.13–10.68) versus 3.33 (95% CI: 1.69–6.58).
    So, based on this study, treating children with antianaerobic antibiotics puts them at risk for developing IBD. It will be interesting to see how the medical community responds to this study, and whether there is greater effort made to avoid giving these powerful antibiotics to children.
    What do you think? Do you have IBD? Did you receive these antibiotics as a kid? Let us know your thoughts by commenting below.
    Source:
    Pediatrics; 24 September 2012

  • Recent Articles

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.

    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. 
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    "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