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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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    CAN HUMAN GUT-DERIVED COMMENSAL BACTERIA HELP TREAT MULTIPLE SCLEROSIS?


    Jefferson Adams


    • Can human gut-derived commensal bacteria help to improve the treatment of multiple sclerosis?


    Celiac.com 08/30/2017 - The human gut is home to a huge and diverse number of microorganisms that perform various biological roles. Disturbances in a healthy gut microbiome might help to trigger various inflammatory diseases, such as multiple sclerosis (MS).


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    Human gut-derived commensal bacteria suppress CNS inflammatory and demyelinating disease. Can they improve the treatment of multiple Sclerosis (MS)?

    A team of researchers recently set out to evaluate evidence that gut commensals may be used to regulate a systemic immune response and may, therefore, have a possible role in treatment strategies for multiple Sclerosis.

    The research team included Ashutosh Mangalam, Shailesh K. Shahi, David Luckey, Melissa Karau, Eric Marietta, Ningling Luo, Rok Seon Choung, Josephine Ju, Ramakrishna Sompallae, Katherine Gibson-Corley, Robin Patel, Moses Rodriguez, Chella David, Veena Taneja, and Joseph Murray.

    In a recent article, the team reports on their identification of human gut-derived commensal bacteria, Prevotella histicola, which can suppress experimental autoimmune encephalomyelitis (EAE) in a human leukocyte antigen (HLA) class II transgenic mouse model.

    P. histicola suppresses disease through the modulation of systemic immune reactions. P. histicola challenge caused a reduction in pro-inflammatory Th1 and Th17 cells and an increase in CD4+FoxP3+ regulatory T cells, tolerogenic dendritic cells, and suppressive macrophages.

    This study indicates that gut commensals may regulate a systemic immune response, and so may have a role in future treatments for multiple Sclerosis, and possibly other autoimmune diseases such as celiac disease.

    Source:


    Image Caption: Photo: CC--Joey Zanotti
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    admin

    The following research was compiled by Don Wiss and posted on the Celiac Listserv news group:
    The MS/gluten/casein connection is mostly only anecdotal as it has never really been studied. This is what I have (much contributed by Ron Hoggan):
    (1) Roger MacDougall was a famous British playwright, who was diagnosed with MS in the 1950s. The doctors felt it was best to keep the information from him. They thought it was in his best interests not to tell him what he had. It was not until he was bedridden that he learned what illness he had. When he knew about it, he did some reading, and went on a gluten & casein free diet. He recovered almost totally. This is from Can a Gluten-Free Diet Help? How? by Lloyd Rosenvold, M.D., [Keats Publishing, 27 Pine Street (Box 876) New Canaan, CT 06840-0876, 1992, ISBN 0-87983-538-9]. MacDougall eventually wrote a pamphlet titled My Fight Against Multiple Sclerosis, pub 1980 by Regenics Inc, Mansfield, Ohio. Rosenvold also includes some other anecdotes in his book.
    (2) In the Oct. 5, 1974, Lancet, Dr. Norman A. Mathesons letter Multiple Sclerosis and Diet was published on p. 831, wherein he outlined his having been diagnosed with MS and subsequently reading Roger MacDougalls story. He then described his return to good health and ended with: I thank Roger MacDougall, whose diet made it possible to carry out these observations.
    (3) Ashton Embry has written an article MS - probable cause and best-bet treatment in which he discusses the dietary and food allergy links to MS.
    (4) In Gluten Intolerance by Beatrice Trum Hunter, Keats Publishing Inc. New Canaan, CT. ISBN 0-87983435-8 She talks about a Dr. R. Shatin in Australia who has suggested that an inherited susceptibility to multiple sclerosis is from a primary lesion in the small intestine resulting from gluten intolerance, and that the demyelination is secondary. Shatin suggested that the high incidence of multiple sclerosis in Canada, Scotland and western Ireland may be related to the predominant consumption of Canadian hard wheat, which has the highest gluten content of all wheat varieties. In contrast, the incidence of multiple sclerosis is low among indigenous Equatorial Africans who mainly consume non-gluten containing grains such as millet.
    (5) In Multiple Sclerosis, by Jan de Vries, Mainstream Publishing, (Thorntons?) UK it recommends absolutely no gluten and very high reduction of dairy products, refined sugar, and saturated fats. He says that one of his most successful case studies, confirm that absolutely not one pinch if flour i.e. absolutely no gluten at all... otherwise you are deceiving yourself.
    (6) According to Dr. Joe Murray at the University of Iowa there is the possibility that the MS patient suffers from a neurological complication of undiagnosed celiac disease. About 5% of celiac patients get nerve damage that can vary from tingling and numbness in the feet to confusion, memory loss, dizziness and loss of balance, visual abnormalities. This sometimes happen in the absence of GI symptoms.
    (7) Lutz, W.J., The Colonization of Europe and Our Western Diseases, Medical Hypotheses, Vol. 45, pages 115-120, 1995
    Dr. Lutz argues that there is a clear, inverse relationship between civilisatory diseases and the length of time the people of a given region of Europe have had to adapt to the high carbohydrate diet associated with the cultivation of cereal grains that was begun in the Near East, and spread very slowly through Europe.
    I quote from the first page of the article:
    In over thirty years of clinical practice, I have found, as published in numerous papers and several books (3, 4), that diet works well against Crohns disease, ulcerative colitis, multiple sclerosis, heart failure, acne and other problems.
    Don Wiss can e-mail a copy of the article text to those requesting.
    (8) There is a fellow named Dave Q that has recovered with a gluten-free diet and lots of supplements. He discusses this, along with other recovery stories.
    (9) There is supposedly a newsgroup for those interested in Natural Recovery of MS. Its alt.support.mult-sclerosis.alternatives. Ask your system administrator to add it if you cant find it. But it seems to be hard to find.
    (10) A page on Milk and MS is from the Carbondale Center for Macrobiotic Studies and blames dairy for the distribution of MS. Visit: http://www.macrobiotic.org/health3.html
    (11) The following is a list of articles in medical journals, which were published at about the time that prednisone became popular in the treatment of MS. They appear to connect MS with celiac-like intestinal morphology.
    Cook, Gupta, Pertschuk, Nidzgorski Multiple Sclerosis and Malabsorption Lancet; June 24, 1978, p. 1366 Fantelli, Mitsumoto & Sebek Multiple Sclerosis and Malabsorption Lancet May 13, 1978 p. 1039-1040 Davison, Humphrey, Livesedge et al. Multiple Sclerosis Research Elsevier Scientific Publishing New York, 1975 I find it curious that the connection between malabsorption and MS stopped at about the same time that prednisone and other such steroids became the treatment of choice for MS. As Im sure you know, prednisone incites the re-growth of the villi despite the ingestion of gluten, in the celiac gut. Investigators who did endoscopies on MS patients admit that they have not asked about the patients use of such drugs.
    (12) Some literature from the celiac view point:
    Drs. Cooke & Holmes in Celiac Disease 1984; Churchill Livingstone, NY say that 10% of celiacs have neuropathic symptoms. Many appear to be associated with demyelination. Fineli et. al. echo that figure in Adult celiac disease presenting as cerebellar syndrome Neurology 1980; 30: 245-249. Cooke & Holmes come right out and express some of their frustration with neurologists for ignoring the potiential for neuropathic celiac. A new school has emerged, on the heels of the following report: Hadjivassiliou, et. al. Does cryptic gluten sensitivity play a part in neurological illness? Lancet 1996; 347: 369-371 They found that 57 percent of those with neurological problems of unknown cause also had antibodies to gliadin, which is a component of gluten. Sixteen percent of them had celiac disease, a much higher level than normally found. Most of the patients with the anti-gliadin antibodies did not have other symptoms of celiac disease such as poor absorption of vitamins. (13) There is supposedly a book on MS written by a Greg Nooney, a fellow that has cured himself with a gluten-free diet. He may be in Colorado.

    Jefferson Adams
    Celiac.com 04/15/2011 - Celiac disease is associated with various autoimmune and neurological diseases. A team of researchers recently completed a study on the prevalence of celiac disease in a prospective series of Multiple Sclerosis (MS) patients and their first-degree relatives.
    The study team included Luis Rodrigo, Carlos Hernández-Lahoz, Dolores Fuentes, Noemí Alvarez, Antonio López-Vázquez, and Segundo González.
    They are affiliated variously with the departments of Gastroenterology, Immunology Services and Neurology at the Hospital Universitario Central de Asturias (HUCA) in Oviedo, Spain.
    For the study, the team analyzed the prevalence of serological, histological and genetic celiac disease markers in 72 MS patients and 126 of their first-degree relatives. They then compared their results with data from 123 healthy control subjects.
    The results showed 7 MS patients (10%) with positive screens for tissue IgA-anti-transglutaminase-2 antibodies, compared with just 3 positive screens for healthy controls (2.4%) (p < 0.05). OR: 5.33 (CI-95%: 1.074-26.425).
    The team found no difference in HLA-DQ2 markers between MS patients (29%) and controls (26%) (NS). The team found 8 MS patients (11.1%) with mild or moderate villous atrophy (Marsh III type) in duodenal biopsies. Results also showed celiac disease in 23 of 126 first-degree relatives (32%).
    The data showed several other associated diseases, especially dermatitis 41 (57%) and iron deficiency anemia in 28 (39%) MS patients.
    MS patients also showed increased frequency of circulating auto-antibodies such as anti-TPO in 19 (26%), ANA in 11 (15%) and AMA in 2 (3%).
    The increased prevalence of celiac disease in MS patients and in their first-degree relatives suggests that early detection and dietary treatment of celiac disease in antibody-positive MS patients is advisable.
    Source:

    BMC Neurology 2011, 11:31doi:10.1186/1471-2377-11-31

    Jefferson Adams
    Celiac.com 05/11/2011 - People with multiple sclerosis and their first-generation relatives have higher rates of celiac disease than the general population, according to a report by a research team in Spain.
    For the study, a research team led by Dr. Luis Rodrigo of University Hospital, Central Asturias, Spain looked at rates of serological, genetic, and histological disease markers in 72 multiple sclerosis patients and 126 of their first-degree relatives. They then compared the results against data from 123 healthy control subjects.
    The team found rates of celiac disease among multiple sclerosis patients that are 5 to 10 times higher than rates for the general population worldwide, which average between 1% and 2%.
    The team found similar levels of  HLA-DQ2 markers in both multiple sclerosis patients (29%) and controls (26%) (NS). They found eight multiple sclerosis patients (11.1%) who showed mild or moderate villous atrophy (Marsh III type) on duodenal biopsy. Results also showed that 26 of 126 first-degree relatives (32%) had celiac disease.
    Multiple Sclerosis patients also displayed increased frequency of circulating auto-antibodies such as anti-TPO in 19 (26%), ANA in 11 (15%) and AMA in 2 (3%).
    Source:

    BMC Neurology 2011, 11:31doi:10.1186/1471-2377-11-31

    Jefferson Adams
    Celiac.com 09/16/2016 - Great news about poop transplants: They work! And now doctors kind of understand how and why they work. This is good news about a humor provoking, but very serious matter.
    Clostridium difficile infection is one of the most common health care-associated infections, and up to 40% of patients suffer from recurrence of disease following standard antibiotic therapy. C. difficile infection has proven to be very difficult to treat. Fecal microbiota transplantation (FMT) has been successfully used to treat recurrent C. difficile infection. Doctors hypothesize that FMT promotes recovery of a microbiota capable of colonization resistance to C. difficile. However, they didn't really understand how it worked.
    Recently, a research team investigated changes in the fecal microbiota structure following FMT in patients with recurrent C. difficile infection, and imputed a hypothetical functional profile based on the 16S rRNA profile, using a predictive metagenomic tool. After FMT, they also noted increased relative abundance of Bacteroidetes and decreased abundance of Proteobacteria.
    The research team included Anna M. Seekatz, Johannes Aas, Charles E. Gessert, Timothy A. Rubin, Daniel M. Saman, Johan S. Bakken, and Vincent B. Young. They are variously affiliated with the Department of Internal Medicine, Division of Infectious Diseases, Department of Microbiology and Immunology, University of Michigan, Ann Arbor, Michigan, USA; Essentia Health, Department of Gastroenterology, Duluth, Minnesota, USA; Essentia Institute of Rural Health, Duluth, Minnesota, USA; and St. Luke's Hospital, Section of Infectious Diseases, Duluth, Minnesota, USA.
    Their results showed that, after transplantation, fecal microbiota of recipients was more diverse, and more similar to the donor profile, than the microbiota before transplantation. Additionally, they observed differences in the imputed metagenomic profile. In particular, amino acid transport systems were over-represented in samples collected prior to transplantation.
    These results Indicate that functional changes accompany microbial structural changes following this therapy. Further identification of the specific microbiota, and functions that promote colonization resistance, may help to create better treatment methods for C. difficile infection.
    Source:
    mBio. 2014 May-Jun; 5(3): e00893-14. Published online 2014 Jun 17. doi: 10.1128/mBio.00893-14. PMCID: PMC4068257

  • 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