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      Frequently Asked Questions About Celiac Disease   04/24/2018

      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 is Celiac Disease and the Gluten-Free Diet? 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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    CHEAP, FAST NEW TEST PROMISES ACCURATE RESULTS FOR CELIAC DISEASE, OTHER DISORDERS


    Jefferson Adams

    Celiac.com 07/26/2012 - For people with celiac disease, the average delay from first symptoms to professional diagnosis is almost 12 years. Moreover, once those people seek medical attention, there is a high risk of misdiagnosis. In fact, researchers estimate that seven cases of celiac disease go undiagnosed or misdiagnosed for every case that is correctly identified.


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    Photo: CC--Horia VarlanCurrent tests for celiac disease require a doctor to conduct a biopsy, followed by a professional analysis of the biopsy results, usually at a specialized lab. Using this method, each test is invasive, often takes several days to produce results, and costs many hundreds of dollars.

    That is all set to change thanks to a pioneering new testing system that offers quick, accurate, cost-effective diagnosis and monitoring of celiac disease. The pioneering new test was developed with EU-funding, and will soon undergo clinical trials in Slovenia. If those trials are successful the test should be available in hospitals and clinics across Europe and elsewhere within a few years.

    The technology was developed in the celiac disease-Medics project by a consortium of 20 partners with funding from the European Commission. The system is the result of a confluence of innovative technologies from several scientific disciplines including microfluidics, nanotechnology and genetic testing.

    In addition to celiac disease, the technology can also be used to diagnose and monitor a wide variety of other diseases, including autoimmune disorders, such as rheumatoid arthritis, spondylitis, thyroiditis, and even cancer - basically any disorder that can be detected by looking for DNA or protein markers.

    Before celiac disease-Medics, explains project coordinator Ciara O'Sullivan, a research professor in the Nanobiotechnology & Bioanalysis Group at Universitat Rovira i Virgili in Spain, "there was nothing like this available for celiac disease."

    Rather than costs of several hundred dollars for a normal biopsy and analysis for celiac disease, the new celiac disease-Medics test will cost less than twenty Euro, and the biomedical interface device a one-time clinic expense of about 6,000 Euro.

    Instead of an invasive biopsy, the new test requires only one drop of blood placed into a device that looks like a credit card, but incorporates several innovative components: a micro-structured fluid network for precise control reagents, a specially adapted surface for capturing the biological components being sought, and an electrically driven sensor system that provides fast detection.

    Once the sample is taken, the disposable device will be placed into a biomedical interface instrument and analysis of the blood sample is carried out in a matter of minutes. Results can then be immediately output to the hospital information system and added to the patient's electronic health record (EHR).

    Prof O'Sullivan says that the device provides both DNA testing - specifically for variants of the HLA gene associated with the disease - and testing for gluten antibodies. This is important, because testing either alone can return false positives. Testing for both means the results ensures accurate results.

    Because the device can detect gluten antibodies, it can be used to monitor the patient's response to gluten-free treatment

    Trials will be conducted over the summer on two to three hundred patients at University Medical Centre Maribor in Slovenia. Results will be compared to the results of celiac tests done with analyzed tissue samples from biopsies.

    'We hope to have a product on the market within two years,' Prof O'Sullivan says. 'We are also looking to launch a follow-up project, probably with public funding, to adapt and extend the system to test for and monitor many other types of diseases.'

    Source:


    Image Caption: Photo: CC--Horia Varlan
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    Guest Glenn Ribotsky

    Posted

    We shall see just how accurate this is.

     

    Certainly, in the past, we've had a lot of tests developed celebrated as "breakthroughs" that turned out not to be specific or sensitive enough.

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    Guest Cyndi

    Posted

    We shall see just how accurate this is.

     

    Certainly, in the past, we've had a lot of tests developed celebrated as "breakthroughs" that turned out not to be specific or sensitive enough.

    How is this test any different from existing tests? Right now, anyone can get blood tests for gluten antibodies and for the associated genes. Yes, the new test would be a lot simpler and cheaper, which is good, but if antibodies plus genes aren't the gold standard now, why would they be with the new version of the tests? And if we can make the new test sufficient for diagnosis, why would anyone get a biopsy? Right now, blood tests plus known gluten sensitivity is enough, though many doctors go for the invasion test to "confirm." (There are false negatives with the biopsies of course because you can't be certain you snipped part of the gut that is damaged.)

     

    Based on the article, I'm not seeing any changes in diagnostics, other than that the tests are much cheaper than before (assuming $20 is the consumer price) so more people will take them and more people with celiac will use them for monitoring. If there is something different about this test, please make that clear.

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    Guest Peter Olins

    Posted

    How is this test any different from existing tests? Right now, anyone can get blood tests for gluten antibodies and for the associated genes. Yes, the new test would be a lot simpler and cheaper, which is good, but if antibodies plus genes aren't the gold standard now, why would they be with the new version of the tests? And if we can make the new test sufficient for diagnosis, why would anyone get a biopsy? Right now, blood tests plus known gluten sensitivity is enough, though many doctors go for the invasion test to "confirm." (There are false negatives with the biopsies of course because you can't be certain you snipped part of the gut that is damaged.)

     

    Based on the article, I'm not seeing any changes in diagnostics, other than that the tests are much cheaper than before (assuming $20 is the consumer price) so more people will take them and more people with celiac will use them for monitoring. If there is something different about this test, please make that clear.

    You hit the nail on the head, Cyndi. It would be a breakthrough if a definitive celiac diagnosis could be made without biopsy, but so far, no blood test has been found that can replace this unpleasant procedure. (The only possible exception is in cases where there is an extremely high anti-TG2 antibody level.) While it is possible that the company has unpublished results supporting their claims, we need to wait until the data can be reviewed independently.

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    admin

    This information came to me from Michael Walker (xix25@dial.pipex.com) of Genesis Diagnostics Ltd.
    Press Release: Genesis Diagnostics Ltd, Cambridge, UK have announced the development of a new and sensitive test for celiac disease. The test will be available through hospital laboratories. The test is based on detecting antibodies to an enzyme called transglutaminase in blood. The new test is more specific for celiac than currently available tests and should result in speedier diagnosis.
    Genesis Diagnostics is a manufacturer of ELISA based kits for autoimmune diagnosis. We already produce kits for gliadin IgG and IgA antibodies, which have been used for the past 5 years as the main test for celiac disease. The new test for transglutaminase was an obvious development of our experience in this area. We will continue to develop and improve blood tests in this area.
    We will be seeking FDA approval for the transglutaminase test kit in 1999. In the mean time it can be used for research only.

    Jefferson Adams
    Celiac.com 11/03/2008 - Blood testing for radioimmunoassay (RIA) tissue transglutaminase auto-antibodies (tTG-Abs) has proven to be a sensitive test for celiac disease follow-up. Recent studies have shown that RIA can accurately detect tTG-Abs in human saliva. However, not much is known about reliability of this method for monitoring the progress of celiac disease over time in patients who are attempting to follow a gluten-free diet.
    A team of researchers recently set out to assess salivary RIA tTG-Abs in celiac children on gluten-free diet. The research team included doctors M. Bonamico, R. Nenna, R.P.L. Luparia, C. Perricone, M. Montuori, F. Lucantoni, A. Castronovo, S. Mura; A. Turchetti, P. Strappini, and C. Tiberti.
    The team evaluated blood and saliva samples taken from 109 children at the time of their diagnosis for celiac disease. The first group included 71 females, with an average age of 9.4 years. A second group included 58 people who were following a gluten-free diet. The second group was broken into two subgroups: group 2a with 36 patients assessed at 3-6 months; and group 2b with 34 patients at 9 months or more (group 2b).
    The research team also included two control groups matched for age and sex. Group 3 included 89 gastroenterological patients, while group 4 included 49 healthy subjects. The team used RIA to detect tTG-Abs in saliva and blood, and compared the results against two other established tests: serum tTG-Abs ELISA and IgA anti-endomysium antibodies (EMA).
    The team detected salivary RIA tTG-Abs in 94.5% of patients from group 1, 66.7% of celiac patients from group 2a, and 50.0% from 2b. They detected blood RIA tTG-Abs in 98.2% of patients from group 1, 72.2% of celiac patients from group 2a, and 50.0% from 2b. The longer patients were on a gluten-free diet, the more the tTG-Abs decreased. The research team also found a correlation between saliva and serum levels (r = 0.75, P = 0.0001). A celiac disease follow-up showed comparable salivary and serum RIA sensitivities, and higher levels for EMA and ELISA methods.
    The research team concluded that it is possible to measure salivary tTG-Abs with a high level of accuracy; both at initial diagnosis for celiac disease, and also while patients are following a gluten-free diet.
    This discovery means that doctors treating people with celiac disease might soon be able to use a simple saliva test to monitor the progress of their patients’ gluten-free diets. Such a development might take remove much of the guesswork for celiacs who are trying to follow a gluten-free diet, and would be particularly useful for patients who might be asymptomatic, or who are at risk for celiac-associated conditions.
    Aliment Pharmacol Ther.  2008; 28(3): 364-370.


    Jefferson Adams
    Celiac.com 06/12/2009 - In a medical first, researchers at UCLA have made a connection between intestinal inflammation and systemic chromosome damage in mice, a discovery that may pave the way for early identification and treatment of human inflammatory disorders, some of which raise the risk for various kinds of cancer, according a study published in Cancer Research.
    Scientists discovered that local intestinal inflammation caused DNA damage to lymphocytes of the peripheral blood circulating throughout the body. So, contrary to conventional medical wisdom, chromosome damage is not limited to the immediate intestine, but involves body tissues far away from the actual inflammation. Their results showed single- and double-strand DNA breaks in the blood, and chromosome damage in peripheral blood indicating systemic genetic damage.
    Inflammatory diseases have been linked to some lymphomas and abdominal, liver and colorectal cancers, said Robert Schiestl, lead author, and professor of pathology, radiation oncology and environmental health sciences and a Jonsson Cancer Center scientist.
    Finding inflammation early – before any symptoms surface - and treating the associated causes quickly may prevent the damage that eventually triggers these cancers, he said. Before the study, researchers had no knowledge that "intestinal inflammation causes damage that can be found throughout the body,” said Schiestl, adding that this "may help explain how inflammation leads to these cancers.”
    Intestinal inflammation can be caused by such maladies as Crohn’s disease, inflammatory bowel disease, ulcerative colitis and Celiac disease. Nearly 1.5 million Americans, and 2.2 million Europeans currently suffer from inflammatory bowel diseases and global incidence is on the rise, Schiestl said.
    The discovery opens up the possibility of using chromosome damage in the peripheral circulating blood as a biomarker to spot intestinal inflammation before any symptoms surface.
    Researchers were able to detect chromosome damage in the blood of specially bred mice before the onset of colitis, said Aya Westbrook, a graduate student of the UCLA Molecular Toxicology Interdepartmental Program and the paper's first author. Westbrook added that disease severity correlated directly with higher levels of chromosome damage in the blood.
    Chromosome damage, according to study author Dr. Jonathan Braun, professor and chairman of the Department of Pathology and Laboratory Medicine at UCLA, may be the “earliest detectable indicator” of intestinal inflammatory disease. Currently, the only way to diagnose patients with inflammatory bowel disease is through full endoscopic exam, which is both invasive and costly. In theory, Braun said, a biomarker blood test might replace the invasive endoscopic exam and allow physicians to identify early inflammatory disease before it develops fully.
    Spotting disease and being able to ward it off early is one of the Holy Grails of all medicine. This breakthrough could “change the natural history of these diseases,” Braun said. For the first time, doctors might have a tool that can actually help spot inflammation, the earliest precursor to multiple kinds of cancer, at its earliest stages, long before any actual disease develops. This could lead to the prevention of tens of thousands of cancers.
    UCLA researchers have launched a clinical trial to confirm their findings in humans, Schiestl said. They’re focusing on patients with Crohn’s disease and ulcerative colitis. They're hoping the discovery will permit them to test new strategies for treating smoldering disease, which we’ve never been able to identify before,” Schiestl said, adding that they might be able to assess new drugs for treating early inflammatory disease.
    The research may also show why some patients with inflammatory disease develop cancers, while others endure chronic inflammation for decades, yet remain cancer-free. Researchers suspect that some unknown molecular mechanisms might work to protect some patients and not others. Finding such mechanisms might lead to tests for predicting which patients with intestinal inflammatory diseases are predisposed to cancer.
    Cancer Research: June 1 2009, Volume 69, Issue 11 

    Melissa Reed
    Celiac.com 08/10/2014 - Gluten comes from the Latin word for glue. It is a protein in wheat and other grains. It will elicit an autoimmune response in celiacs. Other grains like barley, rye and spelt contain gluten as well. In wheat products, the difficult part for celiacs to digest is gliadin. Some fad diets may try to claim glaidin is new, but it is not, and to dispel another myth there isn’t any wheat on the market that is genetically modified.
    Celiac diease isn't diagnosed as often as it should be. In turn, individuals suffer with it for years, not knowing what to do or how to feel better. Celiac disease is often misdiagnosed for different ailments that have similar symptoms. It can seem to be mysterious, since often it takes time to find out what issue is causing the entire ruckus. There are several symptoms that overlap between celiac and other autoimmune disorders, like Type 1 diabetes, IBS, Crohn's and Hashimoto Thyroiditis. Celiac disease and other autoimmune disorders are known to have neurological effects that sometimes result in ataxia, numbness and pain, so Lupus, rheumatoid arthritis or similar disorders often get confused for celiac.To make it more confusing some autoimmune disorders can be triggered by untreated celiac disease.
    Celiac is a genetic disease that is not contagious, but it does medically require a gluten-free diet. An individual with celiac must be careful to read labels on all products they consume. They must be aware of co-mingling of food ingredients in preparation of their meals and must be diligent to not ingest a crumb of gluten!
    There are individuals that don't have the genetic makeup for celiac disease, but yet seem to be unable to digest gluten. Those individuals are considered gluten sensitive. There unfortunately are no tests or strict criteria to diagnose gluten sensitivity, according to a recent Webinar from National Foundation for Celiac Awareness. The gluten sensitivity issue is not yet as clearly defined as celiac disease. Some individuals with gluten sensitivity do have a problem digesting gluten, but it often is just not as severe as the gluten autoimmune reaction that happens to those with celiac disease.
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  • Recent Articles

    Jefferson Adams
    Celiac.com 04/26/2018 - Emily Dickson is one of Canada’s top athletes. As a world-class competitor in the biathlon, the event that combines cross-country skiing with shooting marksmanship, Emily Dickson was familiar with a demanding routine of training and competition. After discovering she had celiac disease, Dickson is using her diagnosis and gluten-free diet a fuel to help her get her mojo back.
    Just a few years ago, Dickson dominated her peers nationally and won a gold medal at Canada Games for both pursuit and team relay. She also won silver in the sprint and bronze in the individual race. But just as she was set to reach her peak, Dickson found herself in an agonizing battle. She was suffering a mysterious loss of strength and endurance, which itself caused huge anxiety for Dickson. As a result of these physical and mental pressures, Dickson slipped from her perch as one of Canada's most promising young biathletes.
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    Jefferson Adams
    Celiac.com 04/25/2018 - A team of Yale University researchers discovered that bacteria in the small intestine can travel to other organs and trigger an autoimmune response. In this case, they looked at Enterococcus gallinarum, which can travel beyond the gut to the spleen, lymph nodes, and liver. The research could be helpful for treating type 1 diabetes, lupus, and celiac disease.
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    Read the full study in Science.

    Tammy Rhodes
    Celiac.com 04/24/2018 - Did you know in 2017 alone, the United States had OVER TENS OF THOUSANDS of people evacuate their homes due to natural disasters such as fires, floods, hurricanes, tornadoes and tsunamis? Most evacuation sites are not equipped to feed your family the safe gluten free foods that are required to stay healthy.  Are you prepared in case of an emergency? Do you have your Gluten Free Emergency Food Bag ready to grab and go?  
    I have already lived through two natural disasters. Neither of which I ever want to experience again, but they taught me a very valuable lesson, which is why I created a Gluten Free Emergency Food Bag (see link below). Here’s my story. If you’ve ever lived in or visited the Los Angeles area, you’re probably familiar with the Santa Ana winds and how bitter sweet they are. Sweet for cleaning the air and leaving the skies a brilliant crystal blue, and bitter for the power outages and potential brush fires that might ensue.  It was one of those bitter nights where the Santa Ana winds were howling, and we had subsequently lost our power. We had to drive over an hour just to find a restaurant so we could eat dinner. I remember vividly seeing the glow of a brush fire on the upper hillside of the San Gabriel Mountains, a good distance from our neighborhood. I really didn’t think much of it, given that it seemed so far from where we lived, and I was hungry! After we ate, we headed back home to a very dark house and called it a night. 
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    When our daughter was almost three years old, we left the West Coast and relocated to Northern Illinois. A place where severe weather is a common occurrence. Since the age of two, I noticed that my daughter appeared gaunt, had an incredibly distended belly, along with gas, stomach pain, low weight, slow growth, unusual looking stool, and a dislike for pizza, hotdog buns, crackers, Toast, etc. The phone call from our doctor overwhelmed me.  She was diagnosed with Celiac Disease. I broke down into tears sobbing. What am I going to feed my child? Gluten is everywhere.
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    Then, my second brush with a natural disaster happened, without any notice, leaving us once again scrambling to find a safe place to shelter. It was a warm and muggy summer morning, and my husband was away on a business trip leaving my young daughter and me to enjoy our summer day. Our Severe Weather Alert Radio was going off, again, as I continued getting our daughter ready for gymnastics.  Having gotten used to the (what seemed to be daily) “Severe Thunderstorm warning,” I didn’t pay much attention to it. I continued downstairs with my daughter and our dog, when I caught a glimpse out the window of an incredibly black looking cloud. By the time I got downstairs, I saw the cover to our grill literally shoot straight up into the air. Because we didn’t have a fenced in yard, I quickly ran outside and chased the cover, when subsequently, I saw my neighbor’s lawn furniture blow pass me. I quickly realized I made a big mistake going outside. As I ran back inside, I heard debris hitting the front of our home.  Our dog was the first one to the basement door! As we sat huddled in the dark corner of our basement, I was once again thinking where are we going to go if our house is destroyed. I was not prepared, and I should have been. I should have learned my lesson the first time. Once the storm passed, we quickly realized we were without power and most of our trees were destroyed. We were lucky that our house had minimal damage, but that wasn’t true for most of the area surrounding us.  We were without power for five days. We lost most of our food - our gluten free food.
    That is when I knew we had to be prepared. No more winging it. We couldn’t take a chance like that ever again. We were “lucky” one too many times. We were very fortunate that we did not lose our home to the Los Angeles wildfire, and only had minimal damage from the severe storm which hit our home in Illinois.
      
    In 2017 alone, FEMA (Federal Emergency Management Agency) had 137 natural disasters declared within the United States. According to FEMA, around 50% of the United States population isn’t prepared for a natural disaster. These disasters can happen anywhere, anytime and some without notice. It’s hard enough being a parent, let alone being a parent of a gluten free family member. Now, add a natural disaster on top of that. Are you prepared?
    You can find my Gluten Free Emergency Food Bags and other useful products at www.allergynavigator.com.  

    Jefferson Adams
    Celiac.com 04/23/2018 - A team of researchers recently set out to learn whether celiac disease patients commonly suffer cognitive impairment at the time they are diagnosed, and to compare their cognitive performance with non-celiac subjects with similar chronic symptoms and to a group of healthy control subjects.
    The research team included G Longarini, P Richly, MP Temprano, AF Costa, H Vázquez, ML Moreno, S Niveloni, P López, E Smecuol, R Mazure, A González, E Mauriño, and JC Bai. They are variously associated with the Small Bowel Section, Department of Medicine, Dr. C. Bonorino Udaondo Gastroenterology Hospital; Neurocience Cognitive and Traslational Institute (INECO), Favaloro Fundation, CONICET, Buenos Aires; the Brain Health Center (CESAL), Quilmes, Argentina; the Research Council, MSAL, CABA; and with the Research Institute, School of Medicine, Universidad del Salvador.
    The team enrolled fifty adults with symptoms and indications of celiac disease in a prospective cohort without regard to the final diagnosis.  At baseline, all individuals underwent cognitive functional and psychological evaluation. The team then compared celiac disease patients with subjects without celiac disease, and with healthy controls matched by sex, age, and education.
    Celiac disease patients had similar cognitive performance and anxiety, but no significant differences in depression scores compared with disease controls.
    A total of thirty-three subjects were diagnosed with celiac disease. Compared with the 26 healthy control subjects, the 17 celiac disease subjects, and the 17 disease control subjects, who mostly had irritable bowel syndrome, showed impaired cognitive performance (P=0.02 and P=0.04, respectively), functional impairment (P<0.01), and higher depression (P<0.01). 
    From their data, the team noted that any abnormal cognitive functions they saw in adults with newly diagnosed celiac disease did not seem not to be a result of the disease itself. 
    Their results indicate that cognitive dysfunction in celiac patients could be related to long-term symptoms from chronic disease, in general.
    Source:
    J Clin Gastroenterol. 2018 Mar 1. doi: 10.1097/MCG.0000000000001018.

    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.