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    • Scott Adams

      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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    Importance of Early Gluten Sensitivity Diagnosis


    Miranda Jade

    Celiac.com 02/08/2012 - Having finally being diagnosed with celiac disease myself, I enjoy writing about this autoimmune disease in my gluten-free advocacy work with my mom, Tina Turbin. However, there is a whole other segment of the population who, rather than having celiac disease, have a food sensitivity to gluten. In fact, according to The Food Intolerance Consumer, gluten-sensitive people make up 15% of Americans, whereas celiac disease is currently estimated to exist in 1% of the population. Clearly, in view of its prevalence in the U.S., gluten sensitivity needs to be addressed, but as it turns out, research is showing that an early diagnosis of gluten sensitivity is particularly crucial in preventing celiac disease and other serious health conditions from developing among the gluten-sensitive population.


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    Photo: CC - milos milosevicAccording to the website of the ALCAT Food and Chemical Sensitivity/Intolerance Test, food sensitivity "induces chronic activation of the innate immune system and gives rise to inflammatory process," and this inflammation "has been linked to countless chronic conditions, including: digestive disorders, migraines, obesity, chronic fatigue, ADD, aching joints, skin disorders, arthritis and many more.' Perhaps you're wondering how a food sensitivity is different from a food allergy. According to ALCAT, food allergies encompass reactions to food that activate the immune system to produce large amounts of histamine, which leads anaphylaxis, a condition that can be deadly, causing swelling in the throat and esophagus so that one can't access air from the lungs or other reactions such as hives and rashes.

    According to Kenneth Fine, MD, in a transcript of a talk he gave to the Greater Louisville Celiac Sprue Support Group, as published by Celiac.com, the immune system reaction that gluten sensitivity causes starts in the intestine because this is where gluten is found after being digested in foods. When this reaction causes damage to the absorptive finger-like projections that line the small intestine called villi, known as villous atrophy, celiac disease is said to exist. However, says Dr. Fine, "Although the small intestine is always the portal of the immune response to dietary gluten, it is not always affected in a way that results in villous atrophy." In fact, he says that most gluten-sensitive people don't have this symptom of celiac disease and are therefore not celiac.

    Despite this fact, the testing that has been commonly administered in order to diagnose gluten sensitivity have yielded positive results only when damage to the villi was noted, a fact which can have devastating health consequences for gluten-sensitive people without such damage, who are likely to continue ingesting gluten. According to Dr. Fine, "This can result in significant immune and nutritional consequences, many of which are irreversible even after treatment with a gluten-free diet." The list of disorders and health conditions that can manifest is long, including, Dr. Fine says, "loss of hormone secretion by glands (hypothyroidism, diabetes, pancreatic insufficiency, etc), osteoporosis, short stature, cognitive impairment, and other inflammatory bowel, liver, and skin diseases, among others." That's why he stresses early diagnosis for gluten sensitivity.

    Dr. Fine seeks to change current testing methods and clear up misconceptions that prevent early diagnosis from being made. One of the misconceptions he discusses is the reliability of specific blood testing for not only antigliadin antibodies but also autoimmune antiendomysial or anti-tissue transglutaminase antibody. He says that "a negative test does not mean you do not have the problem. This is the biggest pitfall of all because the only thing a very specific test, like blood testing for celiac disease, can do is 'rule in' the disease; it cannot 'rule it out.'" This means that people with advanced or long-term celiac disease will show positive results. In fact, when the villi were only partly damaged, only 30% of celiac individuals being tested had positive results.

    Detecting gluten sensitivity early in individuals can have major health benefits, preventing not only the development of celiac disease (that is, villous atrophy, according to Dr. Fine), but a wide array of autoimmune diseases and conditions such as osteoporosis, malnutrition, infertility, certain mental disorders, and even some forms of cancer. I myself was diagnosed in my early 20's after being in and out of hospitals and incorrect diagnoses. Additionally, the treatment for gluten-sensitive individuals diagnosed early would be simple-a gluten-free diet-which should result in improvement in symptoms. With the medical community enlightened by Dr. Fine's research, we can look forward to better testing and earlier diagnosis of the gluten-sensitivity community and their resultant health benefits.

    Resources:


    Image Caption: Photo: CC - milos milosevic
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    Same here...got diagnosed 2 years back. That is my late 20's, gluten-free diet is working on me.

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    The article supports diagnosing gluten sensitivity early, but does not tell us how... It states that blood tests are unreliable anyway... So how do we go about it?

     

    I am non-celiac gluten sensitive, and all my blood tests are negative. I am looking for a way to know if my kids are gluten-sensitive - their blood tests unsurprisingly negative as well... Their symptoms if any are mild and well within the normal human variations (just like mine were as a child - but definitely I was gluten sensitive back then too). They can't tell me if they "feel better" on a gluten-free diet, and it is nearly impossible to keep them off gluten while they eat at school, birthday parties, etc...

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    Guest Ron Corn

    Posted

    Have there been efforts to ban gluten from our food supply. Fifteen % of the population is a big number. Why do suffers and our elected officials allow this product to be used? Have there been lobbying efforts to purge gluten's use? I was just diagnosed two weeks ago and I am shocked that this product is allowed to be distributed.

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    Helpful to be reminded that blood tests do not always show accurately. I had two different blood tests at the same time. So glad I paid for both, the cheaper test was negative. But the second test showed a strong positive and I felt better in days.

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    Guest VPeach

    Posted

    As someone who has a strong gluten intolerance, I have serious concerns about the 100's of products on the market labeled "Gluten Free" that have some form of corn replacing the wheat. Corn is as bad or worse for me, and it is very nearly impossible to find any kind of food product that does not have some form of wheat or corn.

     

    Bought a Rice-A-Roni style rice product recently and it had 4 types of wheat products and 2 types of corn products ... in a box of rice!!! What are food producers thinking for goodness sake.

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  • Related Articles

    Scott Adams
    Like many people with celiac disease, I spent a lot of years and money to go through many tests and misdiagnoses before doctors finally found my problem. Because of the large variety of symptoms associated with celiac disease, diagnosis can be very difficult. Most medical doctors are taught to look for classic symptoms and often make a wrong diagnosis, or no diagnosis at all.
    During my doctor visits my diet was never discussed, even though most of my symptoms were digestive in nature. My symptoms included abdominal pain, especially in the middle-right section while sleeping, bloating, and diarrhea (off and on over a period of several years). A simple (and free!) exclusionary diet would have quickly revealed my problem. An exclusionary diet involves eliminating wheat, rye, oats, barley, dairy products, soy and eggs for several weeks, and recording any reaction as one slowly adds these foods back to their diet.
    It took two years for the doctors to discover that I had celiac disease. During that time I was misdiagnosed with Irritable Bowel Syndrome (IBS), told that I could have cancer or a strange form of Leukemia, treated for a non-existent ulcer with a variety of antibiotics that made me very ill, and was examined for a possible kidney problem. I also underwent many unnecessary and expensive tests including CAT Scans, thyroid tests, tests for bacterial infections and parasites, ultrasound scans, and gall bladder tests. Luckily I ended up reading something about celiac disease in a book on nutrition, which led me to ask my doctor to test me for it. I was finally diagnosed via a biopsy of my small intestine (which is not as bad as it sounds). Although the biopsy is still considered the gold standard of diagnosis, there are also several blood tests for celiac disease.
    I decided to create this Website to help others avoid a similar ordeal. I also want to provide people who know they have the problem with information which will improve their quality of life, and broaden their culinary horizons. To do this, I have compiled information from a large variety of sources including medical journals, books, doctors, scientists and the Celiac Listserv News Group, and posted it all right here. Please remember that I am not a doctor, and none of this information should be considered expert medical advice....enjoy! - Scott Adams

    Scott Adams

    Celiac.com 03/14/2006 - Alba Therapeutics Corporation announced today successful completion of Phase Ib proof-of-concept studies for its lead compound, AT1001. In a 21-patient cohort of celiac disease sufferers, the oral administration of AT1001 versus placebo control induced a significantly positive result in the trials primary target endpoint. "We anticipated a strong signal, however, the magnitude of the response surpassed our expectations," stated Blake Paterson, M.D., President and CEO of Alba. "We are particularly excited, as to the best of our knowledge this is the first demonstration of a desired and systemic immunological effect resulting from a physiological event at a mucosal surface."
    AT1001 is an antagonist to the zonulin system -- a signaling pathway discovered by Alessio Fasano, M.D., Professor of Pediatrics, Medicine and Physiology at the University of Maryland School of Medicine, and the basis of Albas extensive intellectual property portfolio.
    About Zonulin
    Zonulin is a signaling protein that transiently and reversibly opens the tight junctions ("tj") between the cells of epithelial and endothelial tissues such as the intestinal mucosa, blood brain barrier and pulmonary epithelia. Zonulin appears to be involved in many diseases in which leakage occurs via paracellular transport across epithelial and endothelial tight junctions (tj), and thus may play an important potential role in the treatment of autoimmune diseases.
    About Celiac Disease
    Celiac disease (celiac disease) is a T-cell mediated auto-immune disease that occurs in genetically susceptible individuals and is characterized by small intestinal inflammation, injury and intolerance to gluten. According to the National Institutes of Health, celiac disease affects approximately 3 million Americans, although the diagnosis is rarely made. The only current treatment for celiac disease is complete elimination of gluten from the diet, which results in remission for some patients.
    About Alba
    Alba Therapeutics Corporation is a privately held biopharmaceutical company based in Baltimore, Maryland. Alba is dedicated to commercializing disease-modifying therapeutics and drug delivery adjuvants based on the zonulin pathway. Albas lead molecule, AT-1001, is targeted towards the treatment of celiac disease and other auto-immune illnesses.
    Contact: Heather Bakalyar, 410-522-8708 x1106

    Jefferson Adams

    Celiac.com 04/10/2007 - Celiac disease is one of the most common chronic health disorders in western countries. Yet, due largely to poor awareness of celiac disease by primary care physicians, most celiac cases in North America go undiagnosed. A recent study published in the American Journal of Gastroenterology suggests that the North American diagnostic rate for celiac disease can be improved through the use of active case-finding strategies in the primary care setting.
    The study set out to determine the most common celiac symptoms faced by clinicians, and to determine how effective an active case-finding strategy might be in raising the levels of diagnosis. The study drew from a large pool of individuals who attended one of three participating North American clinical practices. 737 women and 239 men with symptoms or conditions known to be associated with celiac disease were tested for immunoglobulin A anti-transglutaminase (tTG) antibodies, and those with elevated anti-tTG were then tested for IgA anti-endomysial antibodies (EMA). Those who tested positive for EMA were encouraged to undergo an intestinal biopsy and HLA typing.
    The median age for those tested was 54.3 years. Of 976 subjects tested, 30 showed a positive anti-tTG test (3.07%, 95% CI 1.98–4.16). 22 patients (18 women, 4 men) were diagnosed with celiac. In these 22 cases, the most frequent reasons for celiac disease screening were bloating (12/22), thyroid disease (11/22), irritable bowel syndrome (7/22), unexplained chronic diarrhea (6/22), chronic fatigue (5/22), and constipation (4/22).
    The prevalence of celiac disease in the serologically screened sample was 2.25% (95% CI 1.32–3.18).
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    Am J Gastroenterol 2007; 102:1–7
    health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.

    Jefferson Adams
    Celiac.com 09/25/2008 - Mucosal inflammation of the small intestine, coupled with damage to intestinal villi, is a classic indication of celiac disease. Recently, doctors have begun to embrace the idea that some patients with positive celiac blood tests may have mucosal lesions that are too small to appear on routine histopathological analysis.
    In the first study of its kind, a team of researchers based in Ireland set out to analyze enterocyte morphology and cytoskeletal structures using a high content analysis technology.
    The research team was made up of doctors Bashir M. Mohamed, Conleth Feighery, Yvonne Williams, Anthony Davies, Dermot Kelleher, Yuri Volkov, Jacinta Kelly and Mohamed Abuzakouk.
    The team examined duodenal biopsies from 14 untreated and 10 treated celiac patients and from 20 non-celiac control subjects. They also investigated tissue sections from six study group subjects before and after the development of gluten-sensitive enteropathy.
    The research team used an anti-α-tubulin antibody to conduct immunohistochemical studies on paraffin-embedded tissue sections. They found important differences in enterocyte morphology and intracellular cytoskeletal structures in the patients with proven celiac disease and those in the study group.
    Moreover, the team observed that these changes existed in the study group prior to any indication of enteropathy, as determined by standard microscopy.
    This is the first time researchers have used high content analysis to show specific details of enterocyte morphology. Such an approach permits doctors to quantitatively analyze enterocyte intracellular structure from standard biopsy samples and allows for detection of minute changes that develop before the classic histological lesion.
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    Central European Journal of Biology
    Volume 3, Number 3 / September, 2008


  • Recent Articles

    Jefferson Adams
    Celiac.com 05/24/2018 - England is facing some hard questions about gluten-free food prescriptions for people with celiac disease. Under England’s National Health Plan, people with celiac disease are eligible for gluten-free foods as part of their medical treatment. 
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    Read more about this research in the online journal BMJ Open.

    Jefferson Adams
    Celiac.com 05/23/2018 - Yes, we at Celiac.com realize that rye bread is not gluten-free, and is not suitable for consumption by people with celiac disease!  That is also true of rye bread that is low in FODMAPs.
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    Source:
    World J Gastroenterol. 2018 Mar 21; 24(11): 1259–1268.doi: &nbsp;10.3748/wjg.v24.i11.1259

    Jefferson Adams
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    Source:
    Bloomberg.com

    Jefferson Adams
    Celiac.com 05/21/2018 - Just a year ago, Starbucks debuted their Canadian bacon, egg and cheddar cheese gluten-free sandwich. During that year, the company basked in praise from customers with celiac disease and gluten-sensitivity for their commitment to delivering a safe gluten-free alternative to it’s standard breakfast offerings.
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    Jefferson Adams
    Celiac.com 05/19/2018 - Looking for a nutritious, delicious meal that is both satisfying and gluten-free? This tasty quinoa salad is just the thing for you. Easy to make and easy to transport to work. This salad of quinoa and vegetables gets a rich depth from chicken broth, and a delicious tang from red wine vinegar. Just pop it in a container, seal and take it to work or school. Make the quinoa a day or two ahead as needed. Add or subtract veggies as you like.
    Ingredients:
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    Dish into bowls.
    Top with veggies, salt and pepper, and sunflower seeds. 
    Splash with red wine vinegar and enjoy!