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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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    SCOTT ADAMS' STORY OF HIS DIAGNOSIS OF CELIAC DISEASE


    admin

    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.


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    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



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    Guest Catherine

    Posted

    Hi there. I guess you've heard this time and time again, but your site is great! I too went through many, many years of mis-diagnosis - almost died. Turns out that at least 2/3 of my family have it also. Thanks for the site and the help. I'm still fighting symptoms and yes, I'm completely gluten-free but the docs say it may be possible that I have Celiac as a secondary disease.....but they still can't figure out the first.

     

    Thanks again and wish me luck. I need a diagnosis and soon.

     

    Catherine

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    Thank you so, so much for this incredibly helpful website! I was just diagnoses with celiac disease a few weeks ago, and as a newbie I'm relying heavily on your lists of safe vs. unsafe ingredients. Thank you, thank you, thank you!! :-)

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    Guest Jane Claflin

    Posted

    Dear website, I have been severely ill since 1998-99. They diagnosed me with a brain disorder called Arnold Chiari Malformation 1. I had three major brain surgeries for the pain. I have suffered all these years and no answer from any gastro doctors or surgeons. Walked into my new GP other day and she said have you heard about celiac sprue. I am floored and thanking God I have finally received and answer from heaven!!! All these years of being bedridden are fixing to be gone and I can live a normal life!This website has given me my life back and one simple word of advice by a doctor after hundreds of them had written me off as crazy. No more pain!!!! Thank you Jesus and Scott for giving me my life back im 48 years old and spend 7-8 years in bed with debilitating pain. There are no words to describe how I feel right now. My sister has same problems too they will be floored to know there is an answer now. Thank You from all my heart, Jane in Texas!!!

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    Guest BackCheck48

    Posted

    Thanks for the site bro! found tons of info that has really helped food wise. I think i have it easy. No symptoms, regular blood work showed low iron and some other stuff so a scope was ordered and I was confirmed as a celiac. (my sister has it and the doc was on the ball so he had the biopsy done) funny thing was that I felt fine, I have always had tons of energy and am never tired. I've been gluten free for about 10 days and I feel even better. I traded my Guinness for jack and coke!!

     

    'take the shortest route to the puck and arrive in ill humor.'

     

    Cordially,

    MEF

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    Guest naomi putticvk

    Posted

    After reading your story Scott I am convinced hat I now have an answer to my problems. I have suffered bloating pain in my right side and intermittent diarrhea for many years now. I am also lactose intolerant and so follow to the best of my ability that kind of diet, so when I next see my doctor in ten days time I will ask him to test me for it. Once again thank you Naomi Switzerland. PS Will keep you up to date on final diagnosis

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    Guest JCarter

    Posted

    Thanks for the website. I have been having progressively worsening symptoms over the past few years that have been escalating over the past few months. I never would have considered celiac disease. Interestingly, when I feel truly terrible I will stay on a clear liquid diet and perk right up - then fall into the same eating patterns and feel terrible. I have had diagnostic tests that to date have been negative. I have an appointment with a GI specialist today and will surely ask him to test me for celiac disease - I am miserable!

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    Guest Charline

    Posted

    Dear Scott,

    I love your site and all your helpful info. I am a mother of a newly diagnosed 8 year old celiac sufferer. I however feel confused even though I trust his gastroenterologist from Children's. So I was hoping you might help me if you could find the time to respond to my question. My son had problems since he was a baby with some type of intolerance but no allergies. Severe reflux as well. Constipation with bleeding off and, and stomach pain after eating which led me to seek a specialist. One antibody was 14 (supposed to be <4) and biopsy showed high lymphocytes, immune cell presence, BUT NO DAMAGE to the VILLI in his small intestine. This is why I am confused. I know he has some autoimmune disorder as I have several (not celiac though) but I want to be 100% sure this is the correct diagnosis before I put him on this diet for the rest of his life. I am sorry for imposing on you but I have dealt with so many doctors with my own health problems. Even hearing I was looking for something to be wrong when I had 3 miscarriages! This was a top doctor from a renowned university. IF, you can find the time to briefly guide me in this difficult diagnosis I would be so greatly thankful. Again, your site is so helpful and I plan on ordering plenty of food soon! Keep up the great work and best to you and your progress!

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    This is an amazing site. I needed to know different recipes and what foods my daughter needs to avoid. She has just gone through so much and had a biopsy yesterday. She is only 8 years old and has lost 6 lbs. and always has chronic stomach pains and loose bowel movements. We should find out the results in a few weeks but she has started today on a wheat free diet. She loves banana bread and was sad she couldn't eat it anymore until we found this site. She loves the new banana bread more than the old type with wheat in it.

    Thank you very much for all this much needed incredible information for a parent learning to care for her child.

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    Guest Rachel

    Posted

    I have found this website very informative and helpful. I was diagnosed with celiac disease right before Christmas. I have been misdiagnosed with IBS for 10 years and finally my body gave up and I lost 30 lbs within 2 months. My new doctor finally took me serious and diagnosed me through blood tests and small intestine biopsy. I am eating gluten free and still having weight loss and still waking up sick every single day, hopefully they help soon. You website gave me a lot of new information. Thank you!

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    Guest Vivian, PT

    Posted

    Dear Scott,

    I love your site and all your helpful info. I am a mother of a newly diagnosed 8 year old celiac sufferer. I however feel confused even though I trust his gastroenterologist from Children's. So I was hoping you might help me if you could find the time to respond to my question. My son had problems since he was a baby with some type of intolerance but no allergies. Severe reflux as well. Constipation with bleeding off and, and stomach pain after eating which led me to seek a specialist. One antibody was 14 (supposed to be <4) and biopsy showed high lymphocytes, immune cell presence, BUT NO DAMAGE to the VILLI in his small intestine. This is why I am confused. I know he has some autoimmune disorder as I have several (not celiac though) but I want to be 100% sure this is the correct diagnosis before I put him on this diet for the rest of his life. I am sorry for imposing on you but I have dealt with so many doctors with my own health problems. Even hearing I was looking for something to be wrong when I had 3 miscarriages! This was a top doctor from a renowned university. IF, you can find the time to briefly guide me in this difficult diagnosis I would be so greatly thankful. Again, your site is so helpful and I plan on ordering plenty of food soon! Keep up the great work and best to you and your progress!

    It is a common misconception that celiac disease is only confined to the small intestines but it is not based on the seminar I attended in the past. If he's already having problems with digestion, most likely he's starting to have the signs and symptoms of gluten sensitivity. Celiac disease is the end stage of gluten sensitivity. There are also manual therapy techniques available and the one I use is called integrative manual therapy along with NAET (Nambudripad's Allergy Elimination Technique) which could help detect where the problem is coming from. Hope this helps answer some of your questions.

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    Guest Kathleen

    Posted

    I gained 10 pounds and had severe abdominal bloating this spring. I've had intermittent problems with diarrhea and constipation over the years. My doctor had a CT scan that showed an enlarged ovary so I was given an internal ultrasound. I had a hemorrhagic cyst but it was not the problem. My doctor sent me to a gastroenterology specialist and he suggested an upper endoscopy, looking for ulcers or polyps. He also did a stomach and intestinal biopsy. The biopsy came back positive for Celiac. I am having blood work done today to confirm and check my gluten levels. I am 50 years old and although I am glad I have a diagnosis, I am having a hard time with the complete change of lifestyle. I have always loved to cook and bake and now I have to modify everything. I often travel with my husband, and this can now be a problem when I travel to places like Africa. I am grateful for this website. I would like to see something on how to adjust to the radical changes one has to make, especially someone my age! Thank you.

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    Guest Sally Dellas

    Posted

    I have found this website very informative and helpful. I was diagnosed with celiac disease right before Christmas. I have been misdiagnosed with IBS for 10 years and finally my body gave up and I lost 30 lbs within 2 months. My new doctor finally took me serious and diagnosed me through blood tests and small intestine biopsy. I am eating gluten free and still having weight loss and still waking up sick every single day, hopefully they help soon. You website gave me a lot of new information. Thank you!

    Hi Rachel,

    Hope you are feeling better by now as it's been over four months since your post. It took me several months before I was finally gluten free. I didn't realize that things like soy sauce and root beer and modified food starch contained gluten.

    Little by little, I discovered all the things that were causing me trouble.

    It sure feels good not to feel bad!

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    Guest Sally Dellas

    Posted

    Hi Kathleen,

    I was 68 when I finally got diagnosed six years ago. I never was too crazy about pasta, bread, and pastries, so I don't miss that, except for some good French or Italian bread now and then.

    Actually, the gluten free diet is a really healthy one, as you can't eat much processed food. Lots of fresh fruits and veggies, brown rice and corn, lean meat, chicken and fish, and dairy products if you don't happen to be lactose intolerant. And even if you are, there are lactose free products or the pills you can take with dairy foods. I happen to LOVE Mexican food, so I'm in luck if I have to eat out. Just make sure there is no wheat in the tortillas or sauces.

    As far as baking goes, I was really getting into turning out piles of Christmas cookies and treats for the family when I" had to go gluten-free, so there went the baking. However, the web is a great source of gluten-free recipes. I make a great lemon sponge cake that is a good substitute for the angel food cake I always loved. And if you live near a Trader Joe's, they have a good gluten-free ginger snap cookie and also reasonably priced mixes for brownies and maybe cookies. I also miss stuffing. I bought some self-rising corn meal and make cornbread, which I then use as the base for the traditional stuffing with onions. celery, sage. etc. It works for me!

    Best of luck to you, and drop me a line and let me know how you're doing.

     

    Regards,

    Sally

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    I thank you so much for this website. I think it's terrific information for people with celiac disease

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    Guest Cathi

    Posted

    Any hope of adding information about those who are gluten free, corn free, soy free and need to be low carbohydrate diet also. It is so hard to find bread recipes or tortilla recipes that would fit this bill. Rice flour and all the starches are really high in carbohydrates.

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    Guest Gabrielle

    Posted

    My friend had stomach problems for over 20 years! The doctors didn't know what was wrong with her. They wrongly diagnosed her for IBS. I now found this website and she has been tested for Celiac two days ago. The results should come in today. Wish her luck!

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    Guest Linda

    Posted

    Thank you for your website and all the comments are helpful also.. I was diagnosed about 20 months ago and have been following gluten-free diet always! I must admit, if I didn't actually get so sick shortly thereafter it would likely be much more difficult to follow. But the thought of what it is to come immediately is probably even more powerful than the long term. I almost died and am grateful to be alive. I do worry terribly about the lack of nutrients since my intestine has not healed and I can receive none. It scares me I must admit and I fear I have had it for years and could be refractory. If you have any suggestions I am open for any and all ideas. Thank you for helping others like yourself!

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    Guest Anna Mae Schroeder

    Posted

    It is most interesting to read what people have to relate about their gluten sensitivity.

    But some folks do not read labels, or know exactly what ingredients contain wheat. It would be good to instruct readers about what ingredients are taboo. THANKS SO MUCH for this site!

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    Guest Cathy

    Posted

    Hi Scott, I contacted you in 1998 after receiving my diagnosis of being a celiac regarding gluten-free food and flours. I have been an avid reader since, and abstain from anything that could possibly have any gluten containing ingredients. I have regained my health after being diagnosed with IBS, gastroenteritis, duodenitis, anxiety, depression, had breast lumps removed, hysterectomy for massive bleeding, lipomas, and reactive arthritis reaction to antibiotics, lower back disc surgery ..... never did any physicians (even after colonoscopy for diarrhea) suggest celiac! Finally had diagnosis and it is truly amazing that I feel better than I have in my whole life since abstaining from gluten since 1998! The reason this is not better known is because there is no drug to advertise as a treatment, therefore no money to be made in pharma or medical world. Just imagine the evening commercials for a drug for celiac: " do you suffer from ...... ask your doctor if xxx is right for you!" All that is needed is abstaining from what is basically poison to your body. It's like NOT sprinkling a little ant poison on your food every day! Thanks so much! Cathy from CO

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    Guest kennedymoore

    Posted

    I gained 10 pounds and had severe abdominal bloating this spring. I've had intermittent problems with diarrhea and constipation over the years. My doctor had a CT scan that showed an enlarged ovary so I was given an internal ultrasound. I had a hemorrhagic cyst but it was not the problem. My doctor sent me to a gastroenterology specialist and he suggested an upper endoscopy, looking for ulcers or polyps. He also did a stomach and intestinal biopsy. The biopsy came back positive for Celiac. I am having blood work done today to confirm and check my gluten levels. I am 50 years old and although I am glad I have a diagnosis, I am having a hard time with the complete change of lifestyle. I have always loved to cook and bake and now I have to modify everything. I often travel with my husband, and this can now be a problem when I travel to places like Africa. I am grateful for this website. I would like to see something on how to adjust to the radical changes one has to make, especially someone my age! Thank you.

    I am 47 started suffering terribly in 1993 and was just diagnosed in 2010. I am always interested in what people actually mean when they say adjust to the changes after diagnosis. Changing my diet was easy. As I figured it out I chose vegetables, fish, shrimp, bake, broil, steam, grill. What was difficult was handling the emotional side of all of the suffering I had endured. I needed a safe place to just talk. I needed someone to hear me about, not think I was crazy. I wanted to understand how all of these doctors could have failed me. I saw several psychiatrist who just offered me medication - wrong answer. Saw 3-4 therapist who basically thought I should get over it - wrong answer. The only comfort was God, my faith and my Bible. The celiac disease support groups help with food choices and lifestyle changes, but I have not been able to identify an emotional healing celiac support group in the United States. I met an addiction therapist who really understands the emotional toll suffering causes. Through treating celiac patients he has come to understand the need for emotional healing. The more we heal emotionally the better we are able to adjust to a new found opportunity for improved health. He is in the process of creating an emotional healing support group for celiacs. I hope that since 2009 you have received the emotional support that we all need and some help with lifestyle changes.

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    Your site says that ALL wines are safe for celiac. Then why do ALL other sites say that some do contain gluten?

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    Your site says that ALL wines are safe for celiac. Then why do ALL other sites say that some do contain gluten?

    We are aware of the claim, the problem is that none have ever tested positive for gluten, and I challenge the other sites to produce such a test. Winemakers don't want gluten in their wine...would be a big mess.

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    Hi Kathleen,

    I was 68 when I finally got diagnosed six years ago. I never was too crazy about pasta, bread, and pastries, so I don't miss that, except for some good French or Italian bread now and then.

    Actually, the gluten free diet is a really healthy one, as you can't eat much processed food. Lots of fresh fruits and veggies, brown rice and corn, lean meat, chicken and fish, and dairy products if you don't happen to be lactose intolerant. And even if you are, there are lactose free products or the pills you can take with dairy foods. I happen to LOVE Mexican food, so I'm in luck if I have to eat out. Just make sure there is no wheat in the tortillas or sauces.

    As far as baking goes, I was really getting into turning out piles of Christmas cookies and treats for the family when I" had to go gluten-free, so there went the baking. However, the web is a great source of gluten-free recipes. I make a great lemon sponge cake that is a good substitute for the angel food cake I always loved. And if you live near a Trader Joe's, they have a good gluten-free ginger snap cookie and also reasonably priced mixes for brownies and maybe cookies. I also miss stuffing. I bought some self-rising corn meal and make cornbread, which I then use as the base for the traditional stuffing with onions. celery, sage. etc. It works for me!

    Best of luck to you, and drop me a line and let me know how you're doing.

     

    Regards,

    Sally

    Any chance on posting the recipe for the sponge cake? I loved to make elaborate cakes before I was diagnosed about 6 months ago. I'm still learning how to live with this!

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    admin

    (Celiac.com 08/13/2000) Because celiac disease has emerged as a public health problem, Swedish researchers conducted a study to analyze the trends in the occurrence of symptomatic celiac disease in Swedish children from 1973 to 1997, and to explore any temporal relationship to changes in infant dietary patterns. The researchers established a population-based prospective incidence register of celiac disease in 1991, and collected data retrospective date from 1973. A total of 2,151 cases met their diagnostic criteria, and were used in the study.
    In addition the researchers collected national data on an annual basis regarding the duration of breastfeeding and intake of gluten-containing cereals and recommendations on when and how to introduce gluten to the diets of infants. The incidence of celiac disease in children below 2 years of age increased fourfold (200-240 cases per 100,000 person years) between 1985 and 1987, followed in 1995 by a sharp decline to the previous level (50-60 cases per 100,000 person years). A pattern like this one is quite unique for a chronic disease of immunological pathogenesis, which suggests that prevention could be possible.
    This study demonstrates that the celiac disease epidemic is in part the result of a change in three factors within the area of infant feeding, including the amount of gluten given, the age of gluten introduction, and whether breastfeeding was ongoing or not when it was introduced. There may also be additional factors involved, and the search for them should be intensified.
    Ivarsson A, Persson LA, Nystrom L, et al
    Acta Paediatr. 2000 Feb;89(2):165-71

    Jefferson Adams

    Celiac.com 07/30/2007 - A study published in the journal Clinical Gastroenterology and Hepatology suggests that a newly proposed system of classifying duodenal pathology on celiac disease provides an improved inter-observation than the less Marsh-Oberhuber classification, and offers an advance towards making a simpler, better, more valid diagnosis of celiac disease. Celiac disease is presently classified according to the Marsh-Oberhuber system of classifying duodenal lesions.
    Recently, a more elementary method has been suggested. That method is based on three villous morphologies—non-atrophic, atrophic with villous crypto ratio <3:1, and atrophic, villi idnetectable—combined with intraepithelial counts of >25/100 enterocytes.
    The study team chose a group of sixty people to be part of the study. Of the 60 patients the team studied, 46 were female and 14 were male. The average age was 28.2 years with a mean range of 1-78 years. 10 people had celiac disease, 13 had celiac disease with normal villi, but a pathological increase in epithelial lymphocytes >25/100 & hyperplastic crypts. 37 patients had celiac disease with villous aptrophy.
    Patients were given biopsies, with at least 4 biopsies were taken from the second part of the duodenum. Biopsies were fixed in formalin and processed according to standard procedures, with cuts at six levels, and stained with hematoxylin resin. The slides were sent randomly to 6 pathologists who were blind to one another.
    The results showed that this new method of classification yielded better inter-observer agreement and more accurate diagnosis that the more difficult Marsh-Oberhuber system.
    Clinical Gastroenterology and Hepatology 2007;5:838–843
    health writer who lives in San Francisco and is a frequent author of articles for Celiac.com.

    Jefferson Adams
    Celiac.com 01/04/2010 - The practice of using antibody testing to diagnose celiac disease has led to an explosion in the number of cases detected among children, coupled with a rise in median age at diagnosis, a new study suggests.
    European studies have shown that celiac disease is a multi-system disorder, affecting 0.3% to 1.0% of all children. A team of researchers recently set out to examine the impact of serological testing on childhood celiac disease in North America The research team consisted of Kelly E. McGowan, BHSc, Derek A. Castiglione and J. Decker Butzner, MD with the Department of Pediatrics, University of Calgary, Calgary, Canada.
    Serological testing makes it easier to spot children with atypical or extra-intestinal symptoms or with conditions associated with celiac disease. Serological testing has resulted in a huge increase in celiac disease cases; it has tripled incidence levels, quadrupled diagnosis age, and brought about a greater understanding of the wide variety of presentations of celiac disease in North America.
    Younger children are more likely to develop classic celiac disease, whereas older children seem more likely to show atypical presentations.
    The goal of the study was to determine the effects of immunoglobulin A endomysial antibody testing on the incidence and clinical presentation of childhood celiac disease.
    Researchers compared the incidence and clinical presentation of celiac disease in two groups of patients. Both groups were under a pretesting group of patients under 18 years of age in 1990–1996  and compared with a testing group of  patients under 18 years of age in 2000–2006.
    Average age at diagnosis was 2 years (95% confidence interval: 2–4 years) in the pretest group (N = 36), compared with 9 years (95% confidence interval: 8–10 years) in the test group (N = 199; P < .001); female/male ratios (1.6:1) were similar (P = .982).
    Incidence of celiac disease increased from 2.0 cases per 100,000 children in the pretest group to 7.3 cases per 100,000 children in the test group (P = .0256).
    Frequency of classic celiac disease decreased from 67% in the pretest group to 19% (test group; P < .001), but the incidence of classic celiac disease did not change (0.8 vs 1.6 cases per 100000; P = .154).
    In the test group, researchers uncovered 13 previously unnoticed clinical presentations in 98 children, including 35 with family history, 18 with abdominal pain, and 14 with type 1 diabetes mellitus.
    The frequency of Marsh IIIc lesions decreased from 64% in the pretest group to 44% in the test group (P = .0403).
    In the test group, classic celiac disease was most common, making up 67% of cases in young children under 3 years, whereas atypical gastrointestinal and silent presentations were more common in older children.
    Overall, the contribution of serological testing to the diagnosis of celiac disease has been enormous. Antibody testing for celiac disease has tripled the incidence of celiac disease and quadrupled the average age at diagnosis, thus offering millions of children a higher quality of health.
    Source: Pediatrics, December 2009.


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    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.
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    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

    Jefferson Adams
    Celiac.com 04/16/2018 - A team of researchers recently set out to investigate whether alterations in the developing intestinal microbiota and immune markers precede celiac disease onset in infants with family risk for the disease.
    The research team included Marta Olivares, Alan W. Walker, Amalia Capilla, Alfonso Benítez-Páez, Francesc Palau, Julian Parkhill, Gemma Castillejo, and Yolanda Sanz. They are variously affiliated with the Microbial Ecology, Nutrition and Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), C/Catedrático Agustín Escardin, Paterna, Valencia, Spain; the Gut Health Group, The Rowett Institute, University of Aberdeen, Aberdeen, UK; the Genetics and Molecular Medicine Unit, Institute of Biomedicine of Valencia, National Research Council (IBV-CSIC), Valencia, Spain; the Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire UK; the Hospital Universitari de Sant Joan de Reus, IISPV, URV, Tarragona, Spain; the Center for regenerative medicine, Boston university school of medicine, Boston, USA; and the Institut de Recerca Sant Joan de Déu and CIBERER, Hospital Sant Joan de Déu, Barcelona, Spain
    The team conducted a nested case-control study out as part of a larger prospective cohort study, which included healthy full-term newborns (> 200) with at least one first relative with biopsy-verified celiac disease. The present study includes 10 cases of celiac disease, along with 10 best-matched controls who did not develop the disease after 5-year follow-up.
    The team profiled fecal microbiota, as assessed by high-throughput 16S rRNA gene amplicon sequencing, along with immune parameters, at 4 and 6 months of age and related to celiac disease onset. The microbiota of infants who remained healthy showed an increase in bacterial diversity over time, especially by increases in microbiota from the Firmicutes families, those who with no increase in bacterial diversity developed celiac disease.
    Infants who subsequently developed celiac disease showed a significant reduction in sIgA levels over time, while those who remained healthy showed increases in TNF-α correlated to Bifidobacterium spp.
    Healthy children in the control group showed a greater relative abundance of Bifidobacterium longum, while children who developed celiac disease showed increased levels of Bifidobacterium breve and Enterococcus spp.
    The data from this study suggest that early changes in gut microbiota in infants with celiac disease risk could influence immune development, and thus increase risk levels for celiac disease. The team is calling for larger studies to confirm their hypothesis.
    Source:
    Microbiome. 2018; 6: 36. Published online 2018 Feb 20. doi: 10.1186/s40168-018-0415-6