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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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    CELIAC DISEASE INCREASES RISK FOR PNEUMONIA


    Jefferson Adams

    Celiac.com 09/14/2015 - People with celiac disease have slightly higher risk for contracting pneumonia, especially in the first year after diagnosis.


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    Photo: CC--NIAIDThe study was conducted a team that included Joe West, MD, an epidemiologist and honorary consultant gastroenterologist at the University of Nottingham.

    The study found that people with celiac disease who are unvaccinated against pneumococcus are about 30% more likely to develop community-acquired pneumonia (CAP) than are unvaccinated people without celiac disease.

    Dr. West says the increased risk is likely due to weakened spleen function in people with celiac disease.

    This elevated risk was not seen in vaccinated celiac patients, or people over 65 years of age.

    The results of the study suggest that clinicians be extra vigilant about vaccinating celiac patients, and health officials in the United Kingdom are now recommend that people with celiac disease receive pneumococcus vaccinations.

    Source:

     


    Image Caption: Photo: CC--NIAID
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  • Related Articles

    Roy Jamron
    Celiac.com 07/01/2006 - With the likelihood that increased intestinal permeability in celiacs caused by gluten damage to the intestinal mucosa leads to a high prevalance of liver damage as well as an increase in food allergy and possible other medical conditions, emphasis on healing the intestinal mucosa should be given an elevated priority. Simply going on a gluten-free diet and waiting months or years for the intestine to heal may not be enough.
    Friendly commensal gut bacteria are an important part of the intestinal barrier, and thus probiotics, such as yogurt, kefir, or supplemental
    probiotic capsules, do help diminish the amount of endotoxins released by pathogenic gut bacteria getting through the barrier. Liver disease studies confirm the benefit of probiotics by reducing inflammation and infection. However, to date, there is no product currently available which can enhance the repair and regeneration process of the mucosal epithelia.
    Undergoing current clinical studies in Crohns patients, Teduglutide may enhance mucosal healing, but requires multiple daily injections:

    Cell Prolif. 2004 Dec;37(6):385-400.
    Teduglutide ([Gly2]GLP-2) protects small intestinal stem cells from
    radiation damage.
    Booth C, Booth D, Williamson S, Demchyshyn LL, Potten CS.
    Abstract:
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    By Martha Kerr
    (Free article, free Medscape registration may be required.)
    http://www.medscape.com/viewarticle/533109
    A while back I posted an abstract about a protein called R-spondin1 which is "a specific and potent stimulator of the human epithelial cells that line the gastrointestinal tract and mouth." R-spondin1 is a product being developed by Nuvelo, Inc. of San Carlos, CA designated as NU206. The press release describing NU206 is:
    Nuvelo Announces NU206 Publication in Science (August 18, 2005)
    http://www.corporate-ir.net/ireye/ir_site.zhtml?ticker=NUVO&script=410&item_id=744876
    An article discussing the discovery and potentials of R-spondin1 is available in the New England Journal of Medicine, and free full text of
    that article is available at the address below:
    NEJM.-Volume 353:2297-2299 November 24, 2005 Number 21
    Inducing Intestinal Growth
    Clara Abraham, M.D., and Judy H. Cho, M.D.
    Free Full Text Reprint of NEJM article:
    http://www.e-medicum.com/newsletters/medicinaInterna/verNoticia.php?noticia=51479
    Nuvelo has recently announced plans for the "initiation of a Phase 1 study of NU206, which is being developed for the treatment of cancer therapy-induced mucositis in the second half of 2006." Obviously the benefits of NU206 go beyond that of cancer therapy. Healing the epithelial tissues of celiacs with NU206 may rapidly eliminate increased intestinal permeability and other associated conditions. Nuvelo had a live webcast of its annual shareholder meeting this Wednesday, May 24, at 11:00 am PDT. No new information on NU206 was provided at the meeting other than that plans to initiate the NU206 Phase 1 study are proceding.
    Replay of Nuvelo Webcast:
    http://www.corporate-ir.net/ireye/ir_site.zhtml?ticker=NUVO&script=1010&item_id=1234084


    Jefferson Adams
    Celiac.com 04/07/2011 - People with celiac disease are 60 percent more likely to develop asthma than people without celiac disease, according to a new study, which appears in the Journal of Allergy and Clinical Immunology.
    Moreover, the study results show that those with asthma are also more likely to eventually develop celiac disease. Indeed, for every 100,000 people with celiac disease, 147 will have asthma that would not have occurred in the absence of the digestive disorder.
    To assess possible links between celiac disease and asthma, Dr. Jonas Ludvigsson of Orebro University Hospital and the Karolinska Institutet in Sweden and colleagues compared more than 28,000 Swedes diagnosed with celiac to more than 140,000 similar people without the disease.
    Ludvigsson cautions that the study merely shows an links between the two diseases, it does not establish that asthma causes celiac disease, or vice versa.
    The exact nature of the association between the two diseases is unclear, but Ludvigsson told reporters that he thinks "the role of vitamin D deficiency should be stressed."
    Ludwigsson points out that people with celiac are more likely to develop osteoporosis and tuberculosis, both diseases in which vitamin D plays a role. If a person with celiac also has low levels of vitamin D, this could in turn affect the immune system, which could increase the risk of developing asthma.
    Another possibility, he points out, is that "asthma and celiac disease share some immunological feature. If you have it, you are at increased risk of both diseases.
    Ludvigsson also addresses the fact that the study did not establish levels of compliance with a gluten-free diet among the participants with celiac disease by noting that general "dietary compliance is high in Sweden," so he believes that "patients with good adherence are at increased risk of asthma."
    Source:

    Journal of Allergy and Clinical Immunology, 2011. doi:10.1016/j.jaci.2010.12.1076


    Diana Gitig Ph.D.
    Celiac.com 03/21/2011 - Two recent population-based studies, both performed in Sweden by Dr. Jonas Ludvigsson, have concluded that people who have had biopsies that reveal villous atrophy are at increased risk of both ischemic heart disease and asthma. But at least regarding heart disease, the bulk of the risk may simply be attributable to inflammation.
    The team of researchers looked at biopsy data collected from all twenty-eight of Sweden’s pathology departments between 2006 and 2008. The data included biopsies performed as far back as 1969, and represented 44,446 individuals: 28,190 with celiac disease, as ascertained by small intestine morphology; 12,598 with duodenal/jejuna inflammation lacking villous atrophy; and 3,658 with latent celiac disease, defined as those with positive celiac serology but normal mucosa. 219,392 healthy controls who had never had biopsies were included as controls. They concluded that celiac disease and inflammation of the small intestine were both modestly associated with ischemic heart disease, whereas latent celiac disease was not.
    Although these findings agree in kind, if not in degree, with reports previously published by others, this study had a number of flaws. First of all, the researchers lack data on individual adherence to a gluten free diet. The authors note that “low dietary adherence is associated with persistent inflammation and therefore might explain the increased risk of ischemic heart disease observed in patients with celiac disease.” They also lack data on blood pressure, smoking status, body mass index, lipid levels, exercise routines, and other established risk factors for ischemic heart disease. Because they found the highest risk in the first year following biopsy, they cede that this risk could be attributable to enhanced inflammation, enhanced stress surrounding a diagnosis with celiac disease, or even an increase in reporting rather than incidence due to more vigilant medical care immediately following the diagnosis with celiac disease. They even note that gastrointestinal and cardiac symptoms are easily confused, further confounding their analysis.
    The second study compared the same 28,190 Swedes with villous atrophy to 140,000 controls. It reported that people with celiac disease were 60% more likely to develop asthma than those without it, and conversely, that people with asthma are more likely to develop celiac disease. “A potential mechanism could be that asthma and celiac disease share some immunological feature,” said Dr. Ludvigsson. “If you have it, you are at increased risk of both diseases.” He also noted that vitamin D deficiency can play a causative role in both diseases, and should be assessed on both celiac patients and asthmatics.
    Sources:
    Circulation 2011; 123: 483-490 Journal of Allergy and Clinical Immunology February 11, 2011 / doi:10.1016/j.jaci.2010.12.1076

    Tina Turbin
    Celiac.com 05/20/2011 - Over the years, researchers have been discovering more and more about celiac disease, an autoimmune disease which is caused by gluten, a protein found in wheat, barley, and rye. Studies have linked the disease to a variety of other medical conditions, such as irritable bowel syndrome, rheumatoid arthritis, and osteoporosis. Researchers have now found a connection between celiac disease and asthma.

    Asthma is chronic lung disease that causes the passages of the lungs to become inflamed and narrowed, resulting in wheezing, shortness of breath, tightness in the chest area, and coughing. It often begins in childhood, and according to the U.S. Department of Health and Human services, more than 22 million people suffer from the condition. Many studies have linked asthma to airborne allergens, but doctors have begun to look into food culprits as well. One such study shows a connection to celiac disease, which isn’t an allergy but rather an autoimmune response to gluten.

    In a study published in the Journal of Allergy and Clinical Immunology, European researchers found that celiac individuals were 60 percent more likely to develop asthma than those without the condition. Celiac disease affects approximately one percent of the population and without treatment, which is a gluten-free diet, can cause a variety of physical and mental symptoms including chronic fatigue, headaches, malnutrition, chronic headaches, and stomach problems.

    Dr. Jonas Ludvigsson of Orebro University Hospital and the Karolinska Institutet in Sweden and his colleagues compared more than 28,000 Swedish celiac patients to more than 140,000 similar people without the disease. The study concluded that only a link between the two could be demonstrated, not that one condition causes the other; the researchers weren’t able to identify the reason for the association.

    One possible factor may be Vitamin D. According to Reuters Health, Dr. Ludvigsson said in an email, "Personally, I think the role of vitamin D deficiency should be stressed." Vitamin D has been demonstrated to be a factor in the development of tuberculosis and osteoporosis, both of which celiacs are more likely to develop. In celiac disease, gluten causes an autoimmune reaction that causes the immune system to attack the small intestine, specifically the villi, the finger-like structures that absorb the nutrients from food; thus celiac patients usually exhibit deficiencies in vitamins and minerals. If a celiac patient isn’t getting enough vitamin D into their system, according to Dr. Ludvigsson, the risk for asthma disease may be increased.

    According to Dr. Ludviggson, Swedish celiac patients adhere well to the gluten-free diet. The study didn’t determine how closely the 28,000 subjects were sticking to their diets, but Ludviggson told Reuters health, "Generally dietary compliance is high in Sweden, so I actually believe that also patients with good adherence are at increased risk of asthma.”

    It is recommended that people who suspect they may have celiac disease or asthma should consult with a qualified medical practitioner for testing, diagnosis, and treatment.
    Resources:

    U.S. Department of Health & Human Services: http://www.nhlbi.nih.gov/health/dci/Diseases/Asthma/Asthma_WhatIs.html Gluten Free Society: Gluten Sensitivity Increases the Risk for Asthma: http://www.glutenfreesociety.org/gluten-free-society-blog/gluten-sensitivity-increases-the-risk-for-asthma/ Reuters: Asthma linked to celiac disease: http://www.reuters.com/article/2011/02/24/us-asthma-linked-celiac-disease-idUSTRE71N4WF20110224

  • Recent Articles

    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. 
    That’s where the story takes a dangerous turn….about 3:15am. I awoke to the TV blaring loudly, along with the lights shining brightly. Our power was back on! I proceeded to walk throughout the house turning everything off at exactly the same time our neighbor, who was told to evacuate our street, saw me through our window, assuming I knew that our hillside was ablaze with flames. Flames that were shooting 50 feet into the air. I went back to bed and fell fast asleep. The fire department was assured we had left because our house was dark and quiet again. Two hours had passed.  I suddenly awoke to screams coming from a family member yelling, “fire, fire, fire”! Flames were shooting straight up into the sky, just blocks from our house. We lived on a private drive with only one way in and one way out.  The entrance to our street was full of smoke and the fire fighters were doing their best to save our neighbors homes. We literally had enough time to grab our dogs, pile into the car, and speed to safety. As we were coming down our street, fire trucks passed us with sirens blaring, and I wondered if I would ever see my house and our possessions ever again. Where do we go? Who do we turn to? Are shelters a safe option? 
    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.
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    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.

    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
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    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    fdfworld.com

    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764