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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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    GLUTEN CHALLENGE: PATIENTS WITH NON-CELIAC GLUTEN SENSITIVITY REPORT MORE SYMPTOMS THAN THOSE WITH CELIAC DISEASE


    Jefferson Adams

    Celiac.com 06/13/2012 - In general, doctors and researchers know a good deal about how celiac disease works, and they are finding out more all the time. However, they know very little about non-celiac gluten sensitivity (NCGS).


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    Photo: CC -- EmeraldimpIn an effort to learn more about non-celiac gluten sensitivity, a team of researchers recently carried out a study to measure the presence of somatization, personality traits, anxiety, depression, and health-related quality of life in NCGS individuals, and to compare the results with celiac disease patients and healthy control subjects. They also compared the response to gluten challenge between patients with non-celiac gluten sensitivity and those with celiac disease.

    The research team included M. Brottveit, P.O. Vandvik, S. Wojniusz, A. Løvik, K.E. Lundin, and B. Boye, of the Department of Gastroenterology at Oslo University Hospital, Ullevål in Oslo, Norway.

    In all, the team looked at 22 patients with celiac disease and 31 HLA-DQ2+ NCGS patients without celiac disease. All patients were following a gluten-free diet.

    Over a three day period, the team challenged 17 of the celiac disease patients with orally ingested gluten. They then recorded the symptoms reported by those patients. They did the same with a group of 40 healthy control subjects.

    The team then had both patients and healthy control subjects complete questionnaires regarding anxiety, depression, neuroticism and lie, hostility and aggression, alexithymia and health locus of control, physical complaints, and health-related quality of life.

    Interestingly, patients with non-celiac gluten sensitivity reported more abdominal (p = 0.01) and non-abdominal (p < 0.01) symptoms after the gluten challenge than patients with celiac disease. The increase in symptoms in non-celiac gluten sensitivity patients was not related to personality.

    However, the two groups both reported similar responses regarding personality traits, level of somatization, quality of life, anxiety, and depressive symptoms. Responses for both groups were about the same as for healthy controls.

    The results showed that patients with non-celiac gluten sensitivity did not show any tendencies toward general somatization, as both celiac disease patients and those with non-celiac gluten sensitivity showed low somatization levels.

    Source:


    Image Caption: Photo: CC -- Emeraldimp
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    Guest Dr Charles Parker

    Posted

    Interesting report, coincides with our personal observations in the office. Some with the most pervasive psychological and biomedical challenges show almost no specific bowel symptoms - and we must work hard to chase down the details.

     

    In our work, with hundreds of IgG testing reviews: milk is even more prominent as a primary causality in immune dysregulation than wheat, and eggs join that triad at the top.

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    Guest SandraB

    Posted

    For us laymen, somatization is "the conversion of mental experiences into bodily symptoms" i.e., the pain in the body is real, but due to mental stress rather than having a physical cause. Known to the cynical as "It's all in the head."

    So it's not all in our heads. It's in our guts - which is where and how we knew it was.

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    Guest Laura

    Posted

    I am very happy to see this article and study! I am new to the gluten-free lifestyle. I was referred to a gastrointestinal doctor who thought my claims of having reactions to gluten other than digestive were crazy. I may be crazy, but I knew I was right!

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    Guest Laura Cunard

    Posted

    When I wrote out a full history of how gluten affects me, the GI I showed it to looked at me like I was nuts. He knew NOTHING about non-celiac gluten intolerance. I left the office rather depressed and went back to taking care of myself without help from any doctor. I'd sure like to find one nearby that does know something.

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    Hi Laura,

    My doctor also knew nothing about non-celiac gluten intolerance and I have since found out that they are not taught much about food intolerance at med school. I had symptoms for over 20 years and have found that the only person able to help me was, well, me! Dozens of doctors, no advice that was of any help, tired, fed up, unwell every single day all down to a tiny protein. Now if they had only told me that 20 years ago, life would have been so much better. I did, however, find a wonderful dietitian who specializes in food intolerance. That may be your best bet.

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    Guest Patricia

    Posted

    Having many of the symptoms for celiac disease (including many positive family members) I decided to go gluten-free 4 weeks ago and feel so much better. Of course, after 4 weeks of being gluten-free, my bloodwork came back negative. I'm now on a gluten challenge for one week (doc recommendation) and will have my blood retested. The first night of having gluten I was really sick (in and out of the bathroom for approximately 6 hours). In the next few days, the symptoms seem to be changing, i.e. constipation. Can anyone tell me if this is a direct result of consuming gluten again? I am extemely frustrated with the process. I'm also concerned that the bloodwork will again be negative and therefore be crazy to go back to a gluten-free diet if not necessary. But, am I correct in thinking that all blood tests can be negative and still have a gluten sensitive issue? I have not had the intestinal biopsy and probably should not have it done if all bloodwork is negative, right? ANY help would be appreciated.

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    By the time my daughter was 19 she was sick and had routinely been seeing specialists for 2 years who thought she might have Lupus, though she tested negative. She is 5'10" and when she finally hit 112 pounds, I said "Thats it!!". I took her to an alternative doctor who diagnosed her as food allergies/sensitivities. She was tested and found to have dairy, eggs, beef, gluten, soy, garlic, and pineapple. Non-Celiac Gluten Sensitivity has already caused so much damage to her GI that she has had 2 surgeries. She eats a very strict diet, which has helped greatly. She is retested annually because your sensitivities can change (which they have). Also... did you know that food sensitivities can cause you to be tired, give you arthritic problems, and skin issues like eczema and rashes? Taking supplements is a must for the rest of your life due to malabsorption and diet.

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    Having many of the symptoms for celiac disease (including many positive family members) I decided to go gluten-free 4 weeks ago and feel so much better. Of course, after 4 weeks of being gluten-free, my bloodwork came back negative. I'm now on a gluten challenge for one week (doc recommendation) and will have my blood retested. The first night of having gluten I was really sick (in and out of the bathroom for approximately 6 hours). In the next few days, the symptoms seem to be changing, i.e. constipation. Can anyone tell me if this is a direct result of consuming gluten again? I am extemely frustrated with the process. I'm also concerned that the bloodwork will again be negative and therefore be crazy to go back to a gluten-free diet if not necessary. But, am I correct in thinking that all blood tests can be negative and still have a gluten sensitive issue? I have not had the intestinal biopsy and probably should not have it done if all bloodwork is negative, right? ANY help would be appreciated.

    Hey Patricia

    I've had chronic constipation for years. My joints and lower back ached regularly, my iron counts were often low, low wbc, low end of B12, bloated, abdominal pain, foul smelling and fatty BM (very small... like almond-sized) and never relieved, gassy, fatigue, and my hair fell out more than normal in the shower. I did have a long list of food and seasonal allergies as a kid... nothing life-threatening, but take Aerius from April to first frost to manage my symptoms. I do get itchy skin and throat/ear canal, and a feeling of water in my ears... like hearing under water. On top of this I am having acid reflux, nausea, and indigestion, with a feeling of a fist in my stomach (which a prescription for Ranitidine is helping magnificently!) All this said...years of these complaints have been fluffed off by my doctor. Every year at the time of my physical I'd complain about these symptoms, and every year he'd put me on iron if blood tests showed low counts, and tell me to drink more water and eat more fiber! What he wasn't listening to is that I DO drink plenty of water, and my diet is VERY high in fruits/veggies and fiber! My mother-in-law calls me the walking Canada food guide!

     

    I was out of work in September when the kids returned to school and I decided to look into things myself. I found an interesting article online that suggested IBS symptoms could be linked to gluten intolerance. My mother-in-law IS celiac, so I am familiar with the diet and the label reading (because I do cook family meals). I always rolled my eyes at her when she suggested I get tested (hubby and kids were tested for celiac disease, but since I'm not in that blood line I didn't bother). After less than a week eating gluten-free, I began having regular bowel movements. After 2 weeks my joint pain was gone, the water in the ear feeling is mainly gone (had a few brief episodes) and pain in stomach gone. Most all of my symptoms are gone or greatly improved... it's been 5.5 weeks now. At 2 weeks gluten-free, I had a doctor's appt. His eyebrows shot up at my reports. He thinks my heartburn problems and my stomach issues may be connected, and I have been referred to a GI and an Alergist. In the meanwhile I had a genetic blood test for celiac disease since at the time of the requisition I'd already been gluten-free for 4 weeks and probably wouldn't show the necessary antibodies. BUT guess what? I got a call this week from the nurse saying I may, in fact, have celiac disease because it showed that my genetic make up supported a probability of Celiac!!! So, now I wait. I am not sure if I would consider going back to wheat in my diet just for a certain diagnosis. If things are working, I don't feel the need to be a "card-carrying Celiac"! I would, though, agree to the biopsies of the esophagus and intestines to rule out any growths or cancer.

     

    Sorry so long-winded. Hope this helps!

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    Guest Leen Coremans

    Posted

    When I wrote out a full history of how gluten affects me, the GI I showed it to looked at me like I was nuts. He knew NOTHING about non-celiac gluten intolerance. I left the office rather depressed and went back to taking care of myself without help from any doctor. I'd sure like to find one nearby that does know something.

    Your story is an exact copy of what I went through, Laura! Very frustrating indeed. Luckily we were both stubborn enough to do what we felt was right and go gluten-free. But a doctor who believes you would sure feel good, so I'm very happy to read these kinds of studies and am impatiently awaiting the day where NCGS will be just as well-known as celiac itself (and preferably receive a more suitable name).

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    Guest Lapinta59

    Posted

    Neither my spouse nor I have been tested for gluten sensitivity but my spouse has had stomach problems for years: bloating, gas, diarrhea, intestinal distress, etc. The docs always gave him Prilosec and Tums but nothing worked. He has other food allergies to oats, eggs, and red dye. We tried a completely gluten free diet and ALL of his symptoms disappeared. It has been nothing short of a miracle. I found on the gluten-free diet that my joint pain, fatigue, depression, blood sugar issues, and dermatitis disappeared. I had been told by my docs that I had osteoarthritis and had been prescribed massive doses of Ibuprofen....now I can say all that pain is gone, my skin in clear and I am no longer fatigued or depressed. Who new gluten could be so destructive!

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    Guest Heather

    Posted

    I am a woman who was diagnosed as Gluten Intolerant when I was 62 yrs.old, by having a food sensitivity test. The test also indicated an intolerance to milk products. The Dr. tested me for Celiac but it came back negative, he said I had IBS. I was suffering with this ever since I was very young and never knew why, it was mild at that time. It has been 7 yrs. since finding out why I was constantly ill with severe back pain from my lower back up into my neck, cramps, bloating and diareah that would last for hours and exhaustion that put me to bed unable to function. The symptoms start the day after ingesting wheat products and it always takes at least 3 days for my body to feel some sense of normal. Since that time I have researched for foods,books and any new info. regarding gluten intolerance. I did find a product called Gluten Ease that allowed me to have something with gluten on occassion when I was eating out. It's been a continuous trial and error struggle. I've learned of the damage it can cause the body, but still struggle with the mental aspect. Everything seems to have gluten in it, even in foods a person would never think would have it. No matter where I go there is always someone else that has the same issue or a relative, adult or child, who is newly diagnosed. I'm still trying to discover why it is that it affects a lot of people, but not everyone. Any new info. would be greatly appreciated.

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    Guest Holly W

    Posted

    Hey Patricia

    I've had chronic constipation for years. My joints and lower back ached regularly, my iron counts were often low, low wbc, low end of B12, bloated, abdominal pain, foul smelling and fatty BM (very small... like almond-sized) and never relieved, gassy, fatigue, and my hair fell out more than normal in the shower. I did have a long list of food and seasonal allergies as a kid... nothing life-threatening, but take Aerius from April to first frost to manage my symptoms. I do get itchy skin and throat/ear canal, and a feeling of water in my ears... like hearing under water. On top of this I am having acid reflux, nausea, and indigestion, with a feeling of a fist in my stomach (which a prescription for Ranitidine is helping magnificently!) All this said...years of these complaints have been fluffed off by my doctor. Every year at the time of my physical I'd complain about these symptoms, and every year he'd put me on iron if blood tests showed low counts, and tell me to drink more water and eat more fiber! What he wasn't listening to is that I DO drink plenty of water, and my diet is VERY high in fruits/veggies and fiber! My mother-in-law calls me the walking Canada food guide!

     

    I was out of work in September when the kids returned to school and I decided to look into things myself. I found an interesting article online that suggested IBS symptoms could be linked to gluten intolerance. My mother-in-law IS celiac, so I am familiar with the diet and the label reading (because I do cook family meals). I always rolled my eyes at her when she suggested I get tested (hubby and kids were tested for celiac disease, but since I'm not in that blood line I didn't bother). After less than a week eating gluten-free, I began having regular bowel movements. After 2 weeks my joint pain was gone, the water in the ear feeling is mainly gone (had a few brief episodes) and pain in stomach gone. Most all of my symptoms are gone or greatly improved... it's been 5.5 weeks now. At 2 weeks gluten-free, I had a doctor's appt. His eyebrows shot up at my reports. He thinks my heartburn problems and my stomach issues may be connected, and I have been referred to a GI and an Alergist. In the meanwhile I had a genetic blood test for celiac disease since at the time of the requisition I'd already been gluten-free for 4 weeks and probably wouldn't show the necessary antibodies. BUT guess what? I got a call this week from the nurse saying I may, in fact, have celiac disease because it showed that my genetic make up supported a probability of Celiac!!! So, now I wait. I am not sure if I would consider going back to wheat in my diet just for a certain diagnosis. If things are working, I don't feel the need to be a "card-carrying Celiac"! I would, though, agree to the biopsies of the esophagus and intestines to rule out any growths or cancer.

     

    Sorry so long-winded. Hope this helps!

    This sounds like my story...I have fought IBS for YEARS, had 1/3 of my colon removed and still fight skin issues, arthritis and worst of all, such severe digestive issues I often feel as though I can't plan anything in my life for fear I will be "sick" that day! My gastro doc keeps giving more meds and also says drink more water, more fiber (take Metamucil and such which just abound turns me inside out!) I eat very carefully, lean meats and lots of fruit, veggies, fiber...but nothing has helped. I am now determined to try the gluten free with great hope for some relief. Thanks for sharing your information!

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    Jefferson Adams
    Celiac.com 09/23/2013 - Patients with non-celiac gluten sensitivity (NCGS) do not have celiac disease, but see an improvement in symptoms when they adopt gluten-free diets.
    A team of researchers recently investigated the specific effects of gluten after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates (fermentable, oligo-, di-, monosaccharides, and polyols [FODMAPs]) in patients with suspected NCGS.
    The research team included Jessica R. Biesiekierski, Simone L. Peters, Evan D. Newnham, Ourania Rosella, Jane G. Muir, and Peter R. Gibson.
    The team performed a double-blind cross-over trial of 37 subjects (aged 24−61 y, 6 men) with NCGS and irritable bowel syndrome (based on Rome III criteria), but not celiac disease.
    They assigned study participants randomly to groups given a 2-week diet of reduced FODMAPs, and were then placed on high-gluten (16 g gluten/d), low-gluten (2 g gluten/d and 14 g whey protein/d), or control (16 g whey protein/d) diets for 1 week, followed by a washout period of at least 2 weeks.
    The researchers then evaluated serum and fecal markers of intestinal inflammation/injury and immune activation, and indices of fatigue.
    The team then crossed twenty-two participants over to groups receiving gluten (16 g/d), whey (16 g/d), or control (no additional protein) diets for 3 days, using visual analogue scales to evaluate symptoms.
    They found that gastrointestinal symptoms consistently and significantly improved for all patients during reduced FODMAP intake, but significantly worsened to a similar degree when their diets included gluten or whey protein.
    The team saw gluten-specific effects in just 8% of study subjects. They saw no diet-specific changes in any biomarker. During the 3-day re-challenge, participants’ symptoms increased by similar levels among groups. Gluten-specific gastrointestinal effects were not reproduced. An order effect was observed.
    A placebo-controlled, cross-over re-challenge study showed no evidence of specific or dose-dependent effects of gluten in patients with NCGS placed diets low in FODMAPs.
    Source:
    Gastroenterology, Volume 145, Issue 2, Pages 320-328.e3, August 2013. More info on the FODMAP diet from Stanford Univerisity.

  • Recent Articles

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

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

    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

    BIOPSY
    Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide.

    WHY A GLUTEN-FREE DIET?
    Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. 
    A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years.
    For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease.
    WHAT ABOUT ENZYMES, VACCINES, ETC.?
    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center

    Jefferson Adams
    Celiac.com 04/17/2018 - Could the holy grail of gluten-free food lie in special strains of wheat that lack “bad glutens” that trigger the celiac disease, but include the “good glutens” that make bread and other products chewy, spongey and delicious? Such products would include all of the good things about wheat, but none of the bad things that might trigger celiac disease.
    A team of researchers in Spain is creating strains of wheat that lack the “bad glutens” that trigger the autoimmune disorder celiac disease. The team, based at the Institute for Sustainable Agriculture in Cordoba, Spain, is making use of the new and highly effective CRISPR gene editing to eliminate the majority of the gliadins in wheat.
    Gliadins are the gluten proteins that trigger the majority of symptoms for people with celiac disease.
    As part of their efforts, the team has conducted a small study on 20 people with “gluten sensitivity.” That study showed that test subjects can tolerate bread made with this special wheat, says team member Francisco Barro. However, the team has yet to publish the results.
    Clearly, more comprehensive testing would be needed to determine if such a product is safely tolerated by people with celiac disease. Still, with these efforts, along with efforts to develop vaccines, enzymes, and other treatments making steady progress, we are living in exciting times for people with celiac disease.
    It is entirely conceivable that in the not-so-distant future we will see safe, viable treatments for celiac disease that do not require a strict gluten-free diet.
    Read more at Digitaltrends.com , and at Newscientist.com