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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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    MOST PEOPLE WITH CELIAC DISEASE OPEN TO PHARMACEUTICAL TREATMENTS


    Jefferson Adams

    Celiac.com 10/17/2013 - A gluten-free diet is till the only treatment for celiac disease, but a number of companies are working on pharmaceutical treatments. However, very little information exists bout the level of interest among patients in using a medication to treat celiac disease.


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    Image: Wikimedia CommonsA research team set out to assess interest levels among patients in medical treatments for celiac disease. The research team included Christina A. Tennyson, Suzanne Simpson, Benjamin Lebwohl, Suzanne Lewis and Peter H. R. Green.

    For their study, the researchers submitted a questionnaire to celiac disease patients and collected data on demographics, presentation, and interest in medication. The questionnaire included three validated celiac disease-specific instruments: Celiac Disease Associated Quality of Life, the Celiac Symptom Index, and the Celiac Dietary Adherence Test.

    The team received 365 responses from people with biopsy-proven celiac disease. A total of 276 women and 170 men over 50 years of age responded to the study. Of these respondents, 154 experienced classic, diarrhea predominant celiac disease. In all 339 people responded to the question asking if they were interested in using a medication to treat celiac disease, 66% of whom indicated that they were interested.

    The questionnaire responses broke down as follows:

    • Older people showed the greatest interest, with 71% of people over 50 years of age saying they were interested, compared with 60% of people under 50 years of age, (p = 0.0415).
    • More men (78%) than women (62%) women were interested (p = 0.0083).
    • People who ate out frequently (76%) showed a greater interest than those who did not (58%), p = 0.0006).
    • People dissatisfied with their weight showed greater interest (73%) than those satisfied with their weight (51%), (p = 0.0003)
    • Lastly, those concerned with gluten-free diet costs (77%) showed greater interest than those not concerned about gluten-free diet costs (64%), (p = 0.0176).

    Interestingly, the list of factors that did not seem to influence interest included length of time since diagnosis, education, presentation, and symptoms with gluten exposure.

    Overall, celiacs with lower quality of life scores showed a higher interest in medication (celiac disease-QOL 69.4 versus 80.1, p < 0.0001).

    This survey shows a fairly strong interest among people with celiac disease in non-dietary, medical treatments.

    Interest was highest among men, older individuals, frequent restaurant customers, individuals dissatisfied with their weight or concerned with the cost of a gluten-free diet, and those with a worse quality of life.

    Just how well any drugs developed to treat celiac disease might be received will likely depend on many factors, including efficacy, side-effects, cost, ease of use, etc.

    Source:


    Image Caption: Image: Wikimedia Commons
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    Guest harparshantvir singh

    Posted

    Very well researched article. Indian herbal medicines have good results in celiac disease. Unfortunately people in western world don't seem to believe in this system of medicine.

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    Drug approvals are often fast-tracked by the FDA, and we later find out that they are not safe or effective. And some drugs have caused severe side effects, including many deaths. A few have been pulled from the market, but most have not. I am not interested in trying any new drugs. After several years, the safety and effectiveness, or serious risks of the drug will be more apparent. Then I might consider trying it, if it proves to be safe.

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    I think it is very important to find a cure. I am finding out how difficult my teenage daughter's life has become (and my life as well, trying to feed her) and am worried when she eats at others' houses and out at restaurants. This disease definitely affects quality of life!

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    I would welcome a drug treatment, depending upon side effects. I would take it prophalactically and still eat as little gluten as possible. I have to dine out a lot and the occassional error is painful for me.

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  • Related Articles

    Jefferson Adams

    Celiac.com 06/26/2007 - In a study published recently in the Scandinavian Journal of Gastroenterology, researchers found that celiac patients commonly have high rates of anti-Saccharomyces cerevisiae antibodies (ASCA). A team of researchers recently set out to assess the frequency anti-Saccharomyces cerevisiae antibodies (ASCA) in patients with celiac disease.
    The team was made up of Dorsaf Toumi; Amani Manka&IUML;; Ramla Belhadj; Leila Ghedira-Besbes; Moncef Jeddi; and Ibtissem Ghedira. They used ELISA to evaluate blood serum for ASCA, IgG and IgA in 238 patients with celiac disease. The team used 80 non-celiac blood donors as a control group. The 238 study subjects were divided into separate groups as follows: 125 untreated celiac patients; 42 celiac patients following a strict gluten-free diet; and 71 celiac patients who did not follow a gluten-free diet.
    Celiac Patients Have Significantly Higher IgG and IgA Antibodies
    Compared to the control group, the 125 untreated celiacs showed a markedly higher frequency of ASCA (IgG or IgA). 27.2% for untreated against 3.7% for control (p=10-5). Among the 71 patients who did not follow a gluten-free diet the occurrence of ASCA was significantly higher in adults than in children (60% against 26.1%, p=0.004). In the 238 patient study group as a whole, ASCA was substantially higher in adults than in children. 35.4% adults showed positive results compared to 21.1% children (p=0.01). Of the 238 subjects 19% (p=0.001), both children and adult, were positive for ASCA IgG versus 6.3% (p=0.001) for ASCA IgA.
    ASCA IgG More Common Than ASCA IgA
    Overall, ASCA IgG was much more common than ASCA IgA. 19% of children and 33% of adults were positive for ASCA IgG compared to 6.3% of children and 12.5% for ASCA IgA. Of the 42 patients who followed a gluten-free diet, all children and 90.5% of adults were negative for ASCA IgG.
    Of the 125 patients with untreated celiac, 20% of children were positive (p=0.01), and 34% of adults were positive. Of those 71 patients who did not comply with a gluten-free diet, 60% of adults and 26.1% of children were positive for ASCA.
    The results of the study confirm that patients with celiac disease show a high rate of ASCA. There was no statistical difference between celiacs following a gluten-free diet and those without celiac disease.
    Scandinavian Journal of Gastroenterology, Volume 42, Issue 7 2007 , pages 821 - 826
     

    Jefferson Adams
    Celiac.com 06/30/2008 - The results of a Hungarian study published recently in the June issue of Pediatrics suggest that people with untreated celiac disease show abnormal resistance to the hepatitis B (HBV) vaccine, while celiac patients on a gluten-free diet show a near normal response to the vaccine.
    A team of doctors led by Dr. Eva Nemes, at the University of Debrecen, administered 2 to 3 doses of recombinant HBV vaccine to 128 patients with celiac disease and an age matched control group of 113 non-celiac patients within a 6-month period. Twenty-two of the celiac patients were following a gluten-free diet when they received the vaccine.
    One month after the last HBV vaccination, the team took blood samples to look for anti-HBV antibodies. The group of 22 patients who received the vaccination while on a gluten-free diet had a sero-conversion rate of 95.5%, which means that more than 9 out of 10 patients developed the desired resistance to hepatitis B.
    The other 106 patients with celiac disease, as well as the control group, were vaccinated at approximately 14 years of age, and their immune response was evaluated by measuring anti-HBV titers about two years later. Of the 106 subjects with celiac disease, seventy had been diagnosed and were maintaining a strict gluten-free diet when they were vaccinated, twenty-seven were undiagnosed and untreated, and nine were diagnosed, but not following a gluten-free diet.
    The seventy subjects with celiac disease that was diagnosed and treated showed a sero-conversion rate of 61.4%. Given the size of the study samples, that’s not significantly different from the 75.2% sero-conversion rate for the control group.
    The big difference arose in those subjects with undiagnosed celiac disease, who showed a response rate of just below 26%, which was substantially lower than the control group and the treated celiac patients. The nine patients with active celiac disease who were not faithfully following a gluten-free diet showed a response rate of 44.4%. The thirty-seven subjects with celiac disease who had failed to respond to the vaccine were placed on a gluten-free diet and given a follow-up vaccine. One month later 36 of them (over 97%) showed a positive response to the vaccine.
    The team concluded that the positive response to the vaccine by celiac patients who were following a gluten-free diet, and the high resistance shown by subjects with undiagnosed celiac disease, and those not following a gluten-free diet, indicates that active celiac disease may play a major role in a failure to respond to the vaccine.
    The team recommends that newly diagnosed patients be checked for resistance to the HBV vaccine, and that those showing resistance be placed on a gluten-free diet before receiving a follow-up dose. They did not go so far as to suggest that those showing resistance to the HBV vaccine be screened for celiac disease, but that would not seem unreasonable, given their results.
    Pediatrics 2008; 121:e1570-e1576.


    Jefferson Adams
    Celiac.com 07/28/2010 - Most people with celiac disease keep themselves healthy by following a gluten free diet. More and more, doctors are recognizing the importance of confirming gut recovery through follow-up evaluation. Still, among clinicians, there is currently no standard for follow-up confirmation of gut healing in celiac disease treatment.
    Many guidelines recommend an initial follow-up biopsy at 4-6 months after the patient begins a gluten-free diet. However, the use of biopsy to confirm gut healing is still controversial, as it can yield enormously variable results.
    A group of researchers recently set out to establish the amount of time it takes for full gut recovery in patients with celiac disease.
    The research team was made up of J.M. Hutchinson, N.P. West, G.G. Robins and P.D. Howdle. They are variously affiliated with the Sections of Medicine, Surgery and Anesthesia, the Section of Pathology & Tumour Biology at the Leeds Institute of Molecular Medicine in Leeds, and with the Department of Gastroenterology of the York Foundation Hospitals Trust, York, UK.
    The team enrolled patients who attended a specialty celiac disease clinic prior to March 2009, and recorded various clinicopathological information into a database.
    The team reviewed histopathology reports for all duodenal biopsies, and scored each biopsy for histopathology based on a modified Marsh grade.
    The team indexed and performed at least one biopsy on two hundred and eighty-four patients.
    The team found marked gut improvement in two-hundred and twenty-seven patients (80%), and a complete return to normal histology in 100 patients (35%). Average recovery time was 1.9 years, with a range of 1.0–4.8 years.
    Patients with less serious celiac disease at the start showed a better overall response (r = 0.281, P < 0.0001), while older patients recovered more quickly (r = –0.200, P = 0.001).
    Patients who best followed a gluten-free diet showed the best biopsy scores (r = –0.134, P = 0.040) and the greatest degree of histological recovery (r = 0.161, P = 0.014).
    Current guidelines for treatment of celiac disease recommend timing repeat biopsy 4-6 months after commencing a gluten free diet.
    These results shows histological recovery generally takes longer than traditionally thought, and that doctors looking to conduct such follow-ups might do well to factor in the patient’s age at diagnosis, the initial disease score, as well as the level of compliance with a gluten free diet.
    Source:

    QJM 2010 103(7):511-517

    Jefferson Adams
    Celiac.com 02/10/2012 - The HBV vaccine is usually effective against common hepatitis B virus (HBV) infection, with just 4-10% of vaccine recipients failing to respond to standard immunization. Some studies suggest that people with celiac disease may have high levels of resistance to the HBV vaccine, compared to the general population.
    A team of researchers recently took a look at the issue of HBV vaccine reliability in people with celiac disease.
    The study team included Mohammad Rostami Nejad, Kamran Rostami, and Mohammad Reza Zali. They are variously affiliated with the Research Center for Gastroenterology and Liver Disease at Shahid Beheshti University of Medical Sciences in Tehran, Iran, and with Acute Medicine at Dudley Group of Hospital in Dudley, UK. Together, they reviewed data from previous studies.
    The ability to respond to recombinant HBV vaccine is associated with certain gene sites. At those sites, certain HLA haplotypes, such as B8, DR3, and DQ2 are common genetic markers among non-responders.
    Since HLA genotypes play an important role in unresponsiveness to the HBV vaccine, and since 90-95% of people with celiac disease have HLA-DQ2, celiac disease may be a factor in this failure to respond to the HBV vaccine.
    For one study, Ertekin et al., a research team gave HBV vaccinations, according to a standard immunization schedule, to 52 children with celiac disease, and another twenty matched for age and sex.
    The average age of the celiac disease patients was 10.7 ± 4 years (range, 4-18 years). Anti-HBs titers were positive in 32 (61.5%) patients and negative in 20 (38.5%) patients, while they were positive in 18 (90%) of the children in the control group (P < 0.05). The review team found statistically significant differences between negative anti-HBs titers, clinical presentation of celiac disease, and dietary compliance in patients with celiac disease (P < 0.05).
    In all, 32 of the 52 children with celiac disease responded favorably to HBV vaccination. This was a substantially lower percentage that the 18 of 20 control subjects responded (P < 0.05).
    Ertekin et al. concluded that a significantly higher percentage of children with celiac disease failed to respond to hepatitis B vaccination, as compared with the control group.
    They concluded that response to the HBV vaccine in children with celiac disease should be investigated, and a different immunization schedule should be developed for them. They suggested that celiac children who follow a gluten-free diet may have a better immune response to the HBV vaccine.
    The data fits with previous studies that confirm the findings that children with celiac disease fail to respond to the HBV vaccine at significantly higher rates than do healthy children.
    In fact, the researchers point out a similar study on adults, Noh et al., revealed that, of 23 adults with celiac disease who had completed a full course of HBV vaccination, 19 tested positive for HBsAb and 13 failed to acquire proper long-term immunity.
    Another study, by Stachowski et al., further cemented this connection between HLA and non-responsiveness to HBV vaccine. In that study, 34 out of 153 patients with end-stage renal disease failed to respond to HBV vaccine, and HLA-DQ2 was found almost exclusively in the non-responder group.
    Long stretches of time between vaccination and antibody testing might be one reason even celiac disease patients who follow a gluten-free diet have significantly reduced post-vaccination levels of HBV antibody. Therefore, current guidelines recommend revaccinating celiac patients once they have established a reliable gluten-free diet.
    This study was not designed to assess the presence of HLA-DQ2 and HLA-DQ8 in the groups. Therefore, future studies assessing HLA haplotypes in celiac disease should seek to describe the role of HLA typing in response to HBV vaccination.
    The evidence indicates that early diagnosis of celiac disease, and treatment with a gluten-free diet may increase the overall percentage of patients responding favorably to the HBV vaccine.
    Treatment of celiac disease with a strict, gluten-free diet seems to play a positive role in the development of antibody memory.
    The review team points out that the high prevalence of celiac disease in the general population and a lack of response to HBV vaccine in untreated patients, invites routine assessment in patients with celiac disease receiving the HBV vaccine.
    Lastly, the review team notes that non-responsiveness to HBV vaccine may indicate undiagnosed celiac disease or noncompliance with gluten-free diet.
    SOURCE:
    Hepat Mon. 2011 August 1; 11(8): 597–598.
    doi:  10.5812/kowsar.1735143X.761


  • Recent Articles

    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.
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    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.
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    My following books will still be available at Amazon.com:
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    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. 
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    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.
     
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    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.
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    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.
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    Source:
    cnbc.com