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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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    NON-CELIAC GLUTEN SENSITIVITY NOT HOLDING UP TO SCRUTINY


    Jefferson Adams

    Celiac.com 08/25/2014 - Numerous people without celiac disease claim to suffer from celiac-like gastrointestinal symptoms when they consume wheat, rye or barley products, and claim that avoiding these products makes them feel better. However, even though many people make this claim, this is largely a self-reported condition. Some data have supported the idea of gluten sensitivity, but the most recent and more complete data seem to indicate that the real culprit might not be gluten, but fermentable, poorly absorbed short-chain carbohydrates known as FODMAPs.


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    Photo: CC--Rick DikemanIn fact the same researcher whose early data supported the idea of non-celiac gluten sensitivity also headed the follow-up study that showed no effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates.

    In this third study, that researcher, Peter Gibson at Monash University in Canada set out to assess patients who believe they have NCGS. The study team included Jessica R. Biesiekierski, PhD, RN; Evan D. Newnham, MD, FRACP; Susan J. Shepherd, PhD, APD; Jane G. Muir, PhD, APD; and Peter R. Gibson, MD, FRACP. They are variously affiliated with the Department of Gastroenterology, Eastern Health Clinical School, and the Department of Gastroenterology, Central Clinical School at Monash University, The Alfred Hospital in Melbourne, Australia, and with the Translational Research Center for Gastrointestinal Disorders, Herestraat in Leuven, Belgium.

    The team put out advertisements calling for adults who believed they had non-celiac gluten sensitivity (NCGS) and were willing to participate in a clinical trial. Respondents were asked to complete a questionnaire about symptoms, diet, and celiac investigation. They received 248 responses, and completed surveys on a total of 147 people. There were 17 men and 130 women, averaging 43.5 years of age.

    The team eliminated seventy-two percent of the respondents for inadequate exclusion of celiac disease (62%), uncontrolled symptoms despite gluten restriction (24%), and not following a GFD (27%), alone or in combination. A full 15% of respondents had received no testing or examination for celiac disease.

    Gluten avoidance was self-initiated in nearly half of respondents; while it was prescribed by alternative health professionals in 21%, by dietitians in 19%, and by general practitioners in 16%.

    Of 75 respondents who had received duodenal biopsies, nearly one-third had no gluten intake, or inadequate gluten intake, at the time of endoscopy. Inadequate celiac investigation was most common if gluten-avoidance was self-initiated (69%), alternative health professionals (70%), general practitioners (46%), or dietitians (43%).

    A total of 40 respondents fulfilled criteria for NCGS. Those folks showed excellent knowledge of and adherence to a gluten-free diet. However, a full 65% of those who met criteria for NCGS showed intolerance to other foods.

    Just over 1 in 4 respondents self-reporting as NCGS fulfill criteria for its diagnosis, while gluten-avoidance without adequate exclusion of celiac disease is common.

    In 75% of respondents, symptoms are poorly controlled despite gluten avoidance. These results also stress the importance of testing for other food sensitivities, and of celiac screening and evaluation for those people claiming non-celiac gluten-sensitivity.

    Clearly, more study needs to be done to determine if non-celiac gluten sensitivity exists, or if there are other possible causes for the symptoms.

    Sources:

     

    The team put out advertisements calling for adults who believed they had non-celiac gluten sensitivity (NCGS) and were willing to participate in a clinical trial. Respondents were asked to complete a questionnaire about symptoms, diet, and celiac investigation. They received 248 responses, and completed surveys on a total of 147 people. There were 17 men and 130 women, averaging 43.5 years of age.

     


    Image Caption: Photo: CC--Rick Dikeman
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    Guest Jacqueline Jones

    Posted

    I don't agree with the conclusion. Dr. Michael Lam has identified some patients with advanced stages of adrenal fatigue syndrome (another illness doctors don't believe in), who have celiac symptoms after inhaling flour (e.g. from baking mix).

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    Guest Terry J. Wood

    Posted

    My diagnosis of non-celiac gluten sensitivity was made by physicians who are professors at the University of Pittsburgh School of Medicine. I am not a celiac. I don't have Chron's disease. (I've had blood tests, colonoscopies and a test requiring I drink barium).

     

    I think my case is pretty solid proof that NCGS exists. Any physician researching this is welcome to contact me. I'd be happy to put them in touch with my doctors.

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    Guest justmyopinion

    Posted

    If you have numerous positive biopsies and don't have DQ2 or DQ8 genes, what term do doctors want to give it? Research on Pubmed shows a lot of newly found genes associated with celiac that have NOTHING to do with the two listed above. Is anyone writing articles on that?

     

    As for FODMAP diet, was handed a copy by a new GI to follow last summer. Said no wheat and or dairy allowed, but you could have beer, raisin bran, whole wheat toast, spelt, oats, yogurt, cheese. Also couldn't have broccoli, onions, garlic, coffee and more. It was 1000s times worse in terms of limitations than a gluten-free/cf diet. Didn't think it made sense and been gluten-free for almost 15 years so I didn't risk it. Have come too far to ever go back to eating gluten if even medically prescribed. Sorry.

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    This can hardly be called a study, it is more of a survey. I mean only 2/3 of the respondents were counted because the rest didn't complete the survey. Second statements like "uncontrolled symptoms despite gluten restriction" are vague. Does this mean gluten restrictions didn't help at all? Helped a bit? Most prescription medicines require the slightest of positive effects to be considered worth prescribing so why no the same with the GFD? I do agree people should do more to check for celiac before going on a GFD, at least the blood tests. You have a great site and it would be great to see you up the quality of your reporting and actually read and report on the study, not just the abstract. Also this is one research team, are there any others? It seems to to me this guy has a bit of a vendetta against NCGS.

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    (1) Monash University is in Australia, not Canada.

    (2) Can you really draw conclusions from a study that excluded 3/4 of potential participants? I'd guess that the remaining 1/4 had less severe symptoms anyway.

    (3) not to be rude, but the main author is also the main author of the FODMAP diet, which is being commercialized as an app -- so he also has a vested interest in promoting FODMAPs over NCGS. In particular, if you read the abstract, the chosen 40 were overwhelmingly people who also identified other food sensitivities -- so they are people with sensitive stomachs, not people with a wheat/gluten problem.

    The rating isn't because of the poor scholarship in the article, but because none of these questions are raised by the summary.

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    Guest GERTA   FARBER

    Posted

    To Celiac.com AGAIN!

     

    Concerning "Celiac, the Mysterious and the Medical Need for Gluten Free Diet"

    I was shocked that you would publish these mistaken facts by writer Melissa Reed.

    She writes that, "There are no tests or strict criteria to diagnose gluten sensitivity." There are several labs which have been diagnosing gluten sensitivity for many years now! My self diagnosis for Gluten intolerance was in 2002, and was verified by EnteroLab.com.

    Dr. Ron Hogan has published "An Interview with Dr. Kenneth Fine of EnteroLab.com and the Intestinal Health Institute." Celiac.com- 10-9-13.

     

    As for her warning about avoiding a gluten-free diet before seeing your doctor, it has been

    suggested by several past celiac researchers that testing may not be necessary at all if a

    gluten-free diet is successful in eliminating troubling side-effects.

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    To Celiac.com AGAIN!

     

    Concerning "Celiac, the Mysterious and the Medical Need for Gluten Free Diet"

    I was shocked that you would publish these mistaken facts by writer Melissa Reed.

    She writes that, "There are no tests or strict criteria to diagnose gluten sensitivity." There are several labs which have been diagnosing gluten sensitivity for many years now! My self diagnosis for Gluten intolerance was in 2002, and was verified by EnteroLab.com.

    Dr. Ron Hogan has published "An Interview with Dr. Kenneth Fine of EnteroLab.com and the Intestinal Health Institute." Celiac.com- 10-9-13.

     

    As for her warning about avoiding a gluten-free diet before seeing your doctor, it has been

    suggested by several past celiac researchers that testing may not be necessary at all if a

    gluten-free diet is successful in eliminating troubling side-effects.

    As the article you mention in Journal of Gluten Sensitivity points out (An Interview with Dr. Kenneth Fine of EnteroLab.com and the Intestinal Health Institute), Dr. Fine's research hasn't been published, and is not generally accepted by the medical community.

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    Guest michelle

    Posted

    Weak, I say. This article and the studies outlined seem to assume that people with NCGS have only gastro-intestinal symptoms. Its simply not true. 147 people does not a conclusion make. Weak.

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    Talk about a misleading headline and "study." I agree that it's more like a survey. If these people really wanted to discover the truth about non-celiac gluten sensitivity, they'd be testing things like cholesterol levels, reproductive hormones, serotonin levels. They'd be asking questions about improvement in symptoms related to migraine headaches, depression, anxiety, diabetes, thyroid issues, inflammation, arthritis, and infertility. They'd be looking at overall weight loss or weight gain. As far as other food sensitivities go: it's no secret that eliminating gluten very often makes other hidden sensitivities more noticeable. How many celiacs find out they have dairy issues once they eliminate gluten? And Dr. Fine's research is not generally accepted by the medical community? Big surprise. His research supports the notion that changing your diet can improve your health. Where's the money to be made in that? Sure, gluten-free bakeries are prospering, but not pharmaceutical companies. That reminds me, who ponies up the cash for medical research? Well, a great deal of the funding comes from pharmaceutical companies. Can you even imagine how much money they stand to lose if a change in diet eliminated the need for antidepressants, anti-inflammatory drugs, infertility treatments, and the like?

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    I'm pretty amazed that the research team at Monash University in AUSTRALIA (not Canada) has a low FODMAP app and a booklet for sale. That just makes the entire "study" suspect.

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    Guest celiacMom

    Posted

    I think poeple misunderstand this research when applying it to diet. Also I agree with previous comments that FODMAP diet lists/instructions are inconsistent between practitioners. This is an evolving process. Folks that feel better when tey eat gluten free foods may indeed be because they are avoiding the FODMAPS in wheat etc. Which would make avoiding gluten part of the equation: where have you seen a FODMAP free food that has gluten?Also remember FODMAPs will irritate any intestine that already has issues, so probably is a good treatment for many GI problems, not just gluten sensitivity. I honestly think since is way behind in the celiac disease/gluten immuno-reactivity area, for personal experience I can thing of infinite hypothesis to test that have not been tested. I do not have celiac disease (per doctor) close family member does; I have seen many doctors and none has a clue what I have. Had a good time when I stop eating gluten a few years back, but as I get older, more and more things make me sick.

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    If you do not have celiac don't do the diet...it is only good for people who have the disease.

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    NCGS is real. I HAVE two genes that make me that way. For those of you who think is does not exist are unenlightened.

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    Guest Jefferson

    Posted

    (1) Monash University is in Australia, not Canada.

    (2) Can you really draw conclusions from a study that excluded 3/4 of potential participants? I'd guess that the remaining 1/4 had less severe symptoms anyway.

    (3) not to be rude, but the main author is also the main author of the FODMAP diet, which is being commercialized as an app -- so he also has a vested interest in promoting FODMAPs over NCGS. In particular, if you read the abstract, the chosen 40 were overwhelmingly people who also identified other food sensitivities -- so they are people with sensitive stomachs, not people with a wheat/gluten problem.

    The rating isn't because of the poor scholarship in the article, but because none of these questions are raised by the summary.

    Thanks for your correction, Icha! My oversight. I'll see that the article reflects the true location of Monash University.

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    I would contest the findings of this "study." Not only is it in conflict of interest with the revelation that the group is releasing a FODMAPs diet/app, it seems to me that the investigators did not take into account the myriad of other physical/neurological symptoms experienced by NCGS and celiac sufferers alike. Moreover, the intestinal symptoms that result from consuming gluten last for DAYS - over which time, according to the way this study was structured, it is completely conceivable that subjects would continue to report symptoms even during the days they were eating the low-to-no gluten diet.

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    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