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    • Scott Adams

      Frequently Asked Questions About Celiac Disease   04/24/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What is Celiac Disease and the Gluten-Free Diet? What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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    Point-of-Care Test Helps Spot Undiagnosed Celiac Disease


    Jefferson Adams

    Celiac.com 01/19/2015 - A team of researchers set out to determine what factors might influence dissemination of a new and validated commercial Point-of-Care Test (POCT) for celiac disease, in the Mediterranean area, when used in settings where it was designed to be administered, especially in countries with poor resources.


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    Photo: CC--JYL4032The research team included S. Costa, L. Astarita, M. Ben-Hariz, G. Currò, J. Dolinsek, A. Kansu, G. Magazzu, S. Marvaso, D. Micetic-Turku, S. Pellegrino, G. Primavera, P. Rossi, A. Smarrazzo, F. Tucci, C. Arcidiaco, and L. Greco.

    For their study, the team relied on family pediatricians in Italy, and nurses and pediatricians in Slovenia and Turkey, to look for celiac disease in 3,559 children aged 1-14 years, 1,480 (ages 14-23 years) and 771 (1-18 years) asymptomatic subjects, respectively. This was done at pediatrician offices, schools and university primary care centers

    The team used a new POCT that detects IgA-tissue antitransglutaminase antibodies and IgA deficiency in a finger-tip blood drop. Subjects with positive screens and those suspected of having celiac disease were referred to a Celiac Centre to confirm the diagnosis.

    The team then estimated POCT Positive Predictive Value (PPV) at tertiary care (with Negative Predictive Value) and in primary care settings, and POCT and celiac disease rates per thousand in primary care.

    At tertiary care setting, PPV of the POCT and 95% CI were 89.5 (81.3-94.3) and 90 (56-98.5) with Negative Predictive Value 98.5 (94.2-99.6) and 98.7% (92-99.8) in children and adults, respectively.

    In primary care settings of different countries where POCT was performed by a different number of personnel, PPV ranged from 16 to 33%, and the celiac disease rates per thousand ranged from 4.77 to 1.3, while and POCT rates ranged from 31.18 to 2.59, respectively.

    This study shows that interpretation of POCT results by different personnel may influence the performance of POC, but that use of POCT is an urgent priority for diagnosing celiac disease among people of countries with limited resources, such as rural populations and school children.

    Source:


    Image Caption: Photo: CC--JYL4032
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  • Related Articles

    Destiny Stone
    Celiac.com 06/10/2010 - New research is currently underway in Ireland, as researchers test "pseudo-cereals" to determine the quality of  replacements for glutenous grains such as, wheat, rye and barley. Many celiacs, especially those with delayed diagnosis', suffer from malabsorbtion and malnutrition. It is therefore more important for celiacs to ingest grains that are vitamin fortified than it is for non-celiacs. Researchers at Teagasc Food Research Ashtown are attempting to address the nutritional concerns for gluten-free products. They are working to  formulate gluten-free bread products that are tasty, and have higher nutritional properties.
    Doctor Eimear Gallagher, of Teagasc Food Research Ashtown, is leading the current research project which primarily focuses on using “pseudo-cereals” such as amaranth, quinoa and buckwheat, to replace gluten containing grains,  also known as wheat, rye and barley. Dr. Gallagher suggests that the demand for new and improved gluten-free bread products is growing  rapidly due to greater public awareness of celiac disease, and the rise in positive celiac diagnoses'.
    Celiac affects approximately 1 percent of the population. Which means that 1 percent of the population must look for alternatives to favored grain products such as bread, pizza and cereals to name a few. While there is a large variety of gluten-free products on the market, many gluten-free products are described as being crumbly, brittle, bland and often rendered  inedible. Gluten-free products are not only considered inferior in texture and taste to their wheat counterparts, but they are also criticized for having inferior nutritional value. Most mainstream breads and grains are vitamin fortified and therefore contain many essential nutrients, vitamins, and fiber. However, most gluten-free grains are typically made with starches and refined flours such as rice, corn and potato starches, which are low in nutrients and are not usually fortified.
    Dr. Gallagher and researchers are studying characteristics of pseudo-cereals to replace wheat in grain products. Amaranth, quinoa and buckwheat are naturally high in nutritional values with high levels of protein and dietary fiber, which make them excellent grain alternatives  for celiacs. Dr. Gallagher's findings showed that all of the pseudo-cereal breads revealed a significant increase in antioxidant and polyphenol activity, compared to the gluten-free control group.
    Teagasc  food researchers are also working hard to create a dairy-based ingredient that can produce the same properties in bread as gluten does. So far researchers have discovered that casein aggregates and forms a protein network which can retain gas in gluten-free dough. The reactions are similar to gluten containing wheat dough, but this is a work in progress and more studies are needed.
    Dr. Gallagher's studies have revealed significant information on ingredients, formulations and technologies used to make gluten-free products, which will help provide edible and healthy alternatives to gluten-free products.
    Source:

    ScienceDaily (May 26, 2010)

    Destiny Stone
    Celiac.com 07/09/2010 - The enteropathy associated with common variable immunodeficiency (CVID) is the most common  symptomatic primary antibody deficient syndrome, with an estimated prevalence of one in one-hundred thousand to one in fifty thousand. However, the relationship between CVID and Enteropathy is still unclear.
    CVID is characterized by decreased levels of of two or more serum immunoglobulin (Ig) isotypes and the presentation of reoccurring infections specifically in the respiratory tract. Gastrointestinal symptoms are widespread with CVID patients as exhibited in as many as 50% of patients presenting with chronic diarrhea.
    A team of doctors evaluated the medical files of 50 CVID patients who exhibited gastrointestinal symptoms to determine the “clinical and hitopathological features of the enteropathy associated with CVID”. Fifteen patients were excluded from the study because they did not meet the recognized criteria for CVID. Data was collected from all patients and included, gender, age, symptoms, body mass index (BMI), as well as parasitological stool testing. Blood samples were taken from each test patient including hemogram, serum protein electrophoresis and measurements of serum folic acid, vitamin B12, iron, and calcium.
    The doctors found the mean age for initial CVID diagnosis to be 36.8 years. Four of the patients were discovered to have a family history of immunodeficiency. 40% of the patients that were tested were determined to have immunodeficiency as revealed by their digestive symptoms. Chronic diarrhea was observed as the most common gastrointestinal symptom with a rate of 92% of the patients studied.
    Gluten-free diet was initiated by 12 patients with villous atrophy, but clinical improvements and partial villous healing only occurred in two patients. Interestingly,  the two patients presenting with celiac antibodies,  did not show an improvement of symptoms. All patients showed positive improvements from steroid therapy. Furthermore, as a result of this study, the observing doctors concluded, that of the  CVID patients exhibiting gastrointestinal symptoms, histological lesions were found in around 80% of the biopsies taken from the colon, stomach, or small bowel.
    The enteropathy corresponding with CVID was found to have has many features that differentiate it from other etiopathological conditions including celiac disease. While replacement Ig therapy was demonstrated to be inadequate for improving gastrointestinal symptoms, steroids, specifically budesonide,were proven successful in reducing inflammation and restoring mucosal architecture.
    Source:

    The American Journal of Gastroenterology , (15June2010) | doi:10.1038/ajg.2010.214

    Jefferson Adams
    Celiac.com 09/20/2010 - People with celiac disease face increased risk of cancer and a large amount of circumstantial evidence suggests that oxidatively damaged DNA may be used to help predict future cancer development in celiac patients.
    To evaluate that hypothesis, a research team set out to assess and describe oxidative stress and oxidative DNA damage in celiac disease patients.
    Anna Szaflarska-PopÅ‚awska, Agnieszka Siomek, MieczysÅ‚awa Czerwionka-Szaflarska, Daniel Gackowski, RafaÅ‚ Różalski, Jolanta Guz, Anna Szpila, Ewelina Zarakowska and Ryszard OliÅ„ski comprised the research team. They are associated with the college of medicine at Nicolaus Copernicus University, in Bydgoszcz, Poland.
    They found that children with celiac disease have higher than normal levels of the oxidative DNA damage biomarkers urinary 8-oxodG and 8-oxoGua, regardless of following a gluten-free diet.
    To measure urinary excretion of 8-oxodG and 8-oxoGua, and levels of oxidative DNA damage in the leukocytes, as well as the level of antioxidant vitamins, the team used high-performance liquid chromatography (HPLC) and HPLC/gas chromatography with isotope dilution mass detection.
    They observed parameters for DNA damage in a group of children with untreated celiac disease, in a group of children with celiac disease following a strict gluten-free diet, and in a control group of healthy children.
    They found that the two groups of celiacs showed significantly higher overall levels of 8-oxodG in DNA isolated from the leukocytes and from the urine samples than did the control subjects, without regard to diet. There was no significant difference  between treated and untreated celiacs. That means being on a gluten-free diet offered no protection from oxidative DNA damage for all children with celiac disease.
    One key difference was that the untreated celiac children showed significantly lower levels of retinol and α-tocopherol, vitamin A and E, compared to the treated celiac children. Between group difference of 0.31 and 3.76 µmol/l, respectively, suggests that a gluten-free diet offers some protection against oxidative damage in treated celiacs.
    From the results indicate that oxidative stress and/or oxidatively damaged DNA in celiac patients cannot be explained by diet alone, and that factors independent of diet play an important role.
    Supplemental vitamin A and E in celiac disease patients may help minimize the risk of cancer development.
    Source:

    Cancer Epidemiol Biomarkers Prev 2010; 19: 1960–1965

    Jefferson Adams
    Celiac.com 12/15/2011 - Until now, studies have only shown a connection between celiac disease and functional gastrointestinal disorders in adults. No solid information exists regarding children.
    Due to the fact that gluten-induced gut inflammation is reversible by dietary manipulation, celiac disease may offer a useful model for examining the role of inflammatory triggers in various functional gastrointestinal disorders.
    Gut inflammation is a well-known cause of functional and structural changes in the central nervous system. Researchers suspect that the culprit is an abnormal afferent input from the gut. Psychological factors may play a role in triggering overt symptoms.
    A research team recently set out to examine connections between childhood celiac disease and functional gastrointestinal disorder in children meeting Rome III criteria. The team included R. Turco, G. Boccia, E. Miele; E. Giannetti, R. Buonavolontà, P. Quitadamo, R. Auricchio, and A. Staiano.
    Their goal was to assess the prevalence of functional gastrointestinal disorders at one year, along with the role of psychological aspects on the development of functional gastrointestinal disorders in celiac disease children.
    For the study, the team enrolled a group of 36 boys and 64 girls (Total = 100 children) with celiac disease, and followed them for one year. They also assembled a control group of 56 children, 25 boys and 31 girls.
    The team had all children and/or their parents complete validated questionnaires for GI symptoms, depression, and anxiety.  The team then compared GI symptoms at diagnosis and after 1 year of gluten-free diet.
    The team was able to follow up on 82 of the patients with celiac disease who followed a gluten-free diet for at least one year. Of those, 23 patients  (28%) met Rome III criteria for functional gastrointestinal disorders compared with 5 of 56 (8.9%) patients from the control group (P = 0.008; χ2 = 6.8; OR: 3.97; 95% CI: 1.40–11.21).
    Most of those children who met Rome III criteria for functional gastrointestinal disorders after one year on a gluten-free diet complained of GI symptoms alone; 21 of 52 children (40.3%) overall.
    Children with celiac disease with FGDIs showed substantially higher levels of anxiety and depression compared to control subjects, and to celiac disease children without functional gastrointestinal disorders (P = 0.02).
    The study shows that children with celiac disease, who follow a gluten-free diet for a year, have much higher rates of functional GI symptoms than do non-celiac control subjects.
    The risk may be due to residual chronic inflammation, and/or to psychological factors, but further study is needed to make that determination.
    Source:

    Alimentary Pharmacology & Therapeutics. 2011;34(7):783-789.

  • Recent Articles

    Jefferson Adams
    Celiac.com 05/22/2018 - Proteins are the building blocks of life. If scientists can figure out how to create and grow new proteins, they can create new treatments and cures to a multitude of medical, biological and even environmental conditions.
    For a couple of decades now, scientists have been searching for a biological Rosetta stone that would allow them to engineer proteins with precision, but the problem has remained dauntingly complex.  Researchers had a pretty good understanding of the very simple way that the linear chemical code carried by strands of DNA translates into strings of amino acids in proteins. 
    But, one of the main problems in protein engineering has to do with the way proteins fold into their various three-dimensional structures. Until recently, no one has been able to decipher the rules that will predict how proteins fold into those three-dimensional structures.  So even if researchers were somehow able to design a protein with the right shape for a given job, they wouldn’t know how to go about making it from protein’s building blocks, the amino acids.
    But now, scientists like William DeGrado, a chemist at the University of California, San Francisco, and David Baker, director for the Institute for Protein Design at the University of Washington, say that designing proteins will become at least as important as manipulating DNA has been in the past couple of decades.
    After making slow, but incremental progress over the years, scientists have improved their ability to decipher the complex language of protein shapes. Among other things, they’ve gained a better understanding of how then the laws of physics cause the proteins to snap into folded origami-like structures based on the ways amino acids are attracted or repelled by others many places down the chain.
    It is this new ability to decipher the complex language of protein shapes that has fueled their progress. UCSF’s DeGrado is using these new breakthroughs to search for new medicines that will be more stable, both on the shelf and in the body. He is also looking for new ways to treat Alzheimer’s disease and similar neurological conditions, which result when brain proteins fold incorrectly and create toxic deposits.
    Meanwhile, Baker’s is working on a single vaccine that would protect against all strains of the influenza virus, along with a method for breaking down the gluten proteins in wheat, which could help to generate new treatments for people with celiac disease. 
    With new computing power, look for progress on the understanding, design, and construction of brain proteins. As understanding, design and construction improve, look for brain proteins to play a major role in disease research and treatment. This is all great news for people looking to improve our understanding and treatment of celiac disease.
    Source:
    Bloomberg.com

    Jefferson Adams
    Celiac.com 05/21/2018 - Just a year ago, Starbucks debuted their Canadian bacon, egg and cheddar cheese gluten-free sandwich. During that year, the company basked in praise from customers with celiac disease and gluten-sensitivity for their commitment to delivering a safe gluten-free alternative to it’s standard breakfast offerings.
    But that commitment came to an ignoble end recently as Starbucks admitted that their gluten-free sandwich was plagued by  “low sales,” and was simply not sustainable from a company perspective. The sandwich may not have sold well, but it was much-loved by those who came to rely on it.
    With the end of that sandwich came the complaints. Customers on social media were anything but quiet, as seen in numerous posts, tweets and comments pointing out the callous and tone-deaf nature of the announcement which took place in the middle of national Celiac Disease Awareness Month. More than a few posts threatened to dump Starbucks altogether.
    A few of the choice tweets include the following:  
    “If I’m going to get coffee and can’t eat anything might as well be DD. #celiac so your eggbites won’t work for me,” tweeted @NotPerryMason. “They’re discontinuing my @Starbucks gluten-free sandwich which is super sad, but will save me money because I won’t have a reason to go to Starbucks and drop $50 a week,” tweeted @nwillard229. Starbucks is not giving up on gluten-free entirely, though. The company will still offer several items for customers who prefer gluten-free foods, including Sous Vide Egg Bites, a Marshmallow Dream Bar and Siggi’s yogurt.
    Stay tuned to learn more about Starbucks gluten-free foods going forward.

    Jefferson Adams
    Celiac.com 05/19/2018 - Looking for a nutritious, delicious meal that is both satisfying and gluten-free? This tasty quinoa salad is just the thing for you. Easy to make and easy to transport to work. This salad of quinoa and vegetables gets a rich depth from chicken broth, and a delicious tang from red wine vinegar. Just pop it in a container, seal and take it to work or school. Make the quinoa a day or two ahead as needed. Add or subtract veggies as you like.
    Ingredients:
    1 cup red quinoa, rinsed well ½ cup water ½ cup chicken broth 2 radishes, thinly sliced 1 small bunch fresh pea sprouts 1 small Persian cucumber, diced 1 small avocado, ripe, sliced into chunks Cherry or grape tomatoes Fresh sunflower seeds 2 tablespoons red wine vinegar  Kosher salt, freshly ground pepper Directions:
    Simmer quinoa in water and chicken broth until tender.
    Dish into bowls.
    Top with veggies, salt and pepper, and sunflower seeds. 
    Splash with red wine vinegar and enjoy!

    Jefferson Adams
    Celiac.com 05/18/2018 - Across the country, colleges and universities are rethinking the way they provide food services for students with food allergies and food intolerance. In some cases, that means major renovations. In other cases, it means creating completely new dining and food halls. To document both their commitment and execution of gluten-free and allergen-free dining, these new food halls are frequently turning to auditing and accreditation firms, such as Kitchens with Confidence.
    The latest major player to make the leap to allergen-free dining is Syracuse University. The university’s Food Services recently earned an official gluten-free certification from Kitchens with Confidence for four of the University’s dining centers, with the fifth soon to follow.
    To earn the gluten-free certification from Kitchens with Confidence, food services must pass a 41 point audit process that includes 200 control check points. The food service must also agree to get any new food item approved in advance, and to submit to monthly testing of prep surfaces, to furnish quarterly reports, and to provide information on any staffing changes, recalls or incident reports. Kitchens with Confidence representatives also conduct annual inspections of each dining center.
    Syracuse students and guests eating at Ernie Davis, Shaw, Graham and Sadler dining centers can now choose safe, reliable gluten-free food from a certified gluten-free food center. The fifth dining center, Brockway, is currently undergoing renovations scheduled for completion by fall, when Brockway will also receive its certification.
    Syracuse Food Services has offered a gluten-free foods in its dining centers for years. According to Jamie Cyr, director of Auxiliary Services, the university believes that the independent Gluten-Free Certification from Kitchens with Confidence will help ease the anxiety for parents and students.”
    Syracuse is understandably proud of their accomplishment. According to Mark Tewksbury, director of residence dining operations, “campus dining centers serve 11,000 meals per day and our food is made fresh daily. Making sure that it is nutritious, delicious and safe for all students is a top priority.”
    Look for more colleges and universities to follow in the footsteps of Syracuse and others that have made safe, reliable food available for their students with food allergies or sensitivities.
    Read more.

    Zyana Morris
    Celiac.com 05/17/2018 - Celiac disease is not one of the most deadly diseases out there, but it can put you through a lot of misery. Also known as coeliac, celiac disease is an inherited immune disorder. What happens is that your body’s immune system overreacts to gluten and damages the small intestine. People who suffer from the disease cannot digest gluten, a protein found in grain such as rye, barley, and wheat. 
    While it may not sound like a severe complication at first, coeliac can be unpleasant to deal with. What’s worse is it would lower your body’s capacity to absorb minerals and vitamins. Naturally, the condition would cause nutritional deficiencies. The key problem that diagnosing celiac is difficult and takes take longer than usual. Surprisingly, the condition has over 200 identified symptoms.
    More than three million people suffer from the coeliac disease in the United States alone. Even though diagnosis is complicated, there are symptoms that can help you identify the condition during the early stages to minimize the damage. 
    Here is how you can recognize the main symptoms of celiac disease:
    Diarrhea
    In various studies conducted over years, the most prominent symptom of celiac disease is chronic diarrhea.
    People suffering from the condition would experience loose watery stools that can last for up to four weeks after they stop taking gluten. Diarrhea can also be a symptom of food poisoning and other conditions, which is why it makes it difficult to diagnose coeliac. In certain cases, celiac disease can take up to four years to establish a sound diagnosis.
    Vomiting
    Another prominent symptom is vomiting.  
    When accompanied by diarrhea, vomiting can be a painful experience that would leave you exhausted. It also results in malnutrition and the patient experiences weight loss (not in a good way though). If you experience uncontrolled vomiting, report the matter to a physician to manage the condition.
    Bloating
    Since coeliac disease damages the small intestine, bloating is another common system. This is due to inflammation of the digestive tract. In a study with more than a 1,000 participants, almost 73% of the people reported bloating after ingesting gluten. 
    Bloating can be managed by eliminating gluten from the diet which is why a gluten-free diet is necessary for people suffering from celiac disease.
    Fatigue
    Constant feeling of tiredness and low energy levels is another common symptom associated with celiac disease. If you experience a lack of energy after in taking gluten, then you need to consult a physician to diagnose the condition. Now fatigue can also result from inefficient thyroid function, infections, and depression (a symptom of the coeliac disease). However, almost 51% of celiac patients suffer from fatigue in a study.
    Itchy Rash
    Now the chances of getting a rash after eating gluten are slim, but the symptom has been associated with celiac disease in the past. The condition can cause dermatitis herpetiformis, which causes a blistering skin rash that occurs around the buttocks, knees, and elbows. 
    A study found out that almost 17% of patients suffering from celiac disease might develop dermatitis herpetiformis due to lack of right treatment. Make sure you schedule an online appointment with your dermatologist or visit the nearest healthcare facility to prevent worsening of symptoms.
    Even with such common symptoms, diagnosing the condition is imperative for a quick recovery and to mitigate the long-term risks associated with celiac disease. 
    Sources:
    ncbi.nlm.nih.gov  Celiac.com ncbi.nlm.nih.gov  mendfamily.com