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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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    Ten Important Things to Know About Celiac Disease


    Jefferson Adams


    • Recent studies show that most people with celiac disease begin to see gut healing in the first year or year and a half.


    Celiac.com 05/02/2018 - Celiac disease is an autoimmune disorder, not an allergy. Celiac disease affects abut 1 in 100 people, and requires professional diagnosis and treatment with a gluten-free diet. There is a good deal of confusion and inaccurate information about celiac disease and a gluten-free diet. Here are some important things to know about celiac disease:


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    1) Celiac Disease Doesn’t Always Have Obvious Symptoms
    People with celiac disease may have few or no symptoms. In fact, these days, most people diagnosed with celiac disease, report few or no symptoms.

    Classic gastrointestinal symptoms include bloating, diarrhea, gas, constipation, and gut pain after consuming wheat, barley or rye. Other prominent symptoms can include fatigue, headache, poor weight gain, and depression. 

    Less classic, but still common celiac symptoms include one or more of the following: anemia, anxiety, skin rashes, infertility, irritability, joint pain, pale mouth sores, thin bones, tingling and/or numbness in hands and feet.

    2) No Symptoms Doesn't Mean No Damage
    The level of celiac-related symptoms or complaints a person has does not equate to the level of gut damage. Few or no symptoms does not mean little or no gut damage. People can have severe celiac symptoms, yet relatively light gut damage on biopsy, or conversely, they can have light symptoms and still have serious gut damage on biopsy.

    3) A Simple Antibody Test Can Point the Way
    If you suspect celiac disease, be sure to talk with your doctor. A simple antibody test or two is usually sufficient to rule celiac disease in or out. If the test is positive, then a doctor will likely recommend a biopsy for confirmation. Recent studies show that a combination of two antibody tests may be better than biopsy. Usually, patients need to be eating wheat when they are tested for celiac disease, but that is changing. There are also some promising new approaches to blood testing for celiac disease.

    4) Early Diagnosis is Key
    The longer you go without treatment, the higher the risk of gut damage, and the greater the likelihood of developing associated conditions. Early diagnosis is especially important in the elderly, as they have a greater risk of developing associated conditions and complications from untreated celiac disease. Still diagnosing celiac disease can be tricky and can take time, partly because the symptoms can be vague, seem unrelated, and can mimic other conditions.

    5) No Cure
    Currently, there is no cure for celiac disease. Several companies are working to develop a vaccine, or other immune therapy for celiac disease, but until we see a major scientific breakthrough, there is no cure for celiac disease. 

    6) Gluten-Free Diet is Mandatory
    A gluten-free diet is the only treatment for celiac disease. For people with celiac disease, a gluten-free diet is mandatory, not optional. If people with celiac disease consume wheat, rye or barley proteins they risk causing serious damage to their health, including gut damage and potential cancer, especially in the long term.

    7) Full Gut Healing Can Take Time
    Recent studies show that most people with celiac disease begin to see gut healing in the first year or year and a half. The vast majority of celiacs on a gluten-free diet heal within two to three years. Gut healing usually corresponds to healing in other affected parts of the body, such as improvements in bone microarchitecture, neuropathy, and other areas of celiac-associated damage.

    8) Gluten Sensitivity Can Increase
    The longer you go without gluten, the more sensitive you may become to accidental gluten ingestion. It’s not uncommon for people with celiac disease to see their sensitivity to gluten increase in the weeks and even years after they give up gluten. That can mean that accidental gluten ingestion can bring on symptoms that are more severe than their original complaints. For many people, this sensitivity may slowly taper off and decrease over time. For others, sensitivity remains high and requires extra vigilance about to make sure food is gluten-free.

    Remember, increased gluten sensitivity does not equal increased gut damage. For some, a fully healed gut may be more sensitive to gluten than a damaged one, and vice versa. 

    Among people on a gluten-free diet due to celiac disease, sensitivity can vary.

    9) Non-Celiac Gluten Sensitivity (NCGS) is a Thing
    You can be sensitive to gluten and not have celiac disease. Researchers have recently confirmed a condition called non-gluten sensitivity. People with this condition experience celiac-like symptoms when they consume gluten. However, they typically do not test positive for antibodies to gliadin, and they typically have a clean biopsy, so no gut damage. Some studies have cast doubt on the existence of non-gluten-celiac sensitivity. Other studies have shown that many people with NCGS react to gluten. Still other studies show that Fructan has emerged as one possible culprit

    10) You Can Still Live a Healthy Life and Eat Delicious Food
    Having celiac disease means making some important adjustments to your diet, but it’s still possible to live a healthy life and eat tasty food. Read more about the best gluten-free breads, burgers, pizzas, and all your favorite gluten-free treats.

    Here is a list of SAFE and UNSAFE foods for people with celiac disease

    Here is a list of easy, list of easy, delicious gluten-free recipes.

    Here is a list of great gluten-free sandwich breads.

    Here is a list of great gluten-free Mexican Fast Food Chains.

    Here's a recipe for a delicious gluten-free No-Bake Cheesecake.

    Knowledge is Power
    Use Celiac.com, and the Celiac.com Forums to get important information and to share your experience with others like you. Other great celiac disease resources include:


    Image Caption: Image: CC--normanack
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    Recommended Comments

    Guest NoWake

    Posted

    Great article!  Everyone with Celiac Disease needs to read this.

    #2, I learned the hard way, I was still eating out at so-called "safe" restaurants and getting sick all the time.  When I talk to others with Celiac I always share this, and 90% of the replies are "I am not as sensitive as you."  Unless they are testing the food, their blood and taking a biopsy they don't know just how much damage is happening due to mishandling and cross contamination.

    #8, I can also agree with 100%, today we have a 100% gluten free home, I no longer eat out unless it's 100% gluten-free establishment, and I read and check all the labels of foods I buy..... and occasionally I get sick as a dog, with 99% of the time not knowing from with.  So, today I much more sensitive than pre diagnosis.     

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    Guest sc'Que?

    Posted

    re: #10?  Cut pre-fab foods out of the regular diet (save gluten-free pre-fab options for traveling or special occasions) and cook WHOLE FOODS FROM SCRATCH as much as possible. Some people are natural chefs, while others need to learn the skills. Either way, this is THE BEST PATH toward a healthy gluten-free lifestyle!

     

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    Guest Laura

    Posted

    That's just wonderful for those people who are only gluten-sensitive or celiacs who do NOT have cross-reactor responses.  Bread, pretzels, cheesecake?  Get real!  Gluten cross reactors: yeast, egg & dairy in addition to gluten "must" be excluded from ingestion by many celiacs since the GI response is the same for many celiac disease patients.  Namely: massive diarrhea. Has anyone read grocery food labels?  Try to find a gluten-free product that does not include a cross-reactor.  What hybridization of modern wheat has succeeded in doing is to "destroy" lives!  Lost ability to attend social gatherings where food is served.  Forget about eating out!  Try to consume the heat extracted oils that are chock full of toxic chemical residues. These cause GI problems as well. Notice how many meats are now "infused" with broth (full of yeast).  I was 55 years old when the new wheat was released in 2009 with its 17% increase in gluten content above the 1960's versions.  The gluten content of 6 slices of todays bread equals 102 slices of the 1960 breads and the "damage" is being discovered with the passage of time.  Every year since 2009, there have been new gluten related disease codes added to the ICD-10 books for physician diagnostic correlations. It is discussting what our society has done to our foodstuffs.  So sad for the young people.  So sad for us all!

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    Scott Adams
    Wine, rum, tequila, and sake are usually safe as their alcohols do not generally come from toxic grains. Some vodkas are also okay. However, as with any other ingested product, you should gauge your reaction and learn as much about your favored brands as possible.
    Grain alcohols are one of those controversial items, but recent ADA guidelines indicate that all 100% distilled spirits are safe, including Whiskey, bourbon and gin. Regular beers, must be avoided, since malt (usually from barley) is an ingredient. Even rice beers use malt, but there are a handful of gluten-free beers on the market today.

    Scott Adams
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    1) Cellulose is a carbohydrate polymer of D-glucose. It is the structural material of plants, such as wood in trees. It contains no gluten protein. 2) Methyl cellulose is a chemically modified form of cellulose that makes a good substitute for gluten in rice-based breads, etc. 3) Recent research indicates that oats may be safe for people on gluten-free diets, although many people may also have an additional, unrelated intolerance to them. Cross contamination with wheat is also a factor that you need to consider before choosing to include oats in your diet.

    Jefferson Adams
    Celiac.com 03/10/2014 - A new blood test under development by researchers at Walter and Eliza Hall Institute can rapidly and accurately diagnose celiac disease without the prolonged gluten exposure needed for current tests.
    The new blood test is supposedly accurate after only three days of gluten consumption, not the several weeks or months traditionally required to make a diagnosis using intestinal biopsies.
    Researchers from the Melbourne institute, with colleagues from biotechnology company ImmusanT in Boston, US, led a study of the blood test in 48 participants, the results of which were published in the journal Clinical & Experimental Immunology.
    Furthermore, says Dr Jason Tye-Din, gastroenterologist and head of celiac research at Hall, preliminary results show that the new diagnostic test can accurately detect celiac disease within 24 hours.
    Dr Tye-Din said that the blood test built on fundamental research discoveries the team had made about coeliac disease.
    "This 'cytokine release' test measures the T cell response to gluten after three days of consumption, and a positive response is highly predictive of coeliac disease," he said. "With this test, we were able to detect a T cell response in the majority of study participants known to have coeliac disease and importantly, the test was negative in all of the patients who did not have coeliac disease, even though they followed a gluten-free diet and thought gluten was the cause of their symptoms."
    The researchers hope larger studies will confirm its role as a widely used tool for diagnosing coeliac disease.
    Source:
    Medicalxpress.com.

    Jefferson Adams
    Celiac.com 09/18/2015 - That old saw about death and taxes might need a bit of amending to include complaints about pharmaceutical companies working on celiac drug treatments.
    One interesting facet of our coverage of the development of various drugs to treat and/or cure celiac disease has been the regular presence of comments questioning the motives,and actions of the companies involved.
    It's funny, but no one complains that companies still make money selling aspirin, and that no one has cured a headache, and that there must be some conspiracy to profit off of those who suffer a headache.
    There's no doubt that there's money to be made producing drugs that treat disease. But, if a company can develop and produce a safe drug to protect celiacs against contamination, or to help reduce symptoms, what's wrong with that?
    Just like an aspirin, I can take it or not take it.
    In the old days, ten years ago or more, people with celiac disease generally suffered in silence, with scant gluten-free food choices, and little information. However, in just a decade, we've got a wealth of information, and multi-billion dollar gluten-free foods market and a number of companies developing drugs to treat or cure celiac disease.
    To me, that's a good thing. Still, there are naysayers. Here's a rundown of comments by readers who seem less than enthused about celiac drugs in development.
    Our recent article, An Update on Every Celiac Disease Drug Currently in Development included the comment:
    "Article's fine. Concept's disturbing. Eating a gluten-free diet is the free, already-proven cure for celiac and gluten-intolerance. They don't have to torture mice and likely other animals to find a 'cure' for something that there already is a cure for. I imagine there is $$ for the researchers here and $$ for the animal labs and $$ for the pharmaceuticals."
    Of our article entitled, How Close Are New Celiac Disease Treatments? one reader wrote:
    "I would be very cautious about taking any of these until it was proven absolutely to have no side effects. There always are some and history has shown some to be deadly." Commenting on our article ALV003 Reduces Gluten Damage in Celiac Disease Patients, one reader commented:
    "I only want to know: how long until random internal organs begin to fail or malfunction as a result of yet another new mystery drug? I'd rather starve to death than be a guinea pig for big pharma again."
    Our article on NexVaxx, entitled Is a Vaccine for Celiac Disease Just Around the Corner? included the following comments:
    "Totally agree with vhill seems like a ploy to poison people with GMO foods that come up with a supposed "'cure'. Eat healthy whole foods this is not a curse its a wake up call to be healthy if you didn't have celiac you'd probably be eating processed crap." Balm wrote: "Thanks but no thanks. I'll remain a celiac and continue to eat healthy. While trying to fix one problem, some will end up with far worse problems." Jonnys wrote: "Stupid idea! Just another way to make more money off of people." These are but a few of the largely positive comments we receive, and we hope you enjoyed them as much as we do.

  • Recent Articles

    Jefferson Adams
    Celiac.com 05/26/2018 - If you haven’t tried a savory pancake, then you’ve been missing out. In many places in the world, savory pancakes are more common than the sweet pancakes. They make a great lunch or dinner twist. This gluten-free version combines scallions and peas, but feel free to add or subtract veggies at will. Serve pancakes them warm with butter for a delicious twist on lunch or dinner.
    Ingredients:
    3 large eggs 1 cup cottage cheese ½ stick salted butter, melted ¼ cup all-purpose gluten-free flour 2 tablespoons vegetable oil plus more for skillet 1 cup shelled fresh or frozen peas, thawed 4 scallions, thinly sliced, plus more for serving 1 teaspoon kosher salt plus more, as desired Directions:
    If using fresh peas, blanch the peas about 3 minutes in a small saucepan of boiling salted water until tender, about 3 minutes (don’t cook frozen peas). Drain well.
    In a blender, add eggs, cottage cheese, flour, 2 tablespoons oil, and 1 teaspoon salt, and purée until smooth. 
    Transfer batter to a medium bowl and stir in peas and scallions. 
    Batter should be thick but pourable; stir in water by tablespoonfuls if too thick.
    Heat a lightly oiled large nonstick skillet over medium heat. 
    Working in batches, add batter to skillet by ¼-cupfuls to form 3-inch-4-inch rounds. 
    Cook pancakes about 3 minutes, until bubbles form on top. 
    Flip and cook until pancakes are browned on bottom and the centers are just cooked through, about 2 minutes longer.
    Serve pancakes drizzled with butter and topped with scallions.
    Inspired by bonappetit.com.

    Jefferson Adams
    Celiac.com 05/25/2018 - People with celiac disease need to follow a lifelong gluten-free diet. However, once their guts have healed, they can still be sensitive to gluten. Sometimes even more sensitive than they were before they went gluten-free. Accidental ingestion of gluten can trigger symptoms in celiac patients, such as pain in the gut and diarrhea, and can also cause intestinal damage. 
    A new drug being developed by a company called Amgen eases the effects of people with celiac disease on a gluten-free diet. Researchers working on the drug have announced that their proof-of-concept study shows AMG 714, an anti-IL-15 monoclonal antibody, potentially protects celiac patients from inadvertent gluten exposure by blocking interleukin 15, an important mediator of celiac disease, and leads to fewer symptoms following gluten exposure.
    The drug is intended for people with celiac disease who are following a gluten-free diet, and is designed to protect against modest gluten contamination, not to permit consumption of large amounts of gluten, like bread or pasta.
    AMG 714 is not designed for celiac patients to eat gluten at will, but for small, incidental contamination. Francisco Leon, MD, PhD, study director and consultant for Amgen, says that their team is looking at AMG 714 “for its potential to protect against modest contamination, not deliberately eating large amounts of gluten, like bread or pasta.” 
    Amgen hopes that AMG 714 will help celiac patients on a gluten-free diet to experience fewer or less sever gluten-triggered events.
    Findings of the team’s first phase 2 study of a biologic immune modulator in celiac disease will be presented at the upcoming Digestive Disease Week 2018. 
    Read more at ScienceDaily.com

    Jefferson Adams
    Celiac.com 05/24/2018 - England is facing some hard questions about gluten-free food prescriptions for people with celiac disease. Under England’s National Health Plan, people with celiac disease are eligible for gluten-free foods as part of their medical treatment. 
    The latest research shows that prescription practice for gluten-free foods varies widely, and often seems independent of medical factors. This news has put those prescribing practices under scrutiny.
    "Gluten free prescribing is clearly in a state of flux at the moment, with an apparent rapid reduction in prescribing nationally," say the researchers. Their data analysis revealed that after a steady increase in prescriptions between 1998 and 2010, the prescription rate for gluten free foods has both fallen, and become more variable, in recent years. Not only is there tremendous variation in gluten free prescribing, say the researchers, “this variation appears to exist largely without good reason…”
    Worse still, the research showed that those living in the most deprived areas of the country are the least likely to be prescribed gluten-free products, possibly due to a lower rate of celiac diagnosis in disadvantaged groups, say the researchers.
    But following a public consultation, the government decided earlier this year to restrict the range of gluten free products rather than banning them outright. As research data pile up and gluten-free food becomes cheaper and more ubiquitous, look for more changes to England’s gluten-free prescription program to follow. 
    Read more about this research in the online journal BMJ Open.

    Jefferson Adams
    Celiac.com 05/23/2018 - Yes, we at Celiac.com realize that rye bread is not gluten-free, and is not suitable for consumption by people with celiac disease!  That is also true of rye bread that is low in FODMAPs.
    FODMAPs are Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols. FODMAPS are molecules found in food, and can be poorly absorbed by some people. Poor FODMAP absorption can cause celiac-like symptoms in some people. FODMAPs have recently emerged as possible culprits in both celiac disease and in irritable bowel syndrome.
    In an effort to determine what, if any, irritable bowel symptoms may triggered by FODMAPs, a team of researchers recently set out to compare the effects of regular vs low-FODMAP rye bread on irritable bowel syndrome (IBS) symptoms and to study gastrointestinal conditions with SmartPill.
    A team of researchers compared low-FODMAP rye bread with regular rye bread in patients irritable bowel syndrome, to see if rye bread low FODMAPs would reduce hydrogen excretion, lower intraluminal pressure, raise colonic pH, improve transit times, and reduce IBS symptoms compared to regular rye bread. The research team included Laura Pirkola, Reijo Laatikainen, Jussi Loponen, Sanna-Maria Hongisto, Markku Hillilä, Anu Nuora, Baoru Yang, Kaisa M Linderborg, and Riitta Freese.
    They are variously affiliated with the Clinic of Gastroenterology; the Division of Nutrition, Department of Food and Environmental Sciences; the Medical Faculty, Pharmacology, Medical Nutrition Physiology, University of Helsinki in Helsinki, Finland; the University of Helsinki and Helsinki University, Hospital Jorvi in Espoo, Finland; with the Food Chemistry and Food Development, Department of Biochemistry, University of Turku inTurku, Finland; and with the Fazer Group/ Fazer Bakeries Ltd in Vantaa, Finland.
    The team wanted to see if rye bread low in FODMAPs would cause reduced hydrogen excretion, lower intraluminal pressure, higher colonic pH, improved transit times, and fewer IBS symptoms than regular rye bread. 
    To do so, they conducted a randomized, double-blind, controlled cross-over meal study. For that study, seven female IBS patients ate study breads at three consecutive meals during one day. The diet was similar for both study periods except for the FODMAP content of the bread consumed during the study day.
    The team used SmartPill, an indigestible motility capsule, to measure intraluminal pH, transit time, and pressure. Their data showed that low-FODMAP rye bread reduced colonic fermentation compared with regular rye bread. They found no differences in pH, pressure, or transit times between the breads. They also found no difference between the two in terms of conditions in the gastrointestinal tract.
    They did note that the gastric residence of SmartPill was slower than expected. SmartPill left the stomach in less than 5 h only once in 14 measurements, and therefore did not follow on par with the rye bread bolus.
    There's been a great deal of interest in FODMAPs and their potential connection to celiac disease and gluten-intolerance. Stay tuned for more information on the role of FODMAPs in celiac disease and/or irritable bowel syndrome.
    Source:
    World J Gastroenterol. 2018 Mar 21; 24(11): 1259–1268.doi:  10.3748/wjg.v24.i11.1259

    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