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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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    MULTI-GRAIN CONFETTI GLUTEN-FREE MUFFINS


    Jules Shepard

    Celiac.com 01/18/2009 - This recipe was born of my new year's desire to experiment with new grains and flavors to achieve more nutritious results in my baking.


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    I was speaking to a support group last Friday night and one of the audience questions was about this very topic: the concern that gluten-free baking often produces less healthy results. I completely agree.

    Now, much of my gluten-free baking and recipes are already on the low-sugar and low-fat end of the spectrum - something I feel very strongly about in my own diet. Take that statement with a grain of Southern sugar though, because this Southern girl knows that sweets still have their place! As I said in my discussion Friday night, chocolate chip cookies were never meant to be good for you!

    However, wherever possible, I try to reduce the sugar, bake with fruits to reduce the fats, and use alternatives for low glycemic values (like using agave nectar). I also substitute so that most all of my baking now is dairy-free, or I at least offer dairy-free options that are just as good. So many of us celiacs really cannot do the dairy anymore anyway, and gluten-free casein-free diets are finding their way into more and more of our homes as well.

    Enjoy these muffins in good health!

    Multi-Grain Confetti Gluten-Free Muffins

    These muffins are aptly named, as they include a host of alternative gluten-free grains and flours, and when broken open, look like a big new year's party! A beautiful, aromatic and healthy muffin - what a great way to start the year off right! If you don't happen to have any of these other grains on hand, simply use the same measurement of my Nearly Normal All Purpose Flour.*

    Ingredients:

    • 2 cup chai tea: add your favorite chai mix to 1/2 cup hot water (according to package portion directions) OR steep 3 chai tea bags in 1/2 cup lowfat milk (dairy or soy, rice or almond)
    • ½ cup gluten-free oats (I used Gifts of Nature brand)
    • 4 Tbs. butter or Earth Balance Shortening or Buttery Sticks
    • 1/3 cup granulated cane sugar (or granulated Splenda)
    • 2 Tbs. agave nectar or 3 Tbs. honey
    • 2 eggs
    • ½ cup natural applesauce, apple butter or pumpkin butter
    • 1 cup Nearly Normal All Purpose Flour™
    • ½ cup almond meal or brown rice flour
    • 2 Tbs. (1/8 cup) flaxseed meal
    • 2 Tbs. (1/8 cup) mesquite flour
    • 2 tsp. gluten-free baking powder
    • ½ tsp. baking soda
    • 1 tsp. ground cinnamon
    • (½ tsp. vanilla + 1 ½ tsp. pumpkin pie spice if not using flavored chai mix)
    • 1 ½ cups chopped berries (cranberries, blueberries, etc.)
    • 1 cup chopped walnuts (optional)
    Directions:
    Coat muffin tins with cooking oil or line with muffin papers. Preheat oven to 325 F convection (preferred) or 350 static.

    In a small glass bowl (for microwave) or a small saucepan (for stovetop), combine the prepared chai tea with the oats and boil for 2 minutes, stir, cover and set aside.

    Whisk together the dry ingredients and set aside. In a large mixing bowl, cream the butter with the sugar. Beat in the agave nectar or honey, applesauce, eggs and finally, the cooked oat mixture. Gradually stir in the dry ingredients and mix until smooth. Lastly, fold in the chopped berries and walnuts, if using.

    Fill the muffin tins 2/3 full and bake until they are light brown: approximately 15 minutes for mini muffins or 22 minutes for regular muffins. Remove from oven, let cool in the pan.

    *This recipe calls for my Nearly Normal All Purpose Flour. You can find the recipe for this flour in my cookbook, Nearly Normal Cooking for Gluten-Free Eating or in various media links on my website, nearlynormalcooking.com, where you can also by this mix ready-made. It produces amazing results in all your gluten-free baking!

    Multi-Grain Confetti Gluten-Free Muffins
    Finished Multi-Grain Confetti Gluten-Free Muffins



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    admin

    When I started eating gluten-free food I discovered a flour mix in a book called Living Healthy with Celiac Disease, Wendy Wark (AnAffect, 1998). In addition to the standard gluten-free flour mix of tapioca starch flour, potato starch flour and rice flour she added cornstarch and sweet rice flour. The addition of these two flours make a huge difference in the texture, flavor, and moisture content in gluten-free baking. I couldnt understand why more people werent using this superior flour mix so I made it my mission to distribute this recipe around. (If you cant tolerate corn, just substitute the cornstarch with equal parts of sweet rice flour and tapioca starch flour.)
    While Wendy gave me permission to use the flour mix and many of her recipes I failed to tell her I was naming the flour mix after her in my book. She has since told me that she found it on the internet and doesnt know the source of the recipe, she doesnt feel that she should take credit for the mix.
    Recently Authentic Foods decided to mix these flours in their factory and sell it as the Multi Blend Gluten-Free Flour, now available at The Gluten-Free Mall.
    Multi Blend Gluten-Free Flour (Wendy Warks Gluten-Free Flour Mix)
    1 cup brown rice flour (requires refrigeration)
    1¼ cup white rice flour
    ¼ cup potato starch flour
    2/3 cup tapioca starch flour
    ¾ cup sweet rice flour
    1/3 cup cornstarch
    2 teaspoons xanthan or guar gum
    I often use only brown rice flour in the mix as it is healthier and better tasting. I buy at least 5 pounds every time I order (from manufacturers that sell a lot of brown rice flour). I keep it refrigerated and highly recommend it over white rice flour. This flour mix is the basis of many of my sweets, breadsticks, tortillas, waffles etc. I also like to use pure buckwheat, amaranth, and quinoa flour to increase the flavor and healthfulness of certain items. It is important to buy these alternative flours from pure, gluten-free sources. Pure in the sense that they are grown in fields that are not adjacent to wheat fields and that they are processed in a 100% gluten-free environment from the field to your table.
    Triple this flour mix recipe and keep it on hand for all of your baking needs. Once you have the flour mix together you are ready for about a months worth of gluten-free baking.
    The Multi Blend Gluten-Free Flour mix is used cup for cup in recipes such as tortillas, pancakes/waffles, and cookies. If you plan to use this flour mix for cakes, sweet breads or brownies add an additional ½ teaspoon of xanthan gum per cup flour mix. I dont use this flour mix for bread, pizza crust, breadsticks, etc. as they require specific flour combinations for the best results (see Cooking Gluten-Free! A Food Lovers Collection of Chef and Family Recipes Without Gluten or Wheat Celiac Publishing, 2002).

    Jules Shepard
    I've been trying to will the coming of warm springtime weather by baking foods I'll want on my next picnic.  No matter that my kids and I eat them on a tablecloth spread out on the living room floor ... our hearts are in the great outdoors!  Whether you're picnicing indoors or out, these filling snack bars will be a treat everyone will enjoy.  Using a hodgepodge mix of dried fruits I have had on hand, I have made this recipe several times with differing ingredients.  Feel free to substitute with whatever dried fruits and or nuts you have on hand -- the base recipe remains the same -- although I recommend at least using figs in this recipe, as they are high in fiber and minerals like potassium, calcium and iron, and their crunchy sweetness is unmistakable throughout.
    Be sure to let the bars cool before you cut them, and if you have any extra crumbs left behind from cutting the bars, save them to sprinkle on top of yogurt or use as a granola-like breakfast cereal with milk.  Any way you prefer, these nutritious gluten and dairy-free bars are sure to be a hit!
    Ingredients:
    1 cup butter or non-dairy alternative like Earth Balance Buttery Sticks or Shortening Sticks (room temperature)
    1 cup light brown sugar
    1/3 cup granulated cane sugar
    2 large eggs
    2 tsp. gluten-free vanilla extract
    ½ tsp. gluten-free almond extract
    ½ tsp. salt
    ¾ tsp. baking soda
    1 tsp. ground cinnamon
    2 cups Jules Gluten Free All Purpose Flour™ *
    2 Tbs. flaxseed meal
    1 cup chopped pecans or walnuts
    1 cup dried tart cherries or cranberries
    1 cup chopped dried figs
    ½ cup golden raisins or dried blueberries
    ½ cup chopped dried dates, apricots, or other dried fruit (optional)
    Directions:
    (*Note - This recipe calls for Jules Gluten Free All Purpose Flour™ which may be made at home according to directions found in my books, Nearly Normal Cooking for Gluten-Free Eating and The First Year: Celiac Disease and Living Gluten-Free, as well as in various media links on my website. It produces amazing results in all your gluten-free baking!)
    Preheat oven to 350 F.  Prepare a jelly roll pan (approximately 15" x 10") or cookie sheet with raised edges by wrapping foil over the top of the pan and greasing the foil-wrapped pan with cooking spray, shortening or butter.  Set aside.
    In a large mixing bowl, cream the shortening with the sugars, beating until the dough is light and fluffy.  Gradually add in the vanilla and almond extracts and eggs.
    In a separate bowl, whisk together the Jules Gluten Free All Purpose Flour™, baking soda, flax seed meal, cinnamon and salt.  Slowly beat this dry mixture into the first large bowl, mixing until incorporated.
    Chop the dried fruit and nuts and stir into the dough.  Spread the thick dough evenly across the prepared pan and bake for approximately 25 minutes, or until lightly browned on top and a toothpick inserted into the center comes out clean.
    Cool fully before cutting or removing.  Cut horizontally and vertically (like a window pane) to form brownie-sized bars and remove carefully to a plate.  Enjoy!


    Jules Shepard

    Correctly measure your flour. When measuring flour, don’t scoop from the bag with your measuring cup.  This compresses the flour.  Use a spoon to scoop flour into the measuring cup and level off with a knife. This will ensure that your flour is measured properly. Bring your ingredients to room temperature before mixing. It is particularly important for yeast recipes to bring all of your ingredients, such as eggs, to room temperature before adding them together to make bread. Yeast needs warmth to grow and if your ingredients are too cold, it may prevent full yeast growth. Make sure your loaf of bread is actually fully cooked. It is very important not to take your bread out of the oven before it is fully cooked. If the bread has a rubbery layer at the bottom, this usually means it was not fully cooked. The best way to tell if the bread is done is to take a baking thermometer and insert it all the way into the bottom of the loaf. The temperature should be approximately 210 F when it is done. Your bread will keep its shape better overcooked than undercooked, so if in doubt, keep it in the oven a bit longer! My recipes have plenty of moisture, so you shouldn’t worry too much about the bread drying out. If baking by oven method, use metal pans. I have found that glass bread pans do not work as well as metal pans in fully cooking a loaf of bread. Metal pans do not have to be fancy or expensive, and you can often even find them in your local grocery store. Rising issues. A great method for letting your yeast breads rise before baking is to turn on your oven to 200F, then turn it off when it has reached temperature. Put your un-raised bread into the warmed oven with an oiled piece of wax paper on top and let it rise according to directions. Once raised, removed the wax paper and bake according to directions. How to prevent your bread from sinking. When your bread is done cooking, turn off the oven and open the door so that the bread can cool slowly. Taking the bread out of a hot oven and quickly transferring it to a cool counter can sometimes cause the loaf to sink in. If it still sinks, it may have too much moisture in it to support itself fully. It should still taste great, but if you have your heart set on a nice crowned loaf, next time try cutting back on the liquid a bit in that recipe or adding ¼ cup of flaxseed meal to help support the bread's structure and enhance its nutritional value, all in one! Altitude and even the day's weather can affect sometimes picky yeast recipes. How to make a multi-grain loaf of bread. To make a more “whole grain” bread, take a basic recipe (for example, Jules’ Sandwich Bread recipe).  In place of the 2 cups of Jules Gluten Free All Purpose flour, add only 1 ¾ cups.  Replace the final ¼ cup with flax seed meal, buckwheat flour, gluten-free oat flour, brown rice flour, or teff flour.  These flours will add more whole grain flavor and additional fiber.  You can also add seeds (flax seeds, sesame seeds, etc.) to add crunch and fiber.  With this amount of different flours, you do not need to adjust the recipe at all.    


    Jefferson Adams
    Celiac.com 05/20/2013 - A team of researchers recently looked at the influence of various proteins on the quality of gluten-free bread formulas. Specifically, the team looked at the influence of different concentrates or isolates of protein on the structure, properties and aging of gluten-free bread.
    The research team included Rafał Ziobroa, Teresa Witczakb, Lesław Juszczakc, and Jarosław Korusa. They are affiliated with the Department of Carbohydrates Technology, the Department of Engineering and Machinery for Food Industry, and the Department of Analysis and Evaluation of Food Quality, at the University of Agriculture, in Krakow, Poland.
    For their study they made gluten-free breads from dough that included albumin, collagen, pea, lupine or soy protein.
    They then analyzed the rheological properties of the dough, and found that bread made with added test proteins showed major differences in its visco-elastic properties.
    Different flours had different effects on specific volume of the loaves. Soy protein and collagen reduced bread volume, while lupine and albumin significantly increased bread volume.
    In each case, the added proteins had a noticeable impact on the color and textural properties of bread crumbs.
    Most of the protein preparations significantly decreased hardness and chewiness of the crumb compared to the control sample.
    Overall, the dough that contained pea protein yielded bread with the most acceptable qualities. The study demonstrated that pea protein created the most acceptable flavor, color, smell and bread crumb in the final product.
    Soy protein proved to be the least acceptable of those tested, as it produced loaves with smaller volume and a compact structure. The results of this study show that adding pea protein can improve bread quality, and help to slow staling of starch based bread.
    Source:
    Science Direct

  • Recent Articles

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

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

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

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

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

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

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

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

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

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

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

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

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

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

    Jefferson Adams
    Celiac.com 04/16/2018 - A team of researchers recently set out to investigate whether alterations in the developing intestinal microbiota and immune markers precede celiac disease onset in infants with family risk for the disease.
    The research team included Marta Olivares, Alan W. Walker, Amalia Capilla, Alfonso Benítez-Páez, Francesc Palau, Julian Parkhill, Gemma Castillejo, and Yolanda Sanz. They are variously affiliated with the Microbial Ecology, Nutrition and Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), C/Catedrático Agustín Escardin, Paterna, Valencia, Spain; the Gut Health Group, The Rowett Institute, University of Aberdeen, Aberdeen, UK; the Genetics and Molecular Medicine Unit, Institute of Biomedicine of Valencia, National Research Council (IBV-CSIC), Valencia, Spain; the Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire UK; the Hospital Universitari de Sant Joan de Reus, IISPV, URV, Tarragona, Spain; the Center for regenerative medicine, Boston university school of medicine, Boston, USA; and the Institut de Recerca Sant Joan de Déu and CIBERER, Hospital Sant Joan de Déu, Barcelona, Spain
    The team conducted a nested case-control study out as part of a larger prospective cohort study, which included healthy full-term newborns (> 200) with at least one first relative with biopsy-verified celiac disease. The present study includes 10 cases of celiac disease, along with 10 best-matched controls who did not develop the disease after 5-year follow-up.
    The team profiled fecal microbiota, as assessed by high-throughput 16S rRNA gene amplicon sequencing, along with immune parameters, at 4 and 6 months of age and related to celiac disease onset. The microbiota of infants who remained healthy showed an increase in bacterial diversity over time, especially by increases in microbiota from the Firmicutes families, those who with no increase in bacterial diversity developed celiac disease.
    Infants who subsequently developed celiac disease showed a significant reduction in sIgA levels over time, while those who remained healthy showed increases in TNF-α correlated to Bifidobacterium spp.
    Healthy children in the control group showed a greater relative abundance of Bifidobacterium longum, while children who developed celiac disease showed increased levels of Bifidobacterium breve and Enterococcus spp.
    The data from this study suggest that early changes in gut microbiota in infants with celiac disease risk could influence immune development, and thus increase risk levels for celiac disease. The team is calling for larger studies to confirm their hypothesis.
    Source:
    Microbiome. 2018; 6: 36. Published online 2018 Feb 20. doi: 10.1186/s40168-018-0415-6