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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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    YOUR GUIDE TO A FABULOUS GLUTEN-FREE THANKSGIVING HOLIDAY!

    Jefferson Adams

    By Jefferson Adams

    Celiac.com 11/11/2011 - Once again, Thanksgiving looms, as does the specter of pulling off a smooth, tasty, gluten-free dinner on the big day.


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    To help make that goal an easy reality, celiac.com once again offers up a heaping of gluten-free information and recipes to help make your gluten-free Thanksgiving celebrations a smashing success!

    For those cooking a gluten-free turkey dinner at home, these helpful tips will make your work easier:

    • Gluten-Free TurkeyFirst,be certain to start with a 100% gluten-free turkey for your gluten-freeholiday dinner. Gluten? In my turkey? Yes! Many brands use gluten whenprocessing their turkeys. Don't assume your turkey is gluten-free. Besure to check the ingredients list. Celiac.com offers a fairlycomprehensive list of safe gluten-free foods and ingredients, along with gluten-free shopping guides to make gluten-free shopping easier.
    • Next,be certain to serve only gluten-free stuffing! Accept no substitute.Don't risk putting gluten-based stuffing in your turkey. Instead,astonish and satisfy all of your guests by preparing celiac.com'sdelicious Best Gluten-free Holiday Stuffing Recipe.
    • Lastly,prepare a simple, delicious gluten-free gravy using Celiac.com'sThanksgiving Holiday Gluten-Free Turkey Gravy recipe, or your favoritegluten-free gravy mix. Thicken homemade gravy with either corn starch orarrowroot flour.
    • Be careful:  Many bouillon cubes contain wheat or gluten, so make sure to use only gluten-free bouillon cubes.
    Make easy, tasty gluten-free side dishes using Celiac.com's extensive listing of gluten-free recipes.

    Order gluten-free baking ingredients and other hard-to-find items like prepared gluten-free pies ahead of time for convenience—this will allow you to spend more time with friends and family rather than spending all of your time in the kitchen!

    Many excellent prepared gluten-free products can now be ordered and delivered directly to your door from places like the Gluten-Free Mall, and your purchases there actually directly support Celiac.com.

    Gluten-free Thanksgiving Recipes:

    Our Great Brined Turkey recipe offers a fabulous way to prepare your gluten-free turkey that will leave your guests quizzing you about your secrets to such a moist, savory bird.

    Spiced Pumpkin Soup makes a delightful holiday treat for yourself, your family, or your guests.

    Gluten-free Stuffing is a holiday staple that keeps them coming back for more.

    Gluten-free Gravy is the perfect topping to your delicious stuffing. If you don't want to prepare your own, be sure to use a gluten-free gravy mix.

    Meanwhile, our recipe for Red Pepper Pumpkin Seeds is sure to delight, and makes a great addition to the holiday snack bowl.

    In addition to our ever-popular recipe for Gluten-free Pumpkin Pie, we offer this delicious variation:

    Ginger Crust Pumpkin Pie:

    Gluten-Free Pumkin PieIn anticipation of the next two months worth of feasting, I’ve been tinkering with this Thanksgiving classic. The crust is perfectly spiced and also goes well with sweet potato pies. A dollop of fresh whipped cream and you’re good to go. Coconut flakes also make a tasty topping.

    Ingredients:

    Crust
    1 ½ cups gluten-free gingersnaps
    ½ cup walnuts
    3 tablespoons light brown sugar
    ¼ teaspoon ground nutmeg
    4 tablespoons melted butter

    Filling
    1 ¼ cup canned pumpkin
    ½ cup sweetened condensed milk
    1 teaspoon each ground ginger, cloves, and cinnamon
    ½ teaspoon salt
    ½ cup sugar
    ¼ teaspoon vanilla extract
    2 eggs, lightly beaten

    Directions:
    Preheat oven to 350 degrees F and lightly butter a 9-inch pie dish.

    For the crust, combine cookies, walnuts, brown sugar, and nutmeg in a food processor and grind to a powder. Slowly add melted butter and pulse until mixture forms clumps. Spread evenly over the pie dish press down until tightly packed. Set aside.

    In the bowl of a mixer, combine pumpkin and condensed milk. Add sugar and salt and beat until well-combined. Add eggs, then vanilla and spices.

    Pour filling into the unbaked pie crust and bake for 40-50 minutes, or until center is set. Cool on a wire rack before serving.

    Image Caption: Photo: Jefferson Adams
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    Guest Jen B.

    Thanks! I use crushed Gluten-Free Corn and/or Rice Chex in place of bread crumbs in my stuffing.

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    Jules Shepard
    Ok, I know these cookies aren't free from peanuts, but they are peanut butter cookies, after all!  If you can do almonds, but not peanuts, definitely try this recipe with almond butter – yum!
    For the rest of us with other dietary restrictions, take heart! These cookies fit the bill! They're delicious, and still gluten-free, dairy-free, egg-free, soy-free, and sugar-free! Yes, they even have a low glycemic index! Enjoy these cookies on their own, or add chocolate chips (dairy-free chips are great too!) for a change of pace. High protein, loads of vitamins and minerals, dietary fiber – it's all there, and in a cookie!!!  Maybe I should have called these “Guilt-Free Cookies”!!!
    Don't be daunted by some of the unusual flour ingredients. Try them if you will, or just use my all purpose blend instead, for a quick and easy recipe substitution.
    Ingredients:
    1 ½ cups peanut butter (natural or no sugar added)
    ¾ cup agave nectar (light or dark)
    1 Tbs. gluten-free vanilla extract
    ¼ cup unsweetened applesauce
    ½ tsp. salt
    1 cup Nearly Normal All Purpose Flour*
    ¾ cup buckwheat flour (or Nearly Normal All Purpose Flour)
    2 Tbs. mesquite flour (or Nearly Normal All Purpose Flour)
    2 Tbs. almond meal (or Nearly Normal All Purpose Flour)
    ½ cup+ chocolate chips (optional)
    Cinnamon and sugar (or granulated splenda) mixture (or cinnamon only) for tops of cookies
    *Nearly Normal All Purpose Flour may be made using the recipe found in my cookbook, Nearly Normal Cooking for Gluten-Free Eating, or on my Web site.
    Directions:
    Preheat oven to 350 F.
    Blend peanut butter and all liquid ingredients together, then add in the dry ingredients, mixing until fully incorporated.
    Prepare a cookie sheet lined with parchment paper. Roll balls of dough approximately the size of ping pong balls in your hands and place on the prepared cookie sheet. Dip a fork in the cinnamon-sugar mixture and press into each cookie to flatten with a criss-cross design.

    Bake for 10-12 minutes and remove to cool on the pan.

    Finished "Free-From" Peanut Butter Cookies
     
    Connie Sarros
    This article originally appeared in the Spring 2003 edition of Celiac.com's Journal of Gluten-Sensitivity.
    Celiac.com 12/14/2011 - Finding a slice of pre-packaged gluten-free bread that is 100% enjoyable seems to be the bane of many celiacs.  So you finally decide to make your own.  You read up on baking breads; you spend money to buy the ingredients; you take the time to prepare the mixture, then you put your creation in the oven.  Oh, the wonderful aroma of bread begins to fill the air.  You wait in anticipation.  Finally, the oven timer goes off and you remove your creation, only to discover that something went terribly wrong!  Don’t despair.  Below are some of the more common problems and solutions. 
    Bread machines have become very popular.  While they are tooted as being time-savers, baking bread in the oven actually takes very little extra time and effort, and usually yields better results.
    The most common complaint in gluten-free bread-baking is that the top of the loaf is dark brown while the inside is still doughy.  If this is a problem for you, try lowering the oven temperature by 25 degrees the next time you bake, and set your oven rack higher.  After the loaf is partially baked, cover it with a piece of foil for the remainder of the baking time.  A sure-fire way to get the inside to bake thoroughly is to use two small loaf pans instead of one large one.  Something else that will cause your bread not to bake through is the density factor, which leads us to issue number two.
    Number two in the complaint department is that gluten-free breads are too dense and heavy.  The alternative flours are heavier than wheat flour, so “tricks” must be played with the dough to obtain lighter, wheat-like results.   The use two smaller pans to bake the bread instead of a single large pan will also help avoid this problem by giving the bread more room to expand.  You can also use a bit more leavening and sugar (the sugar-to-yeast ratio must remain the same for the bread to rise properly).  Use only fresh yeast that is dissolved in warm—not hot—liquid; if the liquid is too hot, the yeast will not rise properly.
    Another trick is to have all of the liquid ingredients at room temperature, and then whip the liquid ingredients together in a blender to incorporate more air before adding them to the flour mixture.  You can also use a little less xanthan gum, and be sure to blend the dough mixture thoroughly, and then knead it a little more.
    The issue of how much liquid to use to make your bread lighter is much more confusing.  If you are using an egg replacer, you may need to add a little more liquid to replace the liquid in eggs.  If you use extra large eggs, and your bread is too dense, try using a smaller size egg.  For a lighter loaf of bread, use slightly less liquid in the recipe; this also applies if you live at a high altitude.  When baking at very low altitudes, slightly increase the amount of liquid.  If you are not confused yet, then continue reading!
    Different gluten-free flours absorb different amounts of liquids.  Some alternative flours require that you add more liquid to your recipe to prevent the loaf from being too dry and crumbly, while others require that you reduce the amount of liquid used to enable the loaf to be lighter and less dense so that it will bake evenly all the way through.  Now “humidity” quietly enters into the picture.  If it is humid, reduce the amount of liquid.  Ultimately, only experimentation will determine exactly how much liquid will be needed for the flours you are using.
    Have you ever taken a perfect loaf of bread out of the oven, only to watch it slowly collapse as it cools?  You are not alone.  This usually indicates that the bread is not completely cooked inside.  The simplest remedy is to use two smaller baking pans instead of one large one.  Increase your oven temperature slightly, and slightly decrease the amount of liquid used.
    After experimenting and adjusting oven temperatures, amounts of liquids used, types of flours used, you finally remove the perfect of loaf bread from the oven.  You wait in anticipation for it to cool.  You get out the knife to cut your first slice—and it crumbles.  Oh, the disappointment!  The dough was too dry, resulting in a loaf that will not hold together.  First—do not throw out the crumbs!  Put them in a small freezer bag and freeze them for the day when you want to make bread dressing, croutons, a crumb topping for a casserole, or breadcrumbs to coat fish, chicken or pork chops, or for use in a meatloaf. 
    To avoid the crumbling when you make bread in the future, reduce the amount of flour mixture slightly.  Add a little more binding by increasing the amount of xanthan gum or dough enhancer.  Use milk (cow, soy or rice) in place of the water called for in the recipe.  Once the bread is baked, cool the loaf completely before slicing it with a serrated knife that has been sprayed with a gluten-free nonstick spray.
    There are many variables when baking with gluten-free flours and yeast.  The important thing to remember is that the “real” taste of bread is achievable.  All the time spent in trial and error will be worth it—enjoy!
     
    No-Knead Toasting Bread
    This bread slices without crumbling, is moist, and is perfect for toasting!
    Ingredients:
    3 eggs
    1 ½ Tbsp. warm water
    1 Tbsp. quick-rising gluten-free yeast
    ¾ tsp. sugar
    ¾ cup milk
    2 cups gluten-free flour mixture
    ½ tsp. gluten-free baking powder
    1 tsp. cinnamon
    ¼ tsp. salt
    ½ cup + 1 Tbsp. sugar
    ¼ tsp. cider vinegar
    2 tsp. gluten-free mayonnaise
    4 Tbsp. butter, melted
    ½ cup gluten-free flour mixture*
    1 egg
    1 Tbsp. sesame seeds
    Directions:
    Place 3 eggs in a bowl of warm water for 10 minutes.  In a small bowl, stir together the 1 ½ Tbsp. warm water, yeast, and ¾ tsp. sugar; set aside for 15 minutes.  Scald milk, then let it cool till lukewarm.  Sift together the 2 cups flour mixture, baking powder, cinnamon, salt, and sugar; set aside.  In a mixer bowl, mix together vinegar, mayonnaise, eggs and melted butter.  Add the yeast and milk and beat until smooth.  Slowly add the flour mixture, beating at low speed until blended.  With a spoon, stir in the remaining ½ cup of flour mixture.   Generously spray a loaf pan (9X5”) with gluten-free nonstick spray.  Spoon the batter into the pan.  Dip a spoon in a little gluten-free flour and use the back of the spoon to smooth the dough in the pan.  Whip the remaining egg with a few drops of warm water, then brush this egg mixture on top of the loaf.  Sprinkle loaf with sesame seeds.  Spray one side of a piece of waxed paper with gluten-free nonstick spray; cover loaf with paper, sprayed side down.  Place a bowl of very hot water on the bottom shelf of the oven.  Place the loaf pan on the shelf above the water.  Close oven door and let the dough rise for 1 hour.  Remove water and loaf pan from oven.  Preheat oven to 350F for 10 minutes.  Remove waxed paper and place bread in oven to bake for 25 to 30 minutes.  If the top of the bread is browning too quickly, cover pan with a sheet of foil until loaf is baked through.  Let baked bread sit in pan for 5 minutes, then remove bread and let it finish cooling on a wire rack.  If you are not going to be eating the bread the day you bake it, wrap it well and freeze it.  Spray a serrated knife with gluten-free nonstick spray to cut the bread.
    *Gluten-free Flour Mixture:
    The flour mixture I use is a combination of rice, potato starch, tapioca and garbanzo bean flours, cornstarch and xanthan gum.  If you are allergic to any of these products, alternative flours may be substituted.
    Jefferson Adams
    Celiac.com 04/26/2013 - A team of researchers recently looked at the influence of grain size on the quality of gluten-free bread formulas. Specifically, the team looked at the influence of different maize flour types and their particle sizes on the quality of two types of gluten-free bread.
    The research team included E. de la Hera, M. Talegón, P. Caballero, M. Gómez. They are affiliated with the Food Technology Area of E.T.S. Ingenierías Agrarias at Valladolid University in Palencia, Spain.
    Maize is a grains that is safe for celiacs to eat. Along with rice, maize is the most cultivated grain in the world. However, while some gluten-free breads include maize in their recipes, there is very little study data on how maize flour impacts gluten-free bread quality.
    For their study, the team looked at the influence of different maize flour types and their particle sizes on the quality of two types of gluten-free bread; one made with 80% water in the formulation, and the other made with 110% water.
    They also analyzed the microstructure of the dough and its behavior during the fermentation.
    The team found that finer flours had a lower dough development during fermentation in all cases. Among the different types of flour, those whose microstructure revealed compact particles were those which produced higher specific bread volume, especially when the particle size was greater.
    Overall, the dough with more water gave breads with higher specific volume, an effect that was more important in more compact flours. The higher volume breads were also softer and more resilient.
    This study shows that type of corn flour and mainly its particle size have a profound influence on the development of gluten-free bread dough during fermentation, and thus on the final volume and texture of the breads.
    The flours with coarser particle size are the best for making gluten-free maize-based breads.
    Still, the study notes that factors beyond flour particle size, such as the maize variety and milling process, influenced the viability of maize flour in gluten-free breads and suggest that these factors should be studied in greater depth.
    Source:
     J Sci Food Agric. 2013 Mar 15;93(4):924-32. doi: 10.1002/jsfa.5826.
    Connie Sarros
    This article originally appeared in the Winter 2004 edition of Celiac.com's Journal of Gluten-Sensitivity.
    Celiac.com 09/25/2014 - Every year, life seems to get more hectic.  There is never enough time to get the things done on the ever-growing “to-do” list, let alone find time to relax.  Then you are diagnosed with celiac disease and suddenly realize you can no longer stop at Subway for a hoagie sandwich on your way home.  You get a sinking feeling in the pit of your stomach as you acknowledge that you will have to actually cook most of your own meals at home!  
    There is no need to panic.  There are many shortcuts that can help you get in and out of the kitchen faster.  Here are just a few:
    Make a list of all the items you buy at the grocery store.  Make your list very specific, organized by aisles at the store.  Print off multiple copies.  As you run out of things during the week, put a check mark next to the item on your list.  When it is time to go shopping, most of your list will already be done. Keep a “basic pantry.”  These are items you should always have on hand.  Not only does this include spices, household cleaners, paper products, and canned goods, but a back-up pantry meal is always good to stock as well.  This can be anything from cans of beans for a bean salad, gluten-free pork and beans or a can of tuna fish, to gluten-free spaghetti and gluten-free spaghetti sauce. Make extras.  If you are making soup, chili, spaghetti sauce, marinated chicken breasts, cookie dough, etc., make two or three times the quantity you need; freeze the extra portions so you have meals that just need to be popped into the microwave on the days you don’t have time to cook. Use disposable foil cookware for those really messy recipes.  Also, dish out dinners in the kitchen, from pot to plate; that way, you won’t have serving dishes to wash. Soak whole potatoes in hot water before baking them—they will cook much faster.  When potatoes need peeling, peel them after they are cooked when they are cool enough to handle and the skins will slip right off. Use leftovers to make a different meal.  Open a bag of ready-to-use lettuce and top it with last night’s leftover corn, taco filling, diced tomatoes, and sprinkle with gluten-free cheddar cheese.  Or top the salad with thin slices of the leftover roast beef, diced leftover asparagus spears…you get the idea.  You can also chop leftovers into bite-sized pieces and place them in a resealable freezer bag, and the next time you have leftovers toss them in.  When the bag is full, open a large can of gluten-free chicken or beef broth, add the contents of the bag, and voila—you have Recycled Soup! Save the crusts.  If you can’t get the kids to eat their crusts, trim them from their bread and store them in a resealable freezer bag (gluten-free bread is too expensive to buy and too time-consuming to make to throw out the crusts!).  When the bag is full, let the crusts dry out for 24 hours, then run them through a food processor or blender, adding spices like dried parsley, garlic powder, paprika, and/or Italian seasoning, and make breadcrumbs. Use a crock pot.  There are many meals that can be made in crock-pots, such as the recipe that follows.  Cut up your leftover veggies and meat from the night before.  You can also cut up potatoes ahead of time and soak them in cold water in the refrigerator.  In the morning, layer everything in the crock pot, add some liquid (gluten-free barbecue sauce, gluten-free spaghetti sauce, tomato sauce, gluten-free broth, or salsa), turn the temperature to low or slow cook, and eight hours later your meal is ready. With a little practice and planning, you can enjoy healthy, quick, gluten-free meals.  Planning ahead is the key to saving time.  Plan your meals for the week, including how you are going to use up the leftovers.  There definitely is time for “life after cooking” on a gluten-free diet.  You can find more quick meal ideas in my book, Wheat-free Gluten-free Cookbook for Kids and Busy Adults.
     

  • 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