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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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    WHOLE GRAINS FOR A GLUTEN-FREE DIET


    Carol Fenster, Ph.D.

    This article originally appeared in the Autumn 2007 edition of Celiac.com's Journal of Gluten-Sensitivity.


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    Celiac.com 03/19/2015 - Almost half of Americans eat no whole grains at all and those who do eat them only consume a single serving per day—far below the 3 to 5 daily servings recommended by the USDA. People often tell me, "I might eat more whole grains if I just knew which ones to choose and how to prepare them."

    Photo: CC--WholeJourneysThere are many wholesome, gluten-free grains that add flavor, variety, and texture to our diet and—if you read this article—you'll know which ones to choose and you'll learn some easy ways to prepare them at home.

    A Quick Definition of Whole Grain
    What is a whole grain? Scientists use technical explanations, but to me it means the WHOLE grain or seed with everything intact and nothing removed. A whole grain contains the outside layer of bran and fiber, the middle layer or germ which contains important nutrients such as B-vitamins, and the inner part called the endosperm which provides energy and carbohydrates.

    Many whole grains are also naturally gluten-free, including amaranth, brown rice (but not white rice because the outer layers are milled away), buckwheat, hominy, millet, quinoa, sorghum, and teff. These grains are generally available at your natural food store. Some of these grains—such as buckwheat—are actually seeds of fruit but we treat them as grains in cooking. Gluten-free whole oats (or oat groats as they're typically called) are whole grain and are available from www.bobsredmill.com and www.creamhillestates.com. Be sure to check with your physician to see if these gluten-free oats are right for you.

    Whole Grains for Breakfast
    When we think of grains, we think of cereal. And, when we think of cereal, we automatically think of breakfast, so let's start there. Whole grains make terrific hot cereal, but they take a while to cook and most people don't have that much time in the morning.

    Of course, you can always cook whole grains the traditional way on the stovetop the night before, if you have time. In my latest book, Gluten-Free Quick & Easy, I encourage ways to more easily incorporate whole grains into our diets with minimal time investment. This is the perfect opportunity to pull that slow cooker out from the back shelf of your pantry or to invest in a pressure cooker. The slow cooker cooks the whole grains overnight or the pressure cooker does it quickly the night before.

    Slow Cooker Grains. Put 1 cup of any of the whole grains mentioned above, 3 ½ to 4 cups water, and ¼ teaspoon salt in a slow cooker. Cook on low all night and the next morning you have hot, cooked whole grains for breakfast. The grains will have softened and resemble porridge because they absorbed lots of water.

    Pressure Cooker Grains. Be sure to follow your pressure cooker's directions. Lorna Sass, in her James Beard award-winning cookbook, Whole Grains: Every Day, Every Way, suggests using 4 cups water, 1 tablespoon vegetable oil, and ½ teaspoon salt for each 1 cup of whole grain. Brown rice can be ready in 15 minutes while gluten-free oat groats take 30 minutes, but these times are significantly shorter than traditional cooking times. You can cook the grains while you're preparing dinner or after the dinner dishes are done. Drain any extra water from the grains and refrigerate the cooked grains before you go to bed. Unlike the slow cooker method, which produces a more porridge-like consistency, whole grains cooked in a pressure cooker more closely resemble their original shape. Cooked whole grains keep refrigerated for about a week. I simply reheat the refrigerated cooked grains in the microwave oven.

    Regardless of whether I cook the grains in a slow cooker or pressure cooker, I like to mix them with honey, agave nectar, brown rice syrup, chopped nuts, or brown sugar and a sprinkle of cinnamon and flax meal for a marvelous breakfast that is packed with fiber and nutrients.

    If you would like to make your own breakfast porridge with the sweeteners and fruit cooked in it, try my easy Slow Cooker Brown Rice Porridge recipe (page 12).

    Whole Grains as Side Dishes
    Whole grains such as brown rice, buckwheat, millet, quinoa, and sorghum stand in nicely for savory side dishes made from rice, couscous, wheatberries, and bulgur. And, the new gluten-free whole oat groats make nice side dishes as well. You will find an excellent Toasted Oat Pilaf recipe at www.bobsredmill.com that demonstrates how to use the new gluten-free steel-cut oats as a savory dish.

    The basic idea is to add herbs and seasonings to the cooked whole grains in the same way and in the same amounts as you would add them to cooked rice, couscous, wheatberries, or bulgur. Any recipe that uses these grains can be adapted to use your favorite gluten-free whole grains.

    Want to Learn More about Whole Grains?
    If you would like to know more about the whole grain stamp used on store-bought foods, go to www.wholegrainscouncil.org. Or, if you want to learn more about nutritional content of gluten-free grains, see Gluten-Free Diet: a Comprehensive Resource Guide by Shelley Case, RD, (Expanded Edition, Case Nutrition Consulting, 2006). To learn more about cooking whole grains using a variety of methods, see Whole Grains: Every Day, Every Way, by Lorna Sass (Clarkson Potter, 2006). Not all of the grains are gluten-free, but the cooking instructions and innovative preparation techniques for the gluten-free grains are very helpful.


    Image Caption: Photo: CC--WholeJourneys
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    Guest Michael

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    The USDA has no business telling us what to eat. Their food pyramid is nothing but marketing and political propaganda. They asked a nutritionist doctor for her recommendations and ignored her opinions, flipping her pyramid upside down. Read the book "Death By Food Pyramid". Dr. D'Adamo says that grains do no good whatsoever for people with blood type O. Many of us celiacs have to be grain-free and legume-free, as has Dr. Terry Wahls for recovery from MS.

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    Guest Debbie

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    Of course the government is ONLY looking out for our best interests when telling us how much of each food group to eat! They also told us FAT was bad, and now we know otherwise! Knowing what grains are gluten free is fine, but assuming the government, which decides the food pyramid, is correct... is just following the lemming off the cliff!!

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    Gastroenterology, Oct 2003, Vol 125, No 4, p1105-13
    Celiac.com 10/30/2003 – It has long been known that celiac disease is caused by T-cell responses to wheat gluten-derived peptides, but the toxicity of other widely consumed grains has not been well studied. The researchers who conducted this study were aimed at determining the toxic T-cell stimulatory properties of barley hordeins, rye secalins, and oat avenins. Except for one instance, they found that there were no identical T-cell stimulatory gluten peptide matches in these grains. There were, however, similar responses found in "11 homologous sequences in hordeins, secalins, and avenins located in regions similar to those in the original gluten proteins," and seven of the 11 peptides were recognized by gluten-specific T-cell lines and/or clones from patients with celiac disease. The team discovered that key amino acids can be substituted, which will either partially or totally stop the T-cell stimulation by the gluten peptides, and that "single nucleotide substitutions in gluten genes will suffice to induce these effects."
    The researchers conclude: "These results show that the disease-inducing properties of barley and rye can in part be explained by T-cell cross-reactivity against gluten-, secalin-, and hordein-derived peptides. Moreover, the results provide a first step toward a rational strategy for gluten detoxification via targeted mutagenesis at the genetic level."

    Jefferson Adams
    Celiac.com 06/30/2010 - Presently, the only proven treatment for celiac disease is a lifelong gluten-free diet. As part of a gluten-free diet, people with celiac disease are encouraged to avoid consuming foods containing rye, along with avoiding wheat and barley.
    However, there is surprisingly little evidence to document the adverse effects of rye in cases of celiac disease. To address this deficiency, a team of clinicians set out to determine conclusively whether rye should be excluded from the celiac diet.
    The team included S. M. Stenman, K. Lindfors, J. I. Venäläinen,  A. Hautala, P. T. Männistö,  J. A. Garcia-Horsman,  A. Kaukovirta-Norja, S. Auriola, T. Mauriala, M. Mäki, and K. Kaukinen
    They are affiliated variously with the Department of Pediatrics, and the Pediatric Research Center of the Medical School University of Tampere, the Department of Gastroenterology and Alimentary Tract Surgery at Tampere University Hospital, the Department of Pharmacology and Toxicology, the Department of Pharmaceutical Chemistry at the University of Kuopio, the Division of Pharmacology and Toxicology, the Division of Pharmaceutical Chemistry at the University of Helsinki, and Technical Research Centre of Finland.
    The goal of the team was to determine whether rye secalin triggers toxic reactions in vitro in intestinal epithelial cell models to the same degree as wheat gliadin.
    Moreover, they examined whether the harmful effects of secalin can be reduced by germinating cereal enzymes from oat, wheat and barley to hydrolyze secalin into short fragments as a pretreatment.
    The data showed that secalin did trigger toxic reactions in intestinal Caco-2 epithelial cells in a similar manner to gliadin. Secalin triggered epithelial cell layer permeability, tight junctional protein occludin and ZO-1 distortion, and actin reorganization.
    High-performance liquid chromatography and mass spectroscopy (HPLC-MS), showed that germinating barley enzymes best degraded the secalin and gliadin peptides. Further in vitro analysis showed that germinating barley enzyme pretreatment ameliorated all toxic secalin-triggered reactions.
    From these results, the team concludes that germinating enzymes from barley offer efficient degradation of rye secalin.
    In future, these enzymes might be utilized as a novel medical treatment for celiac disease or in food processing in order to develop high-quality celiac-safe food products.
    Such enzyme treatments might pave the way for either new treatments for celiac disease, or, new methods of processing rye for production of new, celiac-safe foods.

    SOURCE: Clinical & Experimental Immunology DOI:10.1111/j.1365-2249.2010.04119.x


    Sheila Hughes
    Celiac.com 05/14/2013 - Despite the fact that millet is more nutritious than wheat, as well as other gluten-free grains, modern science lacks the processing technologies to manufacture it on a large scale. Millet is an age-old grain, however we have yet to harness its full potential due to this drawback.
    The preparation of millet includes fermentation, decortication, milling, and sieving. Most of millet being processed today is currently being down on a household level in rural areas, and due to this fact its availability is limited in urban areas. Another challenge with increasing millet production is making sure the nutritional properties are not depleted during the process.
    Current health benefits of millet include high anti-oxidants which could mean a reduced risk of cancer. It is also used more and more in diabetic products because it is high in polyunsaturated fat.
    While there currently isn't a system to produce millet on a large scale, there is research being done in this area. Perhaps in the near future we will see this grain being produced on the scale needed to make it common place in gluten-free products.
    Source:
    http://www.bakeryandsnacks.com/R-D/Millet-promise-stopped-short-by-processing-shortfalls-review

    Chris Bekermeier
    Celiac.com 10/18/2013 - Buckwheat, sometimes referred to as kasha, is often billed as a “tasty alternative to wheat.” That’s all well and good, but is it really gluten-free, and generally considered safe to eat for those who suffer from celiac disease or a gluten sensitivity?  
    Whether or not buckwheat is tasty is a matter of opinion. However, with so much conflicting information available today, it can be hard to tell what’s gluten-free and what isn’t. Here’s the skinny on buckwheat.
    The Facts
    Good news! With its non-wheat status, buckwheat is safely gluten-free. Buckwheat and wheat are, come to find out, actually from completely different botanical families. Derived from the seeds of a flowering plant, buckwheat is not considered a grain or a cereal (though it may be called a pseudo-cereal—don’t let that scare you).
    Buckwheat, in all of its gluten-free glory, is actually closely related to rhubarb. In addition, it is an excellent source of fiber and nutrients. In particular, buckwheat groats (the small, triangular seeds), when cooked, offer 17 grams of dietary fiber or 68% of the daily requirement for a 2,000 calorie per day diet, as well as 22 grams of protein.
    Nutritionally beneficial and sometimes used in treating symptoms of type 2 diabetes and high blood pressure, buckwheat contains rutin. Rutin, a glycoside, has been known to strengthen capillary walls and improve circulation.
    Like many grains, buckwheat can sometimes be cross-contaminated with wheat during processing, transportation or if it is used as a rotational crop with wheat, so it is important to find non-cross contaminated source of buckwheat—make sure the one you use is certified gluten-free.
    Culinary Uses
    Buckwheat groats make a healthy side dish. Also, if you grind the small seeds of the buckwheat plant, you can make buckwheat flour for use in noodles, crepes, and many other gluten-free products. Using buckwheat flour in your cooking will give a strong nut taste to your dishes. You can also contribute raw buckwheat groats to recipes for cookies, cakes, granola, crackers, or any other gluten-free, bread-like item.
    If you’re feeling more creative, buckwheat makes a good binding agent, and becomes very gelatinous when soaked. If you soak, rinse, and then re-dry the groats you can produce a sort of buckwheat chip that is crunchy and can act as a nice side dish.
    When toasted, buckwheat becomes kasha. You can pick out kasha—vs. raw buckwheat—by the color; it’s a darker reddish-brown. In addition, kasha has a strong toasted-nut scent. Conversely, raw buckwheat groats are typically light brown or green and have no aroma.
    Buckwheat
    So, there you have it. You can use buckwheat and kasha safely as a nutritional, gluten-free alternative to wheat, or to create fun and tasty side dishes with buckwheat groats.
    If you’re looking to stock your pantry with all kinds of gluten-free wheat alternatives for your side dishes or even your main dishes, you can safely go for buckwheat in addition to cornmeal, millet, amaranth, cornstarch, garbanzo beans, arrowroot, quinoa or brown rice. Eating a gluten-free diet doesn’t mean you have to rely on the same old wheat alternative for every dish!

  • 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