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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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    WHITE BREAD (GLUTEN-FREE)


    admin

    This recipe has been modified from Bette Hagemans Butter Basted White Bread (More From the Gluten-Free Gourmet, page 38). Here it is:


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    Combine 2 cups white rice flour, ½ cup potato starch flour, ½ cup tapioca flour, 2 ½ teaspoon xanthan gum, 2/3 cup dairy milk powder, 1 ½ teaspoon salt, 2 tablespoons plus 1 teaspoon sugar and 2 ¼ teaspoon saf-instant yeast granules thoroughly. In a separate bowl, combine 4 tablespoons melted butter, 1 cup warm water, 1 teaspoon apple cider vinegar. Slowly add to dry mixture, then add 3 room temperature eggs, one at a time (the mix should feel a little warm). Beat on high for 2 minutes. Cover with plastic wrap and a towel, and rise until doubled (time varies). After the first rise, beat the dough again for 3 minutes on high. Fill a large loaf pan 2/3 full (can use extra dough in muffin tins) Let rise until slightly over top of pan; bake at 350 for 30-45 minutes, covering with alum foil after the first 10 minutes. Delicious, and freezes pretty well.

    This recipe comes to us from Marne L. Platt in New Jersey.


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    Guest Whitney

    Posted

    This bread is very buttery and rich and full of flavor! The texture is similar to a biscuit. I have had problems getting the bread to rise before baking it, but when it does rise, it comes out with nice air bubbles in the bread. This bread is great for sandwiches or just eating plain. Thanks

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    Potato starch flour is what exactly? I live in Costa Rica and have a very hard time finding ingredients listed as such...

    Could I substitute with Potato flakes? Help please...thank you so much!

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    Potato starch flour is what exactly? I live in Costa Rica and have a very hard time finding ingredients listed as such...

    Could I substitute with Potato flakes? Help please...thank you so much!

    Hi Amie, potato starch is not the same as potato flakes. Substitute with corn starch.

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    admin
    This recipe comes from Great Gluten Free Goodies by Rebecca Reilly:
    1 cup sugar
    ½ cup butter, softened
    2 eggs
    3 ripe bananas
    pinch salt
    1 teaspoon baking soda
    2 cups gluten free mix
    ½ teaspoon xanthan gum
    Cream the butter. Add sugar and continue creaming for several minutes Then add the eggs, one at a time. Mash the bananas with a fork, then stir into mixture. Add salt. Mix flour, soda, xanthan together. Gently stir into batter. Spoon into greased pan. Bake at 350 for 1 hour. This is great toasted with butter and cinnamon or honey on top.

    admin
    This recipe comes to us from Jessie James of Canada.
    Here is my very favorite recipe which has evolved over many years of trial and error:
    2 ½ cups brown rice flour
    2 cups white rice flour
    ½ cup bean flour (or potato or tapioca or white rice flour)
    ¼ cup garbanzo bean flour
    2 + 2 tablespoon sugar
    1 ½ teaspoon salt
    1 teaspoon Cream of Tartar
    1 teaspoon baking soda
    ½ cup flax seed (fresh ground in blender)
    1 packet of traditional yeast granules
    2 eggs (room temp)
    ½ cup oil or melted butter
    Method: Put 2 Tablespoon sugar in 2 cups warm water and stir. Add yeast and stir. Leave in a warm place for a few minutes to develop yeast. Sift dry ingredients into large mixing bowl, except flax. Grease two bread pans (13 x 4 ½ is good). Add flax to dry ingredients - do not sift it. Mix flax in well. Add two eggs and ½ cup of oil or melted butter to warm yeast mixture. Whisk until frothy. Pour into dry ingredients and mix. Add another cup of warm water. Batter should be like a thick cake batter - just pourable. Add water a bit at a time and continue stirring to get desired consistency. Do not over beat but be sure all ingredients are thoroughly mixed with no lumps.
    Pour into greased pans and set in warm place to rise for about an hour. Bake at 350 degrees F for one hour. Test with cake tester which should come out clean. Sides should be pulling away from pan. Do not under bake. Up to 20 min. extra wont hurt it. Turn pans upside down on cake racks for 5 min. Remove bread from pan and let cool upside down on rack. When cool, slice with topside down and freeze.
    This makes about 20 slices per loaf. They separate easily with the point of a knife when frozen. To use, toast in gluten-free toaster or on cookie sheet in oven. I toast them 3 times to get right degree of browning. Oven works best.

    admin
    This recipe comes to us from Pat Mazza.
    3 cups of gluten-free(Betty Hagman) Flour Mix **
    1 egg
    1 tablespoon gluten-free baking powder
    2 cups of buttermilk
    1/3 cup of sugar
    ¼ cup melted butter
    2 ½ teaspoons of xanthan gum
    1 teaspoon of salt
    1 teaspoon of gluten-free baking soda
    ½ cup raisins
    Preheat oven to 325F. Grease a loaf pan. Sift dry ingredients together. Whisk milk and egg together, and then add to dry ingredients. Add butter and mix until combined, do not over mix. Add more buttermilk if it seems too dry. Put in prepared pans and bake 50-55 minutes. Check to see if done wit a toothpick and the top is brown. Put pats of butter on top while still hot, if desired.
    **The gluten-free mix is from the Betty Hagman books:
    2 parts white rice flour or 6 cups or 3 cups
    2/3 parts potato starch flour or 2 cups or 1 cup
    1/3 part tapioca flour or 1 cup or ½ cup

    admin
    This recipe comes to us from "Juliet" in the Gluten-Free Forum. It was adapted from The Wheat-Free Cook - Gluten-Free Recipes for Everyone by Jacqueline Mallorica.
    Servings: 8
    Active Prep Time: 5 - 10 minutes
    Cooking Time: 12-14 minutes, 10 minutes cooling time
    Ingredients:
    ¼ cup flaxmeal
    ½ cup brown rice flour (preferably superfine grind)
    ¼ cup potato starch
    ½ teaspoon baking soda
    ½ teaspoon baking powder
    ½ teaspoon xanthan gum
    ½ teaspoon fine sea salt
    1 teaspoon sugar
    ¾ cup buttermilk (or ½ cup plain whole milk yogurt plus ¼ cup milk)
    1 large egg
    2 tablespoons extra virgin olive oil
    Cornmeal for dusting pan (optional)
    Directions:
    Preheat the oven to 450ºF, and heat either a 9” cake pan or heavy, well-seasoned 8 ½” skillet at the same time. Combine all the dry ingredients (minus the cornmeal) and mix well (I use a whisk). In a separate bowl, whisk together the buttermilk, egg, and 1 tablespoon of oil. Using an oven mitt, remove the hot pan from the oven. Add the remaining tablespoon oil and swirl it around to coat the bottom of the pan. Dust the pan with the cornmeal, if using. Pour the liquid ingredients into the dry ingredients, mix until smooth and scrape the batter into the hot, oiled pan. Spread the dough out as evenly as possible inside the pan. Transfer to the oven and bake until brown and crusty, 12-14 minutes. Flip the bread out onto a wire rack, and let cool for 10 minutes before cutting into wedges.
    Option: Use an 8” square pan for more rectangular pieces of bread.


  • Recent Articles

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
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    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
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    fdfworld.com

    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.
     
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    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.
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    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.
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    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