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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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    GLUTEN-FREE DINING OUT


    Melanie Weir

    Celiac.com 04/16/2012 - Can I eat our at restaurants if I’m on a gluten-free diet?


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    Eating out gluten-free is not as easy as it seems.  If you Google "gluten-free restaurants," your bound to find a selection of gluten-free menus and gluten-free yelp reviews.  However, a global definition for gluten-free does not exist in the restaurant world.

    Photo: CC - Unique Hotels GroupMany times, restaurants, bakeries and deli’s offer gluten-free options like salads (with menu side notes like: order salad without croutons or order meat without bread).  If we define gluten-free as less than 20ppm, then the following factors must be followed to ensure safety from gluten contamination (please note this is only a partial list):

    Eating Salads Out

    1. Use of a Separate Strainer: Using a strainer that has been used for pastas or other gluten products, can result in cross contamination.
    2. Salad Dressing: Many salad dressing utilize gluten containing ingredients like malt vinegar, spices, natural flavorings, wheat, etc.
    3. Vegetable Chopping Board: A vegetable chopping board must either be completely sterilized or a gluten-free dedicated board must be used.
    4. Knife: Knife must be sterilized with heat before being used on gluten-free ingredients.
    5. Prep Area: Salad prep stations are often housed beneath shelves filled with bread.  If bread is stored above the salad prep area, then the area cannot be safely maintained as gluten-free.  On an additional note, croutons and other gluten products should not be allowed in the gluten-free prep area (1/6th of a bread crumb is all it takes to be contaminated with gluten).
    6. Salad Toppings: If a topping like chicken, nuts, tofu, peppers or onions are sautéd or prepared on a grill, then the grill and the ingredients must be maintained as gluten-free.
    Gluten-Free on the Grill
    1. A grill must be cleaned before a gluten-free product is cooked on it. A separate area for gluten free foods to be cooked is ideal, but not always possible in restaurant settings.
    2. Many meats are marinated in sauces containing gluten before they are cooked.
    Gluten Free Pizza & Bakery Products
    1. If an exhaust fan is used in the oven, a screen must be used.
    2. Pizza toppings for gluten free pizza should be housed in a separate area.
    3. Cannot be prepared in a facility that uses gluten containing flours, because flour dust in the air settles on food.
    4. Mixing utensils, wooden spoons, scrapes in bowls and cutting boards must be sterile or maintained for just gluten-free products.

    Image Caption: Photo: CC - Unique Hotels Group
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    It isn't necessary, according to the Gluten Intolerance Group of North America (GIG) to have the toppings for a gluten-free pizza stored in a separate area.

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    Guest Gloria Brown

    Posted

    Though once not so sensitive, I now get sick just sitting in a restaurant from breathing gluten which has become suspended in the air and forgetting to wash my hands afterwards from gluten oils on my fingers have picked-up, creating a second-hand contamination (so to speak).

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    Guest Draca

    Posted

    It isn't necessary, according to the Gluten Intolerance Group of North America (GIG) to have the toppings for a gluten-free pizza stored in a separate area.

    Use common sense: if the toppings are not stored seperately they may become contaminated. Who cares what the GIG says. People need to learn to think for themselves.

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    I understand the cleanliness and cross-contamination concerns, but I don't see why knives and cutting boards must be sterilized. Sterilization kills bacteria and viruses but does not get rid of gluten. If you heat a knife that has gluten on it, you will just end up with toasted gluten! Careful washing is sufficient to rid utensils of gluten. Sterilization is not necessary.

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    I'd like more info on heat sterlization. Sterilized gluten sounds like a cross-contamination misunderstanding. I wouldn't eat wheat pasta even if it' sterile. Why not thoroughly wash and rinse knives (assume design and materials don't dictate the knives cannot be adequately cleaned)?

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    Guest blueraiderfan10

    Posted

    It isn't necessary, according to the Gluten Intolerance Group of North America (GIG) to have the toppings for a gluten-free pizza stored in a separate area.

    Yes. this is according to GIG but to be "glutened" just because one wants a pizza is not worth it. (Believe me I know.)

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    Guest Ellen

    Posted

    What's this about sterilizing and heating the knife? This has nothing to do with gluten. I find it annoying when others, let alone others on a gluten-free diet, don't understand the difference between a pathogen and a protein. You cannot "kill" gluten with heat. This might seem like a small matter to pick at, but when we don't understand our own diet and promote ignorance like this, how can we expect other people to understand and take us seriously?

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    Guest Suzanne Thomson

    Posted

    That's a good checklist and it would be great if all restaurants followed these procedures, but in reality I am not convinced that they do. I seem to get glutened every 1 in 3 visit to a restaurant.

     

    I'm also confused about the sterilization of the knife part though! Washing it would make more sense.

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    Guest Joy Rogers

    Posted

    As much of an issue for me is the restaurants that say they have gluten-free items or a gluten-free menu, but seem to be using it as a ploy. I've been to a number of restaurants that claim to provide gluten-free items, but the reality is their choices boil down to either a stripped-down salad or a bland piece of meat and steamed veggies while still charging the full menu price. Grrrr... seriously?! It's not that hard to cook hearty, flavorful meals! I've figured it out, and I am sooo not a trained cook!

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    I know how cross contamination can happen. I am not sure how this helps me dining out as I am not in the kitchen cooking myself.

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    What's this about sterilizing and heating the knife? This has nothing to do with gluten. I find it annoying when others, let alone others on a gluten-free diet, don't understand the difference between a pathogen and a protein. You cannot "kill" gluten with heat. This might seem like a small matter to pick at, but when we don't understand our own diet and promote ignorance like this, how can we expect other people to understand and take us seriously?

    Gluten is a protein, all proteins can be denatured with heat: that is their logic.

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    Daniel Moran
    Celiac.com 05/20/2008 - I am going to be honest—I have not traveled outside the U.S.A. except for Mexico and Canada.  When I went to Mexico it was on a cruise ship, so that meant I could eat on the ship.  I would take snacks to tide me over or get a bag of chips.  Hopefully I will one day be able to tour the world and educate everyone on how to make true gluten-free meals for all of us.  I also hope that my when the time is right I will go on such trips with my loving wife.  So I will tell you how I would approach a trip to another country and you can decide if this is worth a try.
     Planning for the Trip (All per emails and internet and phone calls)

    I would contact the area chamber of commerce or tourist office in the country that I will be going to and see if they have heard of the gluten-free diet or celiac disease. If I was staying at a hotel or resort I would ask them to look into gluten-free meals and if they have a kitchen where I could talk with the executive chef or manager of food and beverages.  I would also tell them that I am a chef from the U.S.A. I would go to celiac.com to locate the nearest celiac support group to where I will be staying.  If there is one I would find out about local spots that I might be able to visit to get gluten-free meals, and if there are any bake shops or natural food stores where I could get some supplies and snacks. I would find a book on the languages that they speak and make a chef Daniel restaurant form so I could eat in a restaurant.  I would have it in all the languages including English for the chef to make sure they understand I am very serous about my health. I would have a card that said “May I speak to the manager and I have a special diet request.” Hopeful I could say that in their language. I would have a gluten-free restaurant card in their language and present it to the chef or manager. I would have a safe and forbidden list in the language where I was visiting.  That way I could check foods from the store so I could eat snacks. I would try to stay at a place with a microwave and possibly a refrigerator.  By doing this if I ran into a language problem I could cook chicken or meats in the microwave (I have cooked whole chickens in a microwave on vacation before and put it in the refrigerator for later). I would carry cards with me to ask for directions or to ask a wait staff for something I might be able to eat.  Like maybe some cheese, beverage, snacks or any type food of the area that I might like.  If you were at a port on the ocean your card could be sauté seafood and with olive oil.  Even if I didn’t look at the menu I would know that because I am at a town on the water, they would have fresh fish coming in. If any of you watch the Travel Channel  you know that there are a lot of different types of foods.  Being a chef I would want to experience all types of different foods.  If I knew something about the local cuisine and how it is prepared before I got there, it could give me an advantage. In Hong Kong I would love to eat some of the hot foods.  Could I eat them?  Is it just the chilies or is it the sauce?  Those are some of the questions I would wonder, so I would research the area and review cookbooks to see how they prepare their foods. If I knew where I would be traveling I would try to contact a local restaurant beforehand to see if I could view their menu for the time when I would be visiting.  If I did this, I could make my Chef Daniel restaurant form up ahead of the visit. I would make sure that when I was at my vacation spot I could get Internet access.  By doing this I could look up restaurants that I see when I am walking around to see if their menus were available online.  Also I would be able to translate a chef Daniel P restaurant form for that place if we decide to go there. I would make sure that I had a phone with internet access to look up info at any time. Also with the phone I could translate a sentence with a Web site I know about.
    As you see I have put a great deal of thought into traveling, but not one of them has been tested.  I wish I could say that these ideas all worked for me and they will for you too.  My thought is that the greatest asset for us celiacs is the Chef Daniel P restaurant form you take into the restaurant.I would have every direction I could give on paper for the chef to see.  When I was cooking I cooked with chefs from around the world.  We all had the same common cause:  To make our customers happy so they will spread the word and come again.  So to me it doesn’t matter if they can read English or Spanish.  It comes down to me as the customer to tell them I have to have a gluten-free meal.  To tell them that if they don’t do as I ask, I could get very sick and it would be their fault, and no restaurant wants to hear that their food caused a person to get sick.
    If you are like me, you are going to want to taste some of the home town small restaurants.  I would know the area as mentioned before, and find out about any fresh vegetables or meats that I would like to try.  On my phone I would access the Internet and I would find information on the town I was in.  When I walked in I would ask for a manager, and if that person doesn’t speak English I would get one of my restaurant cards out to let them read what I am trying to say.  I also would try to read the card out so they could see that I am trying very hard to speak their language.  I believe that shows I am not a stuck up rich person who hires everyone to do what I want. If I mess it up, I would feel it is okay as long as I look like I am trying to commutate to them “I am very serous about my health.”  Asking them questions would be hard but I would have cards with questions on them and I would know what yes or no sound like.  If it was a small café I would ask to talk with the chef.  At least try to speak through my cards and being a chef I usually have no trouble seeing the kitchen.  It is an advantage to be a chef from a very popular resort that is known world wide and I would use that to my advantage.  Even if they never knew of me, I know my way around the kitchen and I would be able to look around to see if I could eat there. I would look to see:

    Is it dirty or clean? Does it look like they cut everything on the same cutting board? Does the cook look very sloppy?
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    Chef Daniel P.


    Jill Schaefer
    Celiac.com 09/11/2008 - After a two-leg flight and multiple trains, Jeff and I finally stepped off the local Circumvesuviana train in sunny Sorrento, our first destination on the fabled Amalfi Coast. It was hot, or as the Italians say, molto caldo. We’d been traveling for nearly 24 hours straight, and as we lugged our bags along the final stretch of cobbled sidewalks toward Casa Astarita, we both felt exhausted, ravenous and more than a bit disoriented.
    Jill: Any nourishment from our 10-hour flight from Chicago to Rome had long since faded. However, American Airlines had made good on its promise to provide Jeff with decent gluten-free meals. The attendant had confirmed his special meal selection at the beginning of the flight, and at both dinner and breakfast he was among the first to be served (much to the envy of the other hungry passengers!).
    Jeff: For dinner American served me a gluten-free meal of blackened chicken on a bed of quinoa, with green beans, melon and a gluten-free German chocolate cookie. Now, airline food is never going to win any Michelin stars, but I was grateful that my meal was gluten-free, hot and reasonably palatable.
    As we checked into Casa Astarita, the helpful receptionist Marella suggested that we try Bar Syrenuse, a nearby ristorante with gluten-free menu options. Marella even gave us a referral card good for a 10 percent discount. After freshening up, we sauntered a couple blocks to the Piazza Tasso, the main square, where we easily found the cheerful and airy establishment.
    Jill: Bar Syrenuse offered a separate gluten-free menu selection. Many of the items, such as the meats and salads, were regular staples on the menu. Jeff had many options to choose from – including gluten-free pasta. I opted for a club sandwich, stuffed with local ham and cheese, and a caffe alla nocciola (hazelnut coffee).
    Jeff: The intense heat of the day was just beginning to break, and I wasn’t in a pasta mood at that moment, so I ordered pollo al forno (grilled chicken with balsamic vinegar, parsley and chili flakes) and an insalata verde (green salad). The food was delicious, and sitting on the terrace made for a lovely introduction to Italy. All this for two for under 25 euros. Perfecto!
    Day Two: Our stay at Casa Astarita included breakfast, and we’d been assured via email of gluten-free options. The staff did not disappoint and even offered to prepare an omelet if Jeff wished. He ultimately chose from the standard offerings of orange/pineapple yogurt, fresh juices, individually brewed coffee, cheese and corn flakes (which for some might best be avoided) before we began our morning walk.
    Jill: During our meanderings through the town and along the cliffs overlooking the spectacular Bay of Naples, we checked out a few potential lunch spots and perused their menus. We decided on a simple outdoor restaurant, Angelina Lauro, near that train station that offered shaded tables and faced a grassy piazza bearing the same name. Jeff had a vegetable and cheese omelet along with fries, which would frequently become his reliable substitute for bread. I had a scrumptious margherita pizza. It was so big that I was able to save half for lunch the next day.
    Jeff: After a short nap followed by another evening walk along the Marina Grande, we again headed for Bar Syrenuse – this time, with gluten-free pasta in mind! We decided to share a few dishes and ordered gluten-free penne pasta with tiny tomatoes, grilled seasonal vegetables and an insalata caprese. The pasta was nicely cooked, with a flavorful sauce. Jill commented it tasted so good she’d have never known it was gluten-free. It was then I realized just how good it felt to be in Italy, sitting outside and eating pasta, an almost forgotten favorite, as the sun went down.
    The manager of Bar Syrenuse is a personable gentleman named Toni. We were able to pull him aside during a pause in his busy dinner rush and ask a few questions about how the restaurant came to offer gluten-free options. Toni explained that there are so many special diets that it is important to offer many choices to attract the fullest clientele, and noted that a wide range of food options is a reflection of good service, which is good for business. Consequently, Bar Syrenuse offers numerous items that cater to a number of specialty diets.
    Day Three: After a torrid afternoon spent traipsing through the ruins at Pompeii, where we’d consumed just a few snacks – gelato, granita and coconut snack bars – we were ready for a proper meal. The day before, we’d spotted several quaint restaurants tucked away in the alleys near our hotel, and so we headed in that direction.
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    Connor Burns
    If you have ever traveled to Newport, RI then you know there are plenty of great restaurants to choose from. But if you have celiac disease or a gluten-intolerance then you know that dining out in an unfamiliar city is very difficult. Luckily, Newport has many gluten-free friendly restaurants that can easily be found if you know about them. I have comprised a list of celiac friendly restaurants in this scenic, colonial city. These restaurants have responded to a survey that was sent to over 100 restaurants and bakeries in Newport. All of the places listed have also stated that they are familiar with the necessary precautions that come with preparing gluten-free food such as avoiding cross-contamination. I have attempted to verify the accuracy of the statements provided by the restaurants to the best of my ability. If you are a tourist or local, I hope this list can help in keeping your gluten-free lifestyle.

    Places that offer gluten-free menus:
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    140 Thames Street Newport, RI
    (401) 849-6334
    www.BrickAlley.comEva Ruth's Specialty Bakery
    796 Aquidneck Avenue Middletown, RI
    (401) 619-1924
    www.EvaRuths.com
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    O'Briens Pub
    501 Thames Street Newport, RI
    (401) 849-6623
    www.theobrienspub.com
    Safari Room at Ocean Cliff (Sunday brunch menu)
    65 Ridge Road Newport, RI
    (401) 849-4873
    www.newportexperience.com
    Tucker's Bistro
    150 Broadway Newport, RI
    (401) 846-3449
    www.tuckersbistro.com
    Yesterday's and the Place
    28 Washington Square Newport, RI
    (401) 847-0116
    www.yesterdaysandtheplace.com

    Places that are familiar with gluten-free foods and offer gluten-free options:
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    27 Connell Highway Newport, RI
    (401) 849-0123
    www.Alittlecafe.usBouchard Restaurant and Inn
    505 Thames Street Newport, RI
    (401) 846-0123
    www.bouchardnewport.com
    Callahan's Café Zelda
    528 Thames Street Newport, RI
    (401) 849-4002
    www.cafezelda.com
    Castle Hill Inn
    590 Ocean Drive Newport, RI
    (401) 324-4522
    www.castlehillinn.com
    * Castle Hill Inn is working with Eva Ruth's bakery to offer more gluten-free options.
    Diego's
    11 Bowen's Wharf Newport, RI
    (401) 619-2640
    www.diegosnewport.com
    Fathoms Restaurant at the Newport Marriott
    25 Americas Cup Avenue Newport, RI
    (401) 849-7788
    Fluke Wine Bar and Kitchen
    41 Bowens Wharf Newport, RI
    (401) 849-7778
    www.flukewinebar.com
    Gas Lamp Grille
    206 Thames Street Newport, RI
    (401) 845-9300
    www.gaslampgrille.com
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    It's My Party Bake Shoppe
    84 William Street Newport, RI
    (401) 619-4600
    www.itsmypartynewport.com
    * Must call in advance to place an order for gluten-free products at It's My Party Bake Shoppe.
    Lucia Italian Restaurant
    186 B Thames Street Newport RI
    (401) 846-4477
    www.luciarestaurant.com
    Mamma Luisa Restaurant
    673 Thames Street Newport, RI
    (401) 848-5257
    www.mammaluisa.com
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    (401) 847-1526
    www.freakyburrito.com
    Sardellas Restaurant
    30 Memorial Boulevard W Newport, RI
    (401) 849-6312
    www.sardellas.com
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    Sushi-go
    215 Goddard Row Newport, RI
    (401) 849-5155
    www.sushi-go.com
    Tallulah on Thames
    464 Thames Street Newport, RI
    (401) 849-2433
    www.Tallulahonthames.com
    The Barking Crab Restaurant
    151 Swinburne Row Newport, RI
    (617) 206-8294
    www.barkingcrab.com
    The Mooring Seafood Kitchen
    1 Sayer's Wharf Newport, RI
    (401) 846-2260
    www.mooringrestaurant.com
    The Smokehouse Café
    31 Scotts Wharf Newport, RI
    (401) 848-9800
    The White Horse Tavern
    26 Marlborough Street Newport, RI
    (401) 849-3600
    www.whitehorsetavern.us
    *Some of these restaurants may only offer naturally gluten-free items, but will be more than willing to accommodate any changes to their options if asked


    Melissa Reed
    Celiac.com 07/24/2014 - People that have celiac disease know one of the main concerns is avoiding gluten when they have meals. Their second biggest concern is the possible co-mingling of ingredients that can contaminate otherwise gluten-free food! So how do you eat at restaurants when you have celiac and still have peace of mind?
    Here is how:
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    Talk about peace of mind; if a restaurant has had the gluten-free food training, know you are safe to eat gluten-free meals there!

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    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