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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 IN KEY WEST FLORIDA


    Hallie Davis

    Celiac.com 10/02/2009 - My hubby and I just returned from a wonderful 5 days in Florida’s Key West, and so I want to write about it  while it is fresh in my memory, for I think my experience may benefit others who are trying to stay gluten-free during a stay there.


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    In preparation for this trip, I first made a list of the top 20 rated hotels and bed and breakfasts (B&B) according to information I found on the internet. I made a separate list of restaurants, bars, and health food stores that also had received good reviews as to being able to provide gluten-free food. We had heard that it is not necessary to rent a car on Key West, so I wanted our hotel to be close to as many of the gluten-free sources of food as possible. So then I found each hotel on Mapquest, and then used the “find nearby” feature to get a list of restaurants near each, noting how many were also on my gluten-free list.

    I discovered that two hotels dominated in being close to multiple restaurants of my gluten-free list: The Gardens Hotel, and Seascape An Inn. Both were close to the main street, which is Duval Street. The Gardens was also close to Pepe’s, Santiago Bodegas, Mangoes, Help Yourself, The Café, Sugar Apple, and Blue Heaven. On the other Hand, Seascape was slightly closer to Duval Street, just around the corner from Hemingway House, and close to Sugar apple, Blue Heaven, Mangoes, and Santiago Bodega’s.

    I called both to get prices. The Gardens Hotel said they charged $185 per night. Seascape said they could give us an off-season discount, bringing our stay down to 109 per night. No contest. We booked with Seascape. When talking with the wonderful Koko, at Seascape, I told him that I was gluten-free, and he said that they would be sure to have boiled eggs, a large selection of cut-up fresh fruits (strawberries, cantelope, honeydew, fresh pineapple, dried apricots), and gluten-free yogurt at their breakfast buffet. He was as good as his word.

    Seascape is owned by Marcia and Dave, who took over ownership last December, and did some renovations. Marcia personally greeted us when we arrived. She had us put our luggage away in our room, and treated us to our choice of a complimentary glass of our choice of red or white wine or beer. Only after we had relaxed for a moment did she register us. Then she talked to us about places to go and things to see, marking both our hotel location, and the locations of some other places on a map that she gave to us. We gabbed a bit, and I found out that Marcia is a delightful person, and used to be a registered nurse in my home state. Then she showed me her capacious coupon drawer, and loaded me down with discount coupons for the various tourist sights and restaurants. That saved us considerable money! She called Blue Heaven for me and found out it was closed for the “off-season.” Too bad, but we did well without it.

    Throughout our stay, here and there I noticed the industriousness of Dave and Martha: Dave out bright and early in the morning skimming fallen leaves from the pool or using a longhandled loping saw to trim falling fruits off of the Chrismas Tree Palm. Martha cleaning, dusting, and polishing everything to perfection.

    As I entered the lovely garden courtyard for the first time, I was immediately greeted by one of the 3 resident cats, Fred, the sociable and laid-back tabby who often has just enough tongue sticking out to be comical. I sat down on one of the deck chairs, and it did not take much coaxing before he jumped up into my lap, and stayed for a good, long time enjoying being “scratched” behind the ears, petted, and massaged.

    Our room had French doors which opened onto garden the courtyard with its 10-person heated spa. The room had a ceiling fan. The beds had lovely fluffy comforters with 3 pillows at each head. This was one of the rooms that Koko had told us was freshly renovated. And it had a hint of that clean scent of Lysol that I appreciate in a hotel room. Above the bathroom sink on a shelf was a vase with a fresh sprig of baby’s breath. In a candy dish on the bedside table were gluten free chocolates and little Reese’s Peanut Butter Cups which are also gluten-free. In the capacious closet were real wooden hangers, not those silly thingies without hooks. Also in the closet were a refrigerator, full ironing board and steam iron, electric blanket for wintertime, luggage rack, and a coffeemaker with all the fixings to make coffee in the room. There was a sizeable flat-screen TV, and a programmable radio-alarm clock with various choices of alarm sounds. The basket of bathroom supplies included not just bar soap, but also body wash; not just shampoo, but also conditioner. On the wall next to the sink was a powerful hair dryer. There was a clean folded dark blue towel designated for use when removing makeup. The rest of the towels, hand towels and wash cloths were snowy white. The shower looked new, shiny, and sparkling clean.

    We had arrived late in the day, so after we were settled in our room we just wanted to have dinner and then return for a nice soak in the spa. I tested the water, and it was a bit cool for me (I have Raynaud’s), so I asked Marcia if they could raise the thermostat on it just slightly. She said “Absolutely!” I asked for an extension cord for my CPAP machine and she was quick to bring one to our room. When we returned from dinner, we had our soak in the spa, and the temperature was perfect! There was a basket of large towels laid out, and a basket for putting used towels into when done.

    In the morning, we discovered that once we had loaded our  breakfast plates and poured our free Champaign mimosas, they could be taken to the covered porch at the side of the house, which had little glass-topped tables. All around were orchids in full bloom – about 8 different kinds. There was a cooling breeze on the porch. Fred and Blackie joined us there, probably hoping for a handout, but polite enough not to ask. 

    Now about dinner. Our first and last dinner of our stay were both at Santiago Bodega’s (SB). Marcia had told us that they had a half-priced tapas special early in the week during the off-season. So we went there.

    There were certain standouts on the Tapas menu at SB. We absolutely loved the dates stuffed with goat cheese, and wrapped with Canadian bacon. Be sure to squeeze a bit of your lime over them. Yum! The beef tenderloin with melted goat cheese on top was to die for. Double-yum! The chicken skewers were also delicious, as were the pork with mango salsa. However, truth be told, the mango salsa was more like raisin salsa, with only a couple tiny bits of mango, and all the rest raisins. The green bean and the asparagus tapas were also tasty. The sangria (you can have your choice of red or white) was also delicious. I should caution that the servings though delicious, seem skimpy, so if you don’t want to break the bank trying to get full, either go on a night when there is a half price special, or follow up your dinner with a trip to Better Than Sex Desserts (see below). Both times we were there, SB had no gluten-free deserts.

    We went to Mangoes twice: once for dinner and once for frozen daiquiri and frozen pina colada and shrimp cocktail. The dinner was scrumptious. We started out with a wonderful salad (big enough to be split in two) of chopped fresh mango, shrimp, lettuce, onion, heart of palm, bacon, etc.) It was yummy! Then my hubby, who is not gluten-free ordered a lobster stuffed with crabmeat. Unfortunately I couldn’t have that because the crab was mixed with a bit of bread. However, hubby shared an untainted bit of the lobster with me, and it was sweet, juicy and succulent. I had the broiled Grouper with broiled tomatoes, served on a bed of rice and asparagus. It was delicious!

    Sloppy Joe’s at 201 Duval Street was also on our list of restaurants. I’m not sure why. They had absolutely nothing on the menu that was gluten-free except for the Havana Nachos. Those were good though: a serving large enough for two, with lots of sliced olives, chopped tomatoes, chopped onions, grated white cheese mixed in, and then chedder on top and melted over it all. It was served with on-the-side containers of sour cream and salsa.

    And remember that there is a Wendy’s at 355 Duval. Be sure to print out their gluten free menu and take it in your purse, so you can know what is safe to order there. One day we had baked potatoes with chives and sour cream, and Cokes, to hold us until a late dinner.

    We had a great time! If you go, be sure to take the Fury glass bottom boat trip. Time it to take the one that is scheduled so as to include the Champaign toast to the sunset on your return from seeing the reef. Then as the boat docks, go over to the Mallory Square sunset celebration to see the various entertainers: tightrope-walking dogs, cats jumping through hoops of fire, magicians, mimes, etc. Lot’s of fun. On your first day, take the on-and-off trolly tour, learning about the history of the island. Be sure to get off and see the butterfly museum, Hemingway House, the Audubon museum, and the Mel Fisher museam that tells about his reclaimation of $200 million in sunken treasure. Explore the various art galleries higher up Duval Street. Buy souvenir T-shirts for your children or nieces and nephews. Enjoy seeing the 6-toed cats, and roosters everywhere! Soak in the spa every evening after dinner.

    I have saved perhaps one of my favorite places for last: Better Than Sex Desserts. Marcia told us about this little dessert and wine restaurant just through the alley from her B&B. We went there after a light dinner elsewhere. We were greeted at the door by the owners: Len Johnson. His wife, Dani is the chef and chocolatier. She came over to talk to me about their gluten-free offering: the “Tongue Bath Truffle.” She was a delightful person, and I really enjoyed talking with her. Anyway, I ordered this dark, rich gluten-free wheatless truffle cake, served dusted with confectioner’s sugar, and dollups of whipped cream. Also served with it was my choice of various sorbets and sherbets. I opted for the raspberry sorbet. Hubby ordered the fresh strawberries to be dipped in a bowl of decadent warm chocolate sauce. We also ordered wine with the dessert, and a decaf coffee for me which had a faint suggestion of cinnamon – great with the dessert. As we were practically groaning with pleasure over these deserts, a live musician was playing the guitar and singing wonderful old songs. My hubby requested two of my favorite songs: Sweet Lorraine, and Nature Boy. I asked for a second cup of decaf in order to stay and listen more. What a lovely end to our evening and our week at Key West!

    Disclaimer: I am not related to Marcia, Dave, Koko, Len, or Dani, or anyone else in Key West! I just know that if anyone deserves to do well in business, it’s them at the Seascape An Inn, and at Better than Sex Desserts. Do give them your business! You won’t be sorry!


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    Your vacation sounds wonderful. It's such a joy to find Gluten Free foods and especially desserts.

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    Guest Liza

    Posted

    I absolutely enjoyed your post! It was quite informative- thank you! My fiance and I are getting married in a sunrise ceremony down in Key West. After that, we are heading out to the Miami port and going on a 1- week Western Caribbean cruise with the entire wedding party to celebrate our union in lieu of a formal reception. Upon our return, my fiance and I are returning to Key West for a week to spend time with each other away from family and friends. I am looking forward to it but, I admit, I am scared of eating! I am highly allergic to gluten as well as to celery and nuts. I am going to take your advice to heart and start making my list of places that will cater to my sensitivity. Thanks once again!

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    I can't believe it, having already decided on Seascape I was just looking for some gluten-free restaurants and came across your your article. Brilliant!! Thank you so much. We are travelling from the UK in November. I have been Coeliac for some years and I must say on our previous trips to USA, everyone has been more than helpful. Thanks again!

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    Guest LuAnne K

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    We just returned from Key West and I loved my breakfast at Le Petit Paris, 825 Duval Street. They are a "natural food" cafe. One day I ate fabulous gluten-free pancakes with strawberries and cinnamon butter. The next day, I enjoyed buckwheat crepes. So yummy!

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    Daniel Moran
    Celiac.com 05/16/2008 - Knowing the Kitchen on Your Travels
    As you travel there is no way around it—you need to eat at a restaurant.  If you are like me, you probably don’t look forward towards eating out.  I have been trained by some of the finest chefs in the world and there wasn’t enough training to prepare me for eating out gluten-free.  Don’t get me wrong, if I was not celiac I could take the menus apart and know everything necessary to impress my wife and order the right food and wine.  Yes I even was involved in wine tasting in Palm Beach Florida.
    That was then and this is now.  Walking into the restaurant, sadly, the first thing I do is ask for the manager and whether or not they have a gluten free menu.  I have been told over and over about restaurants that have a gluten-free menu, and yes, this is great, but in these cases I have found that most of the time:

    The staff in the back is not trained in proper food handling techniques, and cross contamination often occurs. The wait staff (who know I just ordered gluten-free) still put bread rolls on my plate for me to eat, or even croutons on my salad (again, lack of proper training). The gluten-free menu is limited to 3 or 4 items when the full menu has over 40 items to choose from.  Why can’t I have an appetizer, soup, salad, entrée and a dessert?  It is already there in the menu so why do I have to be limited?
    Like I said, it is nice that they offer a gluten-free menu, but when I go out to eat—especially on vacation—I want to be treated special just like my wife and kids.  So when I look at the menu I look for the food I like and then I use my Chef Daniel's restaurant paper to write down exactly what I want and how I want it prepared.I have had comments that some of you think the chef is going to get mad and that you are insulting them by writing down what you want to eat…my reply—this is hogwash!
    For those of you who still believe that they will be upset let’s look at what happens from the chef’s viewpoint during the day at a restaurant.  He waits for the wait staff to bring in the order. It is usually on a ticket stating whether the food should be rare, medium or even broiled or sautéed.  On the same ticket the wait staff tells them what vegetables or whether they will have French fries or baked potato.  Hopefully you see where I am going with this.
    As you must have learned by now, if you have traveled to a restaurant, even one with a gluten-free menu, sometimes the staff doesn’t even know what gluten-free means, and if this is the case how could the chef possibly know?  Who is training them? They come to work and are told they have to make a steak gluten-free.  So they make a steak and put the garnish on it and when the customer gets it they say “wow, this is great, I am about to eat a steak from the gluten-free menu.” HOLD ON!  “Oh no, the garnish on the plate is a fancy fruit relish that is made with malt vinegar.”  CROSS CONTAIMNATION. What I have been saying from the start.  Yes this really happen to me—the liquid from the relish ran down the plate and on my steak—this was a few years ago before I started to use my restaurant/chef skills to order my food.  
     I have talked with some of my chef friends and not one of them said they would get offended, and it would be just like if someone came in to the restaurant and asked me to make a kosher meal.  I am expected to do it right because if I didn’t they would be offended and then they would never return to the restaurant.  If I pleased them, however, they would tell their friends about their positive experience. This would mean more money for the restaurant, and that makes my boss happy. Some of you will still doubt me but that is okay because when I walk into a restaurant I expect to be pampered just like everyone else does.  Be sure to always have a plan B, and be prepared to leave or not eat your meal if there are problems with it.  There are way too many restaurants in a town for me to get sick over a crumb.  Once you start talking with the manager or the waiter you will quickly learn if what they are telling you is real or just hogwash.
    Another Real Experience
    I was given a gluten-free menu at a restaurant and I asked the waiter if he knew what gluten-free meant.  He said “yes,” so I asked him whether croutons come on the salad that I had ordered. He said “sure, croutons come on all the salads and they are already made, but I can take them off”.  I am not making this up folks, this was at a well known Italian restaurant that is a chain all over the USA. I switched to plan B and didn’t eat there. My wife who loves this place did eat and I went to a party store got some snacks. It might be harsh to some but if the waiter is not properly trained how do I know whether the cook or anyone else there is properly trained?  Just because a restaurant has a gluten-free menu means nothing (unless I can verify that the staff was properly trained by speaking to them).
    Fast Food Restaurants
    If you have followed my articles you will know that I like some of the fast food restaurants.  Many of these large chains adhere to strict cooking methods.  This is good for us because they stay the same and there is less of a chance for cross contamination.  In many cases these restaurants use dedicated fryers for certain foods, for example French fries. So you can usually have French fries and not worry about the batter from the chicken nuggets.
    Cross contamination to me is the way the “Gluten Monster” attacks us—when we least expect it.  No matter how much you say or ask, if they put your food on the table that just had gluten on it you’re going to get sick. I always ask for the manager to help me. Here is an example of how I order:

    Could you please give me the double cheese burger with only lettuce, tomato and onion?  I have a special diet request and it is very important that you do not touch any bread or crumbs from any other product. Could you please put fresh gloves on or could you use a plastic fork to get my burgers out?  It is important that the cook back there doesn’t’ get my meal because he has handled other bread with those gloves. I would like catsup, mustard and mayo packages (to read the ingredients myself). I would like French fries if they are cooked in a dedicated fryer. I would like a plain salad and could you please open a fresh bag of the salad mix for me because, again, I am afraid that maybe a crumb got into the salad.  If you can’t open a fresh bag of salad I would go without the salad. I would like to look at a couple of your salad dressings to see what salad dressing I can eat if that is ok with you. Beverage usually isn’t a problem. Gluten in ice cream is a possibility. Always watch the staff the whole time they are making your food to see if any mistakes are made. Never be afraid to say you don’t want something if you fear it.
    There are also other options, for example you might be able to do the chicken or other products if you know that they are gluten-free.  Not all French fries are gluten-free.  Some that have a spice on them might have wheat on them. Be sure to know your fast food place by searching online for information on what you can and can’t eat, and never be afraid to ask.Mexican Cuisine
    Going to Mexican restaurants is one of my favorite options.  Much of the food is made with corn.  After you sit down, review the menu and decide what you want.  The chips are usually corn, but be sure to ask, and if so you can have them with some shredded cheese as an appetizer. Most of the salsas are made with only fresh vegetables.  The main items that you ask for is to make sure they use only fresh foods for you.  This is why you should ask for the manager when you walk in. The manager should be able to help you order.
     If you like hot sauce I would bring it myself.  Those specialty items are small and handy to have if you like them.  You never know what type they will have and it is nice to eat it with your Mexican meal.  If you ask for refried beans and they are gluten-free, I would ask for them to open a fresh can and have them microwave it.  Any of the food that is processed I would ask for fresh can and for them to microwave it.  If they don’t have a microwave they can heat it up in a steamer, broiler or a sauté pan.  You should always be able to eat well at a Mexican restaurant.
    How I Order Gluten-Free Mexican Food:

    I would like some corn chips and cheese melted over the top of them.  You could use the above broiler or just use the microwave to do it. I would like a small tomato, whole not sliced for my salad and for my chips. I would like a mixed green salad from a fresh unopened bag with a small cucumber that I will cut myself. I would like one half of a fresh avocado for my salad and chips. I would like two tablespoons of olive oil and some red wine vinegar for my salad (maybe even a half of a lemon too). Cook 1 cup of meat (no seasoning) add to 2 corn shells and top with fresh cheese from a bag or cut fresh.  Add fresh lettuce and tomato and microwave it until it is hot and melted, then add 4 ounces of corn on top.
    I add some hot sauce when the food comes to the table.How I Order Gluten-Free Italian Food:
    We can’t eat the pasta but some of the mixes that go on the pasta are great.  If it is strips of chicken or shrimp, there are many items that can be looked at.  With sun dried tomatoes or avocado, those could be added to your entrée or salad.  They will have mussels and good meats, you just need to read what they have and make a great meal. When you look at the menu you have to ask or determine, what is sitting on the table by the chef and can I use that for my meal. Every entrée has mizzen pla. (Products in place) meaning that the chef needs everything right next to him to make his meal.  If the entree you are looking at is seafood fettuccini with a cream sauce.  The chef will need fresh seafood, cooked noodles, sauce, vegetables and seasoning. If this was made up already for the night, the noodles and seafood would be garbage.  As a celiac you can take the seafood as long as it is not marinated in something.  That goes for most of the items if you read what is in the entrée.  Know what is fresh and what is frozen and you will be able to pick apart a menu.  Always ask and you will learn for the next time.
    Sample Orders:

    Strips of chicken breast with no skin broiled (please metal brush the grill first before you lay my food down)  cook till done, then lay sundried tomatoes on the chicken strips and top with fresh sliced mozzarella cheese and broil in top-type broiler, or microwave until melted.  If there is no way to melt please slice thin and it will be good enough. •    Fresh spinach with 1-2 lemon and red wine vinegar, two tablespoons olive oil extra virgin, one small tomato and 4 ounces of mozzarella cheese (I will cut the tomato and mozzarella cheese  myself).
    •    Mixed melody of seafood sauté with olive oil then reduce with wine. Place on the side when ¾ of the way done.  Add ¼ cut mushrooms, shallots, fresh garlic, sun dried tomatoes and sauté until down add heavy whipping cream reduce then add the seafood (add nothing if you don’t have heavy whipping cream).  Add fresh herbs chopped up or tear apart (no dried herbs).In this article I offered examples for a few types of restaurants.  I could go on and on. You need to understand how restaurants work to be able to order your food to be made gluten-free.  Please don’t limit yourself to the gluten-free menu only (if they have one).  You should not be discriminated against because you have a health concern.  That is a big word, I know, but we should be able to eat just like the next person can.  Our money is just as GREEN as another person’s.  I would rather pay a little more if I add something to an item then to be told that they can’t do it.  That is why I say that together we can tame the Gluten Monster.  When you are traveling there are a lot of restaurants to choose from.  Be prepared to wait and not be rushed, try to pick a restaurant that is not busy so the chef is not rushed by 20 other orders.  If you follow my approach you will have success eating out gluten-free in restaurants, and your dining experience will be pleasant—like it is suppose to be!
    Gluten-Free Travel Hints:

    You should always try to getthe manager to help you.  In any restaurant they have the most time tohelp you and they will help you because they typically care more thanthe regular workers (today’s restaurants have employees that come inone day and are gone the next.help.  It is sad but that is the way itis so at least try to get the manager. Don’t be ashamed to askfor anything. If you want a hot dog or the chips they put on the sideof the plate ask for a bag with the product inside.  Take out your safeand forbidden lists if needed and look at them to see if you can eat aproduct. 
    Always have your Chef Daniel's restaurant paper with you in your walletor purse.
    Always have a copy of your safe and forbidden lists with youin case you need it to read ingredients. Always have a gluten-free restaurant card in the language you need.
    Crosscontamination is the greatest risk for a celiac when traveling.  Crosscontamination can happen and you would never know it, such as when thechef uses a knife to cut a piece of bread, and then they use the sameknife on your vegetables, or when the chef uses a pair of tongs to flipa breaded chicken and then uses them to flip your sauté chicken.Thereare too many other ways to mention, but the main thing is that glutencould be on the tool before it is used on your meal, and it doesn’tmatter how safe the chef thought he was because you got one crumb andyou are sick for days and that ruins your vacation. Chef Daniel P.


    Daniel Moran
    Celiac.com 06/03/2008 - As you travel and experience the sites of the world you are going to have to stop at a restaurant or destination that has a small kitchen.  Let me tell you a little bit about myself so you can understand that I also started in a small kitchen.
    Chef Daniel P's Autobiography
    I started working at the age of 13 and began my work in a very small tourist town and was promoted up from busboy to dishwasher.  I was so fast at washing the dishes that I was promoted up within a month to cook.  I went from the buffet type restaurant to an ala cart restaurant and buffet line.  At the age of 17 I was completely in charge of the kitchen—this included all ordering, menu making, staff hiring and firing, and every task a person would do to run a successful kitchen.  I didn’t know how to cook though—at least not compared to what I learned later. Yes I could do the basic menus but I wanted more and I left to climb the ladder of a big kitchen—so I set my sites on gourmet food.  At that time I saw that Prince Charles from England was visiting Palm Beach Florida.  I saw that he visited two places while he was in Palm Beach—the Palm Beach Polo Ground and he also visited the Breakers Resort.  I applied at both places when I came to Florida and both wanted to hire me.
    Every one has to start somewhere and you as the traveler are the ones who are going to train the future cooks or chefs.  Yes you—the cook is going to learn from you as celiac patrons, so you need to do the right training.  Let’s use the example of eating on a train that cooks for their patrons as they travel across the country.  I like to think of a small boat or train as two of the most difficult places to prepare a gluten-free meal.  They both are going to be small, and both have the potential to get bumpy while the cook is preparing food.  This means there is a good chance an accident can happen and of course cross-contamination.
    These kitchens probably keep their fires contained in the stove or flat top burners.  By keeping the flame for cooking contained in a box, this means they have less chance of a fire starting and that is very important if you are on a river or going down the train tracks. The cooks are going to use sauté pans, hard top grills, ovens, steam boxes and possibly microwaves.   If you know that you are going ahead of time to these types of restaurants you should see if they can send you the menu ahead of time so that you can look it over.
    Hint: If you know your destination for any of your trip, see if you can get the menu before you arrive, as most places always have their menus prepared ahead of time. If you get the menu you can make up your Chef Daniel P Restaurant Form before you go.
    I would try to spell out your entire meal in great detail.  I also use this technique for all mom and pop restaurants.  You are not insulting a cook or chef by asking them to prepare your meal a certain way.  Every day the cook receives orders from the waitress on how to prepare a particular meal.  Just because you are giving the instructions yourself only means to the chef that you are very serious about how your food is prepared.
    What to Eat And How to Cook Your Meal
    In these type of restaurants that are small and have limited space you have to try to eliminate any mistakes that the cook might make. How…you ask?  Try some of these ideas:

    Notify them ahead a time if you can.  Let the train, boat or any restaurant know that you are coming.  Make sure you tell them the date, time and how many people will be receiving special meals. Don’t be upset if you get there and no one knows that you are coming, it is just part of the business. Have their phone number available so when you arrive in the city you can call a few hours before you arrive to eat.  Just remind them again that you are planning on eating at their restaurant and ask them when their slowest time is. If it is a train or boat ask if you can eat at the last seating time (unless they indicate that an earlier time is slower).  Feel them out to see when the best time is for you to order a specially prepared meal. During your phone call, ask who you should ask for when you do arrive for your meal. Make sure you arrive with your Chef Daniel P Restaurant Form and a pen or pencil. When you arrive ask for the manager or the person you talked to on the phone. Tell the manager in great detail about your special diet request.  Let them know you will be writing out your request that will specifically tell them how to prepare your meal. Ask if there is anything you should know about the kitchen or the chef—anything that could help you in preparing your meal and making it as safe as possible.
    You might have to ask the manager how they cook their food. Some are going to use a flat-top grill, broiler, steamer or even a microwave oven.  Once you find this out it is time to create your meal instructions and present them to the manager so he can deliver them to the cook.How the Cook Prepares Your Food:

    Sautéing: To me is one of the safest ways to have your food prepared.  No matter if the cooks are in a small or large kitchen.  This is how I might write it down for the cook to see:  “Sauté 1 whole chicken breast in olive oil, make sure the pan is very clean and does not have a crumb on it.”  When asking to sauté you can ask for them to make a quick sauce in the pan.  That is what I do, even if it is just to squeeze a lemon on your food, this can add some fresh flavor. Hard Top Grill:  I don’t recommend using this unless you are the very first ones to arrive.  During the day when they cook on the grill pieces of food stay on the grill for the whole day.  You can ask them to use the razor blade to scrape the grill.  Even using the razor blade it is not 100% and food from other meals may get on your food. Steamer: This is a good way to cook as long as your food is the only one in the steamer.  You can ask them to wrap the food and this will keep all crumbs off of your food.  Example:  “Please wrap a piece of salmon up with some saran wrap.  Place it on a holey pan so the steam can circle salmon." Microwave: This is great for potatoes or vegetables and a good way to keep food safe.  I always ask for my veggies to be micro-waved.  This is a great way to get a baked potato.  Even some fish and other entrees can be cooked in the microwave.  Example: “Could you please cook a potato and my vegetables in the microwave.  Put them in a dish then cover with saran wrap.” Fryer: You must stay away from a fryer in small kitchens (unlike fast food chains and some bigger restaurants).  They use the fryer for everything and that means that everything could be in it. When they cook your French fries, the crumbs from the chicken nuggets could get on your food. Boiling: This is another great way to cook food.  You must ask them to only cover the food product that they are cooking.  Some fishes, vegetables and other meats can be cooked this way. If they have a steamer I would ask for that first since they don’t have to wait for it to get hot. Example:  “I would like two eggs boiled or poached in just enough water to cover the entrée so it won’t take so long. You could have the cook put a small amount of water then cover the pan and steam it.” Broiler: Sometimes small kitchens that are moving are not going to have a broiler.  It is the fear of the open fire that could cause a fire in the kitchen.  If they do have one you could ask for this example:  “I would like a piece of salmon on a metal plate.  Cook it until it is done, then splash it with white wine before plating.”

     The main idea you take into small kitchens is this:  It is a lot like cooking at your home (unless you have a huge kitchen).  Those kitchens are made small but can put out large amount of meals if needed.  Those menus are made to accommodate the small amount of storage also.  You need to really know your menu and the ingredients they are using.  Unlike a large kitchen you might not have the extra supplies that a big kitchen has.  They just don’t have the room and you need to think of that.  So if it is a river boat or a train, when you look at the menu some of the items will be canned products, because canned products are so much easier to store than refrigerated items. As you look at the menu take the item you would like and ask them if they can cook it in a sauté pan or maybe in the oven.  This is a very safe way to have your food prepared.
    When I was employed at the resort and we would often have banquets for over 200 people. If the meal was New York strip steak we would put the steaks on the broiler and mark the diamond char marks in order to get the steaks cooked exactly at the same time. We would then pull the steaks off and put them on large sheet pans. Just before we needed the steak, we would put them in the ovens and cook them until they were the proper temperature. The customers never knew that the steaks were cooked in the oven and not the broiler. The char marks on the steak made everyone believe that it was broiled.
    The point is that you can have your food baked as long as you don’t get sick—for me that is the most important thing.  When I do eat out, I don’t care too much about the taste or temperature of the meal—my number one goal is that I get a gluten-free meal and that the restaurant doesn’t ruin my vacation.
    Also, you have to be very careful when you send your food back.   Just remember how busy the cooks are and whether or not they are going to remember your specially ordered meal when it comes back to them.  If they are busy in the back and the waitress says to the cook, “Cook it more,” what do you think happens—will they take as much time as they did the first time?  These are the types of questions that you have to ask yourself when you are sitting at your table and thinking about sending your meal back.
    I know that we all expect a perfect meal when we pay for it.  Sometimes it is just easier to ask them to only warm it up in the microwave. Something to think about is that the microwave is like a closed room where it is not likely that your food will get contaminated.  Most kitchens, especially smaller ones, have a microwave like the one that you use at home.  If you do need your meal cooked more, try to explain it to the manager and remind him that you will get very sick if it gets contaminated—ask the manager nicely if you can watch and see if the cook does it right.
    Another thing to remember when you are eating in these types of restaurants is that they are small and that means the kitchens are small too.  The cooks are going to be right next to each other—only arms and shoulders apart. Remember; if you don’t think they will be able to feed you properly always have a plan B, so you can still eat. Plan your meal to be as simple as possible for them to prepare and you will be able to conquer the Gluten Monster and have a wonderful train or boat experience!
    Chef Daniel P. 

    Melissa Blanco
    Celiac.com 10/19/2010 - The plane soared above the vast, blue Pacific Ocean as the gorgeous state of Hawaii loomed beneath it.  When we descended into our tropical destination of Maui, my stomach was a bundle of excited energy, with visions of walks along the beautiful sandy beaches and lounging poolside, soaking in the sun’s rays.  My husband and I’d planned this trip for months—budgeted for the most cost effective airfare, researched affordable hotels, packed swimsuits and summer clothing for our family of five.  Yet, as every person with celiac disease understands, traveling has its hidden dangers of gluten-contaminated food, restaurants that aren’t attuned to the needs of food intolerance sufferers, and the common question of: what am I going to eat when I’m away from my comfort zone, away from my home?
              
    Our adventure began in a resort on the Ka‘anapali Shores of Maui, as the sun was setting and a warm breeze rustled through the swaying palm trees.  While my family mapped out their wish list of activities to embark on during our paradise vacation, I brainstormed what I’d eat in the land of sugar cane, flowered leis, and tropical fruits.  As the warm sun rose each morning, I ate the breakfast bars I’d packed in my suitcase along with a cup of Hawaiian Kona coffee, which we purchased after arriving.  For coffee lovers, I highly recommend it, www.konacoffee.com.  Kona coffee was available at the hotel gift shop, grocery store, and sold as whole beans packaged at the local Starbucks.
              
    Although my diet for the week relied heavily on grilled chicken salads, fresh fruits, vegetables, and almonds, I also sampled local restaurants with my family.  We were interested in venues that offered a children’s menu, had a welcoming and fun atmosphere, and were possibly places providing a chance for exploration and cultural experience.
    Cheeseburger in Paradise
    Anyone who’s ever listened to the song, “Cheeseburger in Paradise” by Jimmy Buffet, will understand my desire to eat at the restaurant.  Maui’s Cheeseburger in Paradise is located on Front Street in beautiful Lahaina.  The two story restaurant sits beside the water, as a cool breeze wafts through a windowless dining area, while patrons enjoy cocktails and their signature burgers and steak fries.  When I spoke to the hostesses, dressed in festive grass skirts, I was informed that they did not have a gluten-free menu, but could accommodate gluten intolerant guests by serving burgers without buns and salads.  Although I contemplated ordering one of the grilled salads, I ultimately decided upon the signature Cheeseburger in Paradise, minus the bun, and a basket of sweet potato fries.  I might have been tempted to try the steak fries as well, but learned from my server that they are flavored with a seasoning salt containing gluten.  It was a pleasant experience and my only wish was that I’d have brought a license plate to hang on the restaurant wall with others from across the country.  If interested, check out their website at, www.cheeseburgerland.com.
    Old Lahaina Luau
    Also located on Front Street in Lahaina, Hawaii, this Luau is worth attending if only for the traditional Hawaiian Hula performance.  The Old Lahaina Luau is a family affair located beside the ocean, providing a beautiful sunset view, as ceremony and tradition are celebrated following pre-dinner learning activities for both adults and children.  Upon entering the Luau, girls are presented with a flower for their hair and everyone is given a fresh flower lei.  Adults are offered the signature island alcoholic beverage, a Mai tai—it is up to the patron whether or not to accept it.  Before attending the Luau we called in advance and requested a gluten-free menu.  This gluten-free request was confirmed by my server when I arrived.  Additionally, I was presented with a complete food ingredient list by him for the buffet.  I would advise anyone with a gluten intolerance to request a gluten-free meal because while reading the ingredient list, I discovered most of the dishes contained soy sauce.  As I joined my family in choosing fresh fruits, salad, and vegetables from the buffet line, my server placed a warm, freshly prepared gluten-free meal of grilled chicken breasts and steamed vegetables where I was seated.  Overall, it was an amazing night and a wonderful time to experience a traditional Lu‘au while enjoying a delicious meal.  For more information or to make a reservation: www.oldlahainaluau.com.
    Pacific Whale Foundation Lana‘i Snorkel and Dolphin Watch Eco-Adventure
    The non-profit Pacific Whale Foundation offers several eco-adventures for people wishing to experience the marine life of Hawaii.  We chose to take the five hour Snorkel and Dolphin Cruise, which provided a continental breakfast, barbeque lunch, and refreshments.  After departing from Lahaina Harbor, snorkel gear and flippers in hand, we sailed patiently through the choppy waters of the Pacific Ocean in search of dolphins.  We weren’t disappointed when about an hour into our adventure we spotted several spinner dolphins spectacularly jumping out of the pristine blue water to entertain us.  In preparation for this voyage, I called ahead to inquire about food offerings and was assured that a gluten-free meal would be provided to me.  I came to find out, while on the cruise, that it was basically a standard meal for all passengers, in which I was to choose only the food that didn’t contain gluten.  As I live with a family who normally consumes gluten, this picking and choosing was not uncommon to me.  For breakfast, I sampled fresh pineapple and passed on the banana bread.  For lunch, I ate barbecued chicken with lettuce and tomato.  As a service to vegetarians, a veggie burger is provided upon request.  I would certainly recommend this cruise for people that are interested in dolphin sightings or who want to be introduced to snorkeling.  For those who have celiac disease, I’d also suggest bringing along some extra snacks.  For more information, www.pacificwhale.org.
    Hard Rock Café Maui
    In an effort to introduce my children to the cultural likes of good old rock and roll, I suggested that we eat dinner at the Hard Rock Café, located in the Old Lahaina Center, of Maui.  I was happy to find that a children’s menu was available, but slightly disappointed to learn that a gluten-free menu wasn’t.  Our server, however, was more than helpful, willing to look at food ingredients in the computer for me and alert me to items containing gluten.  Unfortunately, the nachos I’d been craving contained wheat, so I instead ordered a cheeseburger, minus the bun.  It was my second cheeseburger of the week and I was truly unable eat a quarter of it because it was such a generous portion.  The atmosphere was lively and loud, nothing less than what I’d expect from a Hard Rock Café.  It was a fun night out and I was happy to leave with a Hard Rock Café Maui tee-shirt from the restaurant gift shop.  If you’re looking for a quieter venue and are interested in seafood, there is a Bubba Gump Shrimp Company located directly across the street from the Hard Rock Café, providing shrimp and lots of Forrest Gump memorabilia.  Hard Rock Café’s website is www.hardrock.com.  Bubba Gump Shrimp’s website is www.bubbagump.com.
    Our vacation to Maui was primary restricted to the beautiful Ka‘anapali Shores and town of Lahaina, therefore I didn’t explore a lot of the island, nor did I locate any grocery stores providing a gluten-free selection.  This is not to say that they don’t exist, rather, that I was not able to shop at one.  I’d recommend travelers to take their own gluten-free snacks, as long as they are approved through the agricultural inspection.  Hawaii is a state full of fresh produce, including savory pineapple, seafood, and sweet potatoes, which provide many healthful options for those with celiac disease.  My family also enjoyed the thirst quenching and tasty shaved ice, www.ululanisshaveice.com, and the extremely delicious frozen treat, gelato, and its dairy-free counterpart, sorbetto, www.onogelatocompany.com.
    For the residents of Maui, I appreciate your understanding and willingness to accommodate my gluten intolerance.  To you I say, “mahalo.”


  • 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:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.

    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. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    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.
     
    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