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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 THE GREAT OUTDOORS


    Phyllis Morrow

    Celiac.com 04/29/2008 - We were unloading our rafting gear at Lee’s Ferry, about to plunge into a 19 day private (self-guided) trip on the Colorado River through the Grand Canyon. Very hungry after a long travel day, people were happily handing around the pizzas that they had picked up en route. I was walking back towards the pick-up truck, looking forward to the gluten-free supper of stuffed grape leaves, rice and salad that I’d stashed on the front seat. My anxieties had been crowding around me all day long, shoving each other like a bunch of rowdy teenagers. I was nervous about big water, scorpions, rattlesnakes, rock scrambling, new traveling companions and, of course, food. To my dismay, the truck was gone, off on a distant errand in town. Suddenly, one, lone sniveling child of an emotion stepped out in front of the others. “You’re going to starve,” she whimpered. Turning my back so my fellow travelers couldn’t see my distress, I felt tears run down my face. Rationally, I knew that the pick-up would be back in a few hours. I knew, too, that the boxes and boxes of food that I had helped to select would arrive later that evening. But at that hungry moment, desolation and self-pity threatened to overwhelm me. 


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    It can feel scary to venture away from the familiar settings in which you have a high degree of food control. But outdoor activities – and outdoor eating – are too much fun to pass up. With a positive attitude, smart planning, and a measure of trust, you can get out and enjoy camping, hiking, biking, boating and picnicking. That day on the banks of the Colorado, I gently prodded my hunger back into the crowd of emotions, scrounged around for some nuts, and, yes, survived until my dinner returned.  Over the next 220 miles of rocks and rapids, I turned my mind to other thrills and chills. And I had plenty to eat.

    While not always in such remote surroundings, I regularly enjoy a wide variety of outdoor activities and have, over the years, developed some strategies for going gluten-free from the mountains to the sea. Here are some suggestions that will variously serve from the local state park to the Grand Canyon and the Alaskan backcountry.

    First, preparing and eating gluten-free foods outdoors comes with a particular set of challenges. Here are some things to consider.

    • Control over food selection – from choosing the menus to purchasing food and beverages – can be especially problematic if your trip takes you far from the road and the grocery store. Unless you plan to trap rabbits and eat wild greens, you’ll need to make sure that you have enough gluten-free food for the duration.
    • Keeping cooking surfaces, eating surfaces, and utensils free of gluten contamination takes care when you have little or no hot running water.
    • Fellow travelers need to be educated about your needs. That’s important whether they are sharing cooking duty or just helping you keep some ravenous 12-year old from eating up all of the gluten-free cookies (that inexplicably look more delicious than the Oreos packed for the rest of the group).
    • Depending on the type of trip, more general food restrictions, such as concerns about perishability or weight, may compound your gluten restriction by narrowing the choice of what you can bring.
    • Packing gluten-free baked items (bread, crackers, cookies) takes special care because of their comparative fragility.
    • The ability to access your gluten-free food items requires logistical packing decisions; you need to be able to find your dinner for day one on day one, not buried at the bottom of the supplies with items that nobody plans to excavate until day six.
    • Accidents and moments of disappointment are bound to occur. Imagine the “oh no” second when someone bumps your elbow just as you are about to tuck into the one and only gluten-free bowl of chili. You watch your lunch cascade, as if in slow motion, into the dirt. At some point, you can expect someone to absent-mindedly put a gluten-contaminated knife in the jam. You can figure on a meal where you belatedly discover gluten on an ingredient label although the cook assured you that you could eat “everything” he prepared.
    Don’t be daunted. I’ll give some suggestions for dealing with all of these challenges. But let’s start with overall approaches to food planning:
    • Using a separatist approach, you can plan your own menu and essentially eat apart from others. Depending on the duration and complexity of the planned trip, this can be a simple alternative that guarantees you full control over what you eat. For example, I just did a cross-country ski day trip with friends and we each packed our own sandwiches. I brought some gluten-free chocolate cake and a thermos of tea to share, and my friends shared their carrot sticks and nuts. Bingo, everyone was happy and felt sociable. Separatism is generally not a good approach on a multi-day trip, though, where people plan to cook together. For one thing, separate planning and preparation mean duplication of effort. Worse, you’ll be left out of the social interaction of cooking in camp and you may feel like a leper when everyone else sits down to some delicious meal and you are trying to make the best out of a reconstituted cup of gluten-free dried soup mix.
    • A second option is to make the outing gluten-free for everyone. This works well if you have the time and the skills to take the lead in arranging food. If you have good taste and are a competent trip/food planner, nobody will be the wiser and, in fact, they’ll generally appreciate having you do the work. Since other people don’t think about gluten one way or the other, they certainly won’t care that they are using mustard or ketchup or soy sauce that happens to be gluten-free. They’ll be perfectly happy with meals based on rice, potatoes, corn tortillas, gluten-free pancake mix, brownies and other gluten-free foods. Tasty and filling meals make most people happy, and unless they are unreasonable (in which case you shouldn’t invite them along next time) they won’t get bent out of shape if they can’t have their favorite brand of sausage in the morning. Bread is the obvious exception, since few gluten-free breads meet the criterion of “I can’t tell the difference.” So have someone else bring the bread, if that’s an issue.
    • A third, often very practical, option falls somewhere between these two extremes. In this case, you participate in the menu planning and make sure that as many staples and other items as possible are gluten-free (e.g., peanut butter, condiments, canned goods). Where planned meals call for some gluten-containing items, you provide gluten-free equivalents for yourself. You label each item visibly (e.g., a masking tape label with black permanent marker reading “Gluten-free Bagel for Susie”) and pack it so that it will be accessible for the appropriate meal. So you make sure that the spaghetti sauce purchased for the entire group is gluten-free but you include a package of gluten-free pasta for your own meal. You bring your own bread, cookies, cereal and crackers for all meals and snacks. You also participate in cooking so that you can avoid cross-contamination and, where necessary, set portions aside before gluten-containing ingredients are added. For example, if everyone else wants their fresh trout dredged in flour, you just reserve your portion, dredge it in cornmeal, and fry it in a separate pan. You also request to serve yourself first before others accidentally contaminate a dish.
    The Grand Canyon trip that I mentioned at the start was one of two that I have taken where I had to trust strangers to provision the group. Although we guided our own trip, we hired professional outfitters to supply the rafts and food. In that situation, I consulted extensively on the menu choices and requested that processed foods be kept at a minimum; instead I asked that they supply mostly basic ingredients (fruits, vegetables, eggs, butter, cheese). I also asked if items would be in their original packages so that I could check labels for gluten. I brought a variety of gluten-free starches to supplement and substitute for items on the planned menu. I picked up gluten-free snacks at a Trader Joe’s – more than I needed, in the end. The kids with us were thrilled when, after having consistently shooed them away from my goodies, I was able to generously share them towards the end of our time together.

    The second trip provisioned by strangers turned out to be an unexpectedly relaxed and gourmet experience for me. In this case, it was not possible for me to participate directly in the food planning. But I was touched and surprised by the kindness and care of my traveling companions. I found out that the two men who had volunteered to take food responsibility were doctors (as well as fine cooks). A phone conversation and e-mail exchange during the planning period reassured me that they understood about celiac disease. They went out of their way to make meals that were safe and delicious. There was another unexpected benefit to that trip. A physician’s assistant who was also with us contacted me a few weeks after we all returned home. She told me that having just traveled with me made her pick up on some likely symptoms in a young patient. A celiac diagnosis was confirmed, and she had called to ask for some advice on contacts and reliable sources of information, which she passed on to the patient.

    Implicitly, I’ve brought up the need to educate your fellow travelers here. In general, it’s a good idea both to describe your gluten-free needs in advance and to participate in cooking and clean-up during the trip. Unless and until you can trust that other cooks and food-handlers “get it,” you’ll want to be in or near the food action most of the time. There, you can demonstrate what’s required, take care of cooking portions separately when necessary and serve your own food. While maintaining a scrupulously uncontaminated washing environment is tough while camping, I strongly suggest that you at least reserve one cooking pot for water only. That pot will never get pasta residue or other gluten scraps stuck to the bottom and you will always have a source of clean hot water for cooking (i.e., for hot beverages or adding to instant foods) and washing up. The others may appreciate this rule, too, since it will prevent their morning hot chocolate from having oatmeal or bits of last night’s curried lentils floating in it!  If you are lucky enough to have a pre-educated friend along, or if your traveling companions are quick and considerate learners, at times you’ll be able to relax your vigilance. Whenever my husband is cooking or washing-up, for example, I can go help out with other chores – or sit down with a glass of wine and a book.

    Because your companions are likely to be gluten-oblivious, though, you can expect an occasional mishap. For those moments of disappointment, when your dinner has just been ruined or has driven off in the cab of the pick-up truck, you should keep an easy meal in reserve. Make it something that you like (how about that Annie’s gluten-free Mac and Cheese?) so that you don’t feel too deprived. Or set aside a favorite dessert so that if you have to make do with a minimal supper you can at least have a special sweet.

    Whether you are supplying your own food or relying primarily on others, a few tricks will help you keep your edibles edible.  There are things that I always carry with me: at least one thin, flexible plastic cutting board; one or two plastic containers; and a set of utensils. The light plastic cutting board allows you to create an instant clean surface for food preparation or consumption anywhere you go. In fact, I keep one or two in my suitcase for ordinary travel and they are also essential in my home kitchen.  If the mats you purchase are too large for convenience, cut them down to a size (6” x 8” or 8” x 11”) that fits easily into your backpack, bike pannier, or food box. They are so flat that they take up virtually no space and you’ll have solved the problem of gluten-y picnic tables (or airline trays or food court counters, for that matter). The mats are very easy to wash, rinse and dry and can be kept clean in a plastic bag for the next use; you might want to size yours to fit into a half-gallon Ziploc bag. Having your own set of utensils is useful for obvious reasons, but for camping and picnics a good pocketknife is essential. When someone else takes out his or her knife to cut food for everyone, volunteer yours for the purpose, since you can be sure it’s gluten-free. Plastic containers will help you keep your gluten-free baked goods intact, particularly if you try to pack them just tightly enough that the goods will not rattle around inside. I find a couple of sandwich-sized plastic containers very useful, as well as a few others of assorted sizes. Small containers that fit into a waist pack or day pack will protect your lunch much better than a plastic bag. Mark your containers “Gluten-free foods only” so that they do not become mixed up with containers for general food storage.

    There is one caution about keeping your foods separate that I can illustrate with a little story. On one overnight biking/camping trip, I forgot to remove my gluten-free snack bars from my bicycle pannier. When I saddled up the next morning, I discovered that small campground thieves (probably squirrels) had chewed right through the fabric to get at them. My bag was ruined, but at least we weren’t camping in bear country that night…a reminder that wild animals are just as happy to eat gluten-free as anything else.

    Camping foods usually need to be relatively compact even if you have the luxury of carrying a lot (in a car, RV, motorboat or raft). Weight is, of course, an additional issue if you are backpacking, bicycling, or kayaking. Depending on which activity you’re doing, you can pick and choose among some of these easy options:

    • Trail mix: It’s a snap to make your own with gluten-free dried fruits, nuts, coconut, chocolate chips, and/or gluten-free cereal. Just use care in your selections. For example, while whole dates are usually gluten-free, chopped dates are often dusted in barley flour so that they will not stick together.
    • Snack bars/energy bars: Take some of your favorites (check the nutrition/health food section of your grocery store as there are an increasing number of possibilities out there) or, if you are so inclined, you can even make your own granola bars based on gluten-free granola, such as Bakery on Main or Trader Joe’s brands, or by using gluten-free rolled oats.
    • Boil-in-bag foods and pre-cooked foods: If weight is not an issue, these are convenient and non-perishable. Heat up a pan of water, slip in the pouch, cut it open and eat: if you are worried about keeping pans clean, this completely solves any cross-contamination problem. Tasty Bite makes a variety of gluten-free Indian and Thai foods packaged in “smart pouches.”  They are commonly available in regular grocery stores. To save packing room, toss out the boxes at home and bring only the pouches, but be sure to label them with a permanent marker if the pouches do not have the contents printed on them, since they will all look alike. Pre-cooked polenta rolls are similarly convenient.
    • Instant cereal: For gluten-loving campers, instant oatmeal in individual serving packs is a standard breakfast item. I don’t know of anyone marketing gluten-free oats this way, but an equivalent for gluten-free campers is quinoa instant hot cereal, similarly packaged (Altiplano Gold makes several flavors that can be ordered on-line). You can also pre-measure quick-cooking cereal, such as rice cereal, in Ziploc bags with a little salt and flavorings (cinnamon, sugar, etc.) of your choice. Pre-measure in the drinking cup that you plan to bring camping with you. Then you can use the same cup to measure water proportionately. I use the same method for measuring and packing other dried foods such as rice, quinoa, or polenta, often including herbs and spices: mark the contents, amount of water needed, and cooking time on the plastic bag.
    • Cured or dried meats: Freybe makes salami-type sausages that are compact and keep well. Shelton makes gluten-free turkey jerky. Though quite expensive, it is very lightweight.
    • S’mores: A facsimile of everybody’s camping favorite is easy to make. Marshmallows are typically gluten-free (find a brand that is labeled as such), as are plain Hershey’s chocolate bars. Substituting gluten-free cookies for graham crackers makes gluten-free s’mores even more decadent than the originals.
    • Dried foods:  A variety of dried foods, such as bean flakes, potato flakes, and vegetables are available in gluten-free versions and make packing light and camp cooking quick. As always, you need to read labels. Rice (including brown rice) that has been partially pre-cooked and dried does not take long to prepare. If you are using a small camp stove, quick-cooking items save on fuel weight, too.
    • Dutch oven baked goods: If your trip is such that you can carry an aluminum (lighter than cast iron) Dutch oven and some charcoal, you can turn out cornbread, brownies, and cakes that will make you the hit of the crowd. Bring your favorite gluten-free mixes, or mix up your own dry ingredients from your favorite recipes. Don’t forget to bring the necessary wet ingredients, too, of course. Search for Dutch oven camping recipes on-line to learn the basic technique. It’s not hard.
    Okay, now you have no excuses not to get out there. Have a great gluten-free summer and remember that getting active and outdoors is as important as eating well.

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    Guest Linda McMullen Marcy

    Posted

    Wonderful 'food' for thought. I rarely even visit out of town family because of the dealing with the hassle of meals. This makes me feel a lot braver.

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    Guest debslo

    Posted

    Great article! It was very informative and parts of it made me smile :-)

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    Guest Cathey Rickman

    Posted

    I loved the article. I recently found out that I had Celiac disease. I have to travel with work and this has given me great ideas. Thanks!

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    Guest Penrice

    Posted

    Good article but... gluten-free oats?? Is there such a thing?? Oats are the one food I have to avoid at all costs as I get black outs/ faint/ bursts of adrenalin that cause my body to jump.

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    Guest Mom to Many Gluten Free Kids

    Posted

    Thank you so much! It is so nice to see others take courage and enjoy life! We have had an active summer including a 2 1/2 day 22 mile pioneer trek. We ate well and survived the walking! I was one of the cooks for 60 people and fed my celiac teen too. I used a small pan and cooked over the coal chimney that we heated charcoal in for the gluten dutch ovens. It worked really well. It was not gourmet, but she ate well.

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    Guest Samantha

    Posted

    My fiance is a guide and I am outdoor enthusiast we have just begun preparing all new recipes and its been a step by step work. I've been really worried about trips after one of the top paddling resorts refuses to accommodate celiacs even in there dinning hall. We look forward to soon offering gluten free trips and eventually coming out with a trail cookbook. Thank you so much I never thought I could travel in a non-gluten free group again.

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    Guest Phyllis Morrow

    Posted

    Good article but... gluten-free oats?? Is there such a thing?? Oats are the one food I have to avoid at all costs as I get black outs/ faint/ bursts of adrenalin that cause my body to jump.

    Penrice - Oats that are labeled as gluten-free are grown and processed in environments that are not contaminated by wheat or other gluten-containing grains. Many celiacs can tolerate them well. But some people, like you, report sensitivity to oats and need to avoid them. You can find more information on the subject of oats and celiac disease on the web and elsewhere.

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    Thank you for this amazing detail inspiring us to stop letting celiac disease get in the way of our love of camping and outdoors. We will instead embrace it and learn to use Dutch ovens and do campfire cooking and all gluten-free. Once we learn, we can volunteer to make food for the group and keep it all gluten-free!

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    Jill Schaefer
    Celiac.com 11/19/2008 - Day Four: After a ride on a local public bus, which hugged the narrow road's teetering edge and rounded hairpin curves with an alarming sense of speed, we felt grateful for the solid earth beneath our feet in Positano. Our first order of business was to check into the Hotel Villa Rosa and find a nearby trattoria to fill our grumbling stomachs! One of the staff, Stefania, recommended Caffè Positano on the Fornillo side of the town and arranged for a courtesy taxi to deposit us at its doorstep. Without a doubt, its chief allure was the alfresco terrace facing the sea. Situated across the road from the main restaurant and kitchen, the terrace held a dozen or so umbrella-topped tables and beckoned foreigners with unforgettable views.
    Jill: We decided to share an enormous plate of salty prosciutto and cold sweet melon as an appetizer. Jeff ordered pesce spada griglia (grilled swordfish) and I chose petto di pollo aceto (grilled chicken with a balsamic vinaigrette, parmesan and arugula). We nibbled at each other's dishes and savored every bite of that culinary welcoming, so much so that we'd find ourselves back for more during our stay. Days later, upon seeing zuppa di verdura (minestrone soup) on the menu, Jeff asked how it was prepared. Our server confirmed it did not contain any noodles/macaroni or gluten, and Jeff was pleased to have his fill of the strictly vegetable-based soup, which we learned is how minestrone is typically prepared in the region. Experimental cook that he is, Jeff was eager already to replicate the recipe when we returned home to San Francisco.
    Jeff: The Villa Rosa provided an ample gluten-free breakfast. Each morning my tray included a gluten-free chocolate croissant and gluten-free toast with butter and jam, along with our usual assortment of coffee, tea and yogurt. After we finished a late breakfast, lounging at the beach was one of our favorite things to do. Like many beach areas, lunch fare leaned toward sandwiches, pizzas and the like. The few restaurants tended to be overpriced, but we found a reliable alternative in the salumeria, the Italian version of the delicatessen which means "cured meat shop." It had a variety of cheeses, meats and salads priced by the kilo. In addition to fresh pasta and pasta salads, the place usually had salads that were pasta-free and gluten-free.   
    Also, once I discovered that French fries were readily accessible (yes, in Italy) and the minestrone was, in my experience, always gluten-free, I knew I had a reliable fallback. This reinforced my confidence and led us to make an exception of avoiding sit-down lunches near the beach. We tried La Cambusa, where the waiter called us by our city of origin: Mr. and Mrs. San Francisco.  I had my staple fallback meal, and Jill snacked on a tasty ham and cheese omelet that she washed down with a glass of prosecco.
    Jill: While most of our experiences were positive, we had a few missteps along the way. During our first evening at a beach snack shop, Jeff ordered saltimbocca, a dish generally prepared with rolled veal, prosciutto or ham and cooked in a wine and butter sauce. However, what he ended up with was a sandwich version, pressed between thick slabs of bread, that I stuck in our fridge for my lunch the following day. Another time for dinner, we visited Donna Rosa, a family-run trattoria perched high in the hills of nearby Montepertuso, where the locals know to go to eat well and on the cheap. For an appetizer we chose scallops which, to our consternation, were lightly dusted with a bread-crumb gratin that wasn't described on the menu. These surprises could have been averted, though, if we hadn't let down our guard and relied too heavily on the menu. Ultimately, these experiences nudged us to remember to ask questions upfront and not get too comfortable.
    Day Nine: When we arrived in the more isolated fishing village of Praiano, a veritable country cousin to cosmopolite Positano, Jeff plopped down in the pastel-hued restaurant of the Hotel Margherita mere minutes after dropping his bags. He was famished and awaited a sumptuous plate of spaghetti posillipo, made with the hotel's gluten-free spaghetti and mushrooms. In fact, Jeff was so enamored with the heaping dish of gluten-free goodness that he borrowed my digital camera to snap a photo and in a flurry of excitement accidentally erased all of our other pictures! Well, at least we've got the memories...
    The Hotel Margherita proprietor Suela and her husband Andrea were also attentive to Jeff's breakfast needs. In addition to the standard buffet that had a generous gluten-free assortment of eggs, deli meat, cheeses, yogurt, coffee and tea, they purchased extras for Jeff, including a sweet, gluten-free lemon muffin and gluten-free toast.
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    Day Twelve: Perched on the cliffs, Ravello is often heralded for its gardens, Villa Rufulo and Villa Cimbrone, and has played host to departing Crusaders, famous authors and numerous other visitors throughout history. The town's stone walls, quaint walkways and tight, cobblestone streets exude the charm of antiquity. Gluten-free dining proved to be equally simple here. We arrived at the Hotel Graal early afternoon and were starving after two long cramped bus rides from Praiano. We headed to the restaurant, where the maître d' guided us to a shaded table on the terrace. Soon we lunched on gluten-free mushroom penne pasta and salad and took in stunning views of the ocean and the nearby seaside village of Minori.
    Jill: Perusing our guidebook, we found a trattoria tucked away beyond the main piazza called Cumpa' Cosimo and decided to give it a try for dinner. Thankfully we'd made a reservation, as the medieval-inspired place that was dotted with pictures of celebrities and run by Italian nonna (grandmother) Netta Bottone filled up fast. Everything on the menu looked enticing. The roasted rabbit caught Jeff's eye, along with more minestrone soup. He couldn't seem to get enough of the stuff! Craving comfort food, I bypassed the local specialties for a four-cheese pizza and glass of beer. After trying a bit of Jeff's entrée, though, I had a serious case of rabbit envy! We were pushing our last-bite limits when Netta paraded over to our table with a complimentary dessert, something like a cross between cheesecake and tiramisù, which Jeff picked at in order to avoid the crust (Celiac.com does not recommend doing this), and I couldn't resist polishing off. When Jeff mentioned that he was a writer as we paid our tab, Netta darted back to the kitchen and returned with a plate of figs and grapes. From her garden, she said, and insisted we put them in our pockets for later.
    Day Fourteen: Rome may be the Eternal City, but we had all of a day and a half there to explore, with the half starting after our nine-hour transit by private car, Amtrak train and then a female Formula One taxi driver at Termini Station. Since the next day was Sunday and we had no desire to fight the faithful who would attend mass, we opted for a quick visit to St. Peter's and from there trotted over to the Trastevere district for dinner. The Trastevere, a bohemian counterpart to New York's East Village, is one of my favorite places and it won over Jill, who hadn't quite been captured by the Roman magic.
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    Melissa Blanco
    Celiac.com 09/01/2009 - I recently passed a milestone, upon reaching the first anniversary,since my celiac disease diagnosis.  There was no golden coin or awardceremony, but rather a sense of personal accomplishment.  Although itis true that I feel better not eating gluten than I have in years—Istill miss my former diet every single day.  I no longer crave glutenfilled meals, nor do I feel sorry for myself, as often as I did,immediately following my diagnosis.  Yet, I still find it necessary tojustify my condition whenever I get confused looks at dinner parties orpotlucks.  There are also the days when I will pass a pizza shop orhave a craving for a glazed donut with my morning coffee.  It is inthose moments when familiar pangs will resurface and make me long forjust an instance that I could put on my gluten shield and indulge.
    Itwas at this time last year, that I celebrated my first summergluten-free.  I ate at only restaurants with gluten-free selections, Ibegan dabbling in store bought wheat-free mixes, and jumped up and downin my kitchen the day my husband discovered a gluten-free bakery,several towns away.  Last summer was also my first opportunity totravel gluten-free.  It was during those normally carefree months thatI attended a Family Camp, at a retreat center, in the mountains. Although I meticulously planned for the trip; packing clothing, extratennis shoes, swimming essentials, and toiletries—I neglected toremember that I now had dietary limitations which would possibly have atremendous impact on the outcome of this family weekend.  Yes, I packedgluten-free breakfast bars and fresh fruit, but that was it.  I didn’tcall ahead and ask if they had menu options for celiac sufferers, nordid I plan for lunches and dinners.
    Walking into the retreatcenter dining hall among the smell of fresh baked bread, pasta salad,and breaded chicken made my mouth water like one of Pavlov’s dogs.  Iglanced around the table to see salad drizzled with vinaigrette andrealized that was all I would be eating for the day.  My head began toache and tears stung the back of my eyes.  I inwardly cursed myself formy lack of preparation.  I am the mother of three young children, thewife of a deployed soldier, a responsible and organized woman—yet Icompletely forgot to prepare for a weekend in the mountains, withceliac disease.
    I soon learned two of my fellow campers alsosuffered from gluten intolerance and was informed that there wasgluten-free bread and peanut butter, in the kitchen.  I breathed a sighof relief as I walked up to the chef and asked him if I could possiblyhave a slice of gluten-free bread.  He looked at me and responded,“sure, but this is the only loaf we have, so when it’s gone, it’sgone.”  He was completely put off by my request and irritated thatthree celiacs would arrive at his retreat center, simultaneously,forcing him into a position to alter his meals for dietaryrestrictions.  I grabbed the smallest slice of bread in the loaf,ensuring that the young boy with celiac would have food to eat, andwalked out of the kitchen, in tears.
    That was one year ago, andalthough the date on the calendar has changed, I am still coping withmy condition and learning to travel gluten-free.  My husband recentlyreturned from his yearlong deployment to Iraq, and decided it was timeto treat the family to a couple days of fun-filled water adventure;with a trip to Great Wolf Lodge in Grand Mound, Washington.  It wouldbe an understatement to say that my children were excited—rather, theywere beyond ecstatic at the prospect of water slides, swimming pools,and the giant bucket of water which spills and drenches everyone in itspath, every few moments.      
    I packed my morning gluten-freebreakfast bars, alongside of my toddler’s swim diapers, and we hit theroad, ready for an adventure at Great Wolf Lodge.  As I prepared formeals of bunless hamburgers and grilled chicken Caesar salads, minusthe croutons, my children began psyching themselves up for the thrillof a rushing waterslide.  I wasn’t sure how food allergies would begreeted at this indoor water park, as was I nervous for a reoccurrenceof past experiences.  My ultimate hope was that my Celiac Disease wouldbe understood and recognized for its seriousness.   

    The Loose Moose Cottage

    Onthe first evening of our stay, my husband suggested eating at The LooseMoose Cottage, to partake of their dinner buffet.  After being seatedin a comfortable booth, we ordered our drinks, before I perused ourselection of food for the evening.  The buffet was quite organized witha variety of offerings assembled in different ethnic sections featuringMexican food, Italian food, and Chinese cuisine.  There was a selectionof sautéed vegetables, potatoes, and sliced roast beef; a kid’s stationwith macaroni and cheese and mini corndogs, a salad bar, and a dessertstation.  After preparing my children’s’ plates, I approached a chef,as she refilled the nacho tray, and asked if the enchiladas were madeusing corn or flour tortillas.  She informed me that they were madewith flour before asking if there was something she could help me with.I told her that I have celiac disease, and expected to explain to herwhat that was; yet was surprised as she began walking down theselection of foods, informing me one-by-one which were safe for me toeat.  As I kept up with her, amazed at her accommodating demeanor, sheworked all the way from the Mexican food to the salad bar.  She thenwalked back to the kitchen and returned with two pieces of gluten-freegrilled chicken breast.  As I was thanking her, she offered to make megluten-free pasta.  When I declined, she told me that if I would likethem to make me pasta the following day, to let the kitchen know andthey would be more than happy to prepare it for me.
    My personalreview of The Loose Moose Cottage: The food was good, the service wasexceptional, and the atmosphere was accommodating for my family.  Theonly thing which would have made dining easier would have been if eachdish’s ingredients were listed on a sign beside the dish itself.
      

    Poolside Grill

    During our afternoon of swimming, we ventured outside where staff wereoffering grilled hamburgers and hotdogs, along with potato chips anddrinks.  The smell of the grill was invigorating—after several hours ofswimming, we were starving—so my husband and I decided it was time fora power lunch.  I requested a hotdog, without a bun.  The chef lookedat me and asked, “Do you have celiac disease?”I nodded my headand said, “Yes, I do.”  Then I watched with astonishment as sheimmediately removed the plastic gloves she had been using, beforereplacing them with new gloves, and sticking my hotdog on a clean partof the grill.  When I questioned her about her knowledge of foodallergies, and specifically celiac disease, she explained that GreatWolf Lodge has a lot of guests with food restrictions and the chefsmake every effort to be knowledgeable and helpful.
    My personal review of the Poolside Grill: The food was delicious and the staff was informed and respectful.

    Bear Paw Café

    The smell ofthe Bear Paw Café began wafting through the air the moment I exited theelevator.  This small café is not to be taken lightly by the averagedieter, with the aroma of delicious desserts; fudge, ice cream, bakedgoods and popcorn.  Typically, this is an area I would avoid; however,I decided that in order to fully assess the food selections of theGreat Wolf Lodge, it would only be fair to visit the bakery.  Plus, Ireally wanted a piece of fudge. When I approached the personat the counter and explained that I was unable to eat anything withwheat in it and wondered if they had any gluten-free offerings, shesmiled and went to find a person more capable of assisting me.  A bakercame out from the kitchen and greeted me with a smile, before tellingme that her mom has suffered from Celiac Disease for twenty-years.  Shethen pointed out the assortment of gluten-free fudges and offered tomake me gluten-free cookies.  Although I was tempted to take her up onthe cookies, I rather, chose a piece of fudge.  I can say, without adoubt—it was delicious.
    My personal review of the Bear Paw Café:The fudge was delicious and the service was exceptional.  I do wishthere was more of a variety of baked goods for those with foodallergies; such as wheat, peanut, and egg-free ingredients.

    Camp Critter

    Forour final meal at the Great Wolf Lodge, we ate at the Camp Critterrestaurant.  After a day of swimming, we were all completely famishedand felt at home in the warm atmosphere of this sit down restaurant. The menu had a variety of kids’ meal offerings, as well as adultselections ranging from burgers, to salads, to steaks.  I was onceagain met with a server who was knowledgeable and sympathetic to mydietary restrictions.  I asked for a cheeseburger, without a bun, andwhen it was delivered, I was informed that my fries were made inseparate oil, to avoid cross contamination.  What can I say; it wasAll-American dining, and my entire family enjoyed it. Mypersonal review of Camp Critter: Although the menu did not have avariety of gluten-free selections; the food I chose was preparedgluten-free, cooked well, and the staff was accommodating and helpful.
    After two fun-filled days of water bliss at the Great Wolf Lodge, wedeparted for home, exhausted, and with chlorine seeping out of ourswimming suits.  I rate our trip 5 of 5 stars—it was a great get-away,and I didn’t feel hindered by my celiac disease.  And on a side note…mykids thought the water park was amazing.
      


    April Baxter
    This article originally appeared in the Summer 2010 edition of Celiac.com's Journal of Gluten-Sensitivity.
    Celiac.com 07/17/2010 - My husband and I recently returned from a trip to the Sandals Royal Bahamian Resort in Nassau, Bahamas.  What a wonderful experience! The resort itself was beautiful but the people working there made the vacation special. Prior to our arrival, I contacted the General Manager, Jeremy Mutton, advising him of my dietary requirements. He promptly responded that I would be taken care of without any problems and had informed the appropriate staff.
    Upon our arrival, I was greeted by the Executive Sous Chef, Seanette Brice, and the Food/Beverage Manager, Sieon Wintz, who catered to all my dietary needs. I was so impressed by their knowledge of celiac disease and how they took the necessary precautions in having all of my meals prepared.  There are 9 or 10 restaurants on the property – most of them we dined at and they all were aware of my gluten free needs – the chefs would actually come out to speak with me prior to each meal – they often made a little something extra for my plate. The Italian Restaurant carried gluten free pasta; the pizzeria on the beach had a special pizza made for me with no cross-contamination; French fries were made in a dedicated fryer; desserts were made especially for me. Fresh fruit was plentiful as well every day. All meals/snacks were excellent. Seanette even offered to pack me a lunch the day we went into town to shop!
    I highly recommend visiting this resort for a relaxing, gluten-free travel experience. I did ask if all Sandals resorts catered to gluten-free needs, but they could not speak on their behalf – each destination would have to be contacted.
    The website is: www.sandals.com  (Resort – The Royal Bahamian)


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

    Use of a Separate Strainer: Using a strainer that has been used for pastas or other gluten products, can result in cross contamination. Salad Dressing: Many salad dressing utilize gluten containing ingredients like malt vinegar, spices, natural flavorings, wheat, etc. Vegetable Chopping Board: A vegetable chopping board must either be completely sterilized or a gluten-free dedicated board must be used. Knife: Knife must be sterilized with heat before being used on gluten-free ingredients. 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). 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
    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. Many meats are marinated in sauces containing gluten before they are cooked. Gluten Free Pizza & Bakery Products
    If an exhaust fan is used in the oven, a screen must be used. Pizza toppings for gluten free pizza should be housed in a separate area. Cannot be prepared in a facility that uses gluten containing flours, because flour dust in the air settles on food. Mixing utensils, wooden spoons, scrapes in bowls and cutting boards must be sterile or maintained for just gluten-free products.

  • 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