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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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    HOW TO EAT A GLUTEN-FREE BREAKFAST WHILE TRAVELING


    Daniel Moran

    Celiac.com 05/14/2008 - Staying at a Hotel or Bed and Breakfast with Breakfast Included


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    With your trip you will have to stay at a hotel or resort. I am going to discuss my thoughts on how to eat and stay safe. I will be talking about breakfast because some hotels and B&B’s offer free breakfasts. Lunch and dinner are different subjects that need to be discussed in great length.

    It is very important for you to keep the Gluten Monster away during your trip.  If you are in a hurry just grab some fruit, clean it, and leave.  If you want to stay, you have to monitor how the wait staff warms the food up.  In the past I have asked to see the ingredients from various boxes so don’t be afraid to ask to see packages.  You are looking for a variety of things. After I find out if I can eat the food I again observe the staff and how they handle the food I will be eating.

    • Are they careful or sloppy?
    • Do they use the same plate in a manner that might cause cross contamination?
    • Once I decide that I can eat the breakfast I wait until they bring fresh food out and I take food from the fresh plate.
    • I do ask for clean plate if they use the same plate for everything.
    • If the staff does use the same plate I ask if they can use a different or fresh plate for me.  I also sometimes give them my plate and ask them nicely if they could put some of the cooked product on my plate before they do anything else with it.
    Always explain your diet the best you can and let the staff know that you have a special diet and that they have to be very careful with your food.  Tell them you get very sick and you must be extra careful.  If the staff doesn’t speak English well you can try using a gluten-free restaurant card in the language they speak, or just keep it short and try to explain in the easiest possible way.

    In the hotels where they warm up sausage, eggs and pancakes I have found that I was able to eat the breakfast sausage and the eggs.  These products came to the hotel already cooked and frozen so all the staff had to do was put them into the microwave and heat them up. I just asked to look at the boxes that the food came in so that I could read their ingredients. As mentioned, I always wait for a fresh batch of food to come out, and I even go as far as to use a clean fork to serve the food out of the pan or plate before it is dumped into the chafing dish. 

    I would have already explained to the wait staff in detail of my special diet needs so they will already know that I take my health very seriously. By taking the food out of the pan I hopefully take care of the accidental cross contamination from other patrons.  If you take the food out of the pan as it sits there for all to use you are taking the chance that somebody has spilled a crumb into the pan.  Be kind to the wait staff and they will help you.

    For the other products served at the hotel like fruit be sure to wash it to make sure it is clean.  If they are using bulk cereal it is probably not a cereal that you can eat so stay away unless you read the ingredients on the box or are certain that it is gluten-free.  Remember that bulk cereals might have different ingredients than the versions that you are used to—or it could be another brand or another type. Hard boiled eggs are sometimes available—just be sure to ask for them right out of the pot or wash them very well.  Some of the eggs have vinegar in the buckets to preserve them so be careful to read it thoroughly and also ask the staff if they have poured the end of a bucket into the bucket you are looking at.

    In small kitchens like these you will find that the staff will often pour the remaining food back into the container if it can be reused. You have to determine if this is happening. Notice if the containers are very full or empty—will the staff let you open a fresh bucket or box if you ask?  If it is early they won’t have much trouble doing that for you because they are going to use it anyway, but if it is at the end of breakfast they might not want to open a new container. 

    Remember to always have a plan B and to be nice. If necessary have your Chef Daniel's restaurant paper that can be used to explain your illness.  Sometimes it is easier for people to read celiac disease so they can understand.  I always grab a piece of fruit for later in case I have trouble finding lunch and it is a good snack to have.  Once you have your breakfast it is out to lunch.

    Gluten-Free at Buffet Breakfasts
    If you are at a hotel that offers a buffet breakfast for free it is the same procedure as above.  Always try to get a fresh pan as it comes out to eliminate cross contamination from other customers.  Try to talk with someone in charge like the manager who could help you if they are not busy. Be nice and explain your illness and how sick your will get.  Don’t be afraid to ask for the ingredients.  Ask for them to cut or tear the ingredients out of the box for you if possible.  Sometimes they have written them down for me and brought it out to our table.  Make sure you ask whether they using fresh eggs or “egg products.”  Also ask if they are putting something in the eggs to keep them from turning green.  If they are using real eggs they have to keep them from turning green.  Real eggs turn green from the heat and the chefs sometimes put lemon juice or vinegar in the eggs while they cook them.

    Always ask—no matter how silly you think it is—whether they add anything to the food. Seasoning salt sometimes has wheat in it, so ask if they use something besides just salt
    and pepper. Remind them how sick you will get if you eat a little piece of gluten and never be ashamed to ask.  Always ask for your food to be unseasoned—that also eliminates the risk here.

    Whatever you want make sure that you try to get the freshest that they have and also use a clean fork to retrieve your food. Most of the tongs or spoons are going to be used from one container to the next.

    If the staff can help you they will, so ask and be patient don’t expect to be out fast.  If you are expecting to be fast then you probably will be sick.  In some cases you can ask for some fresh products from the back.  Find the person who has been helping you and if the food you want is taking a long time to empty or just isn’t getting refilled on the buffet line.  Ask if someone can go to the back and get you some food.  Hand them your clean fork and ask them nicely if they can use this to get the food on your plate.  As long as you are nice they will help you. Always try to ask someone who seems to care about the establishment where you are eating—you will know them.

     Don’t forget to ask how they cooked your food.  Just because the sausages are gluten-free doesn’t mean they cooked them that way.  They could cook them on the same grill that they cooked the pancakes on and you will have bread on your sausage!  Most places cook sausage and bacon in the oven but you need to ask how they cook everything.  Are the scrambled eggs cooked on the grill—if so can they cook you a small batch on the side?  Keep that in mind with all of the food you are going to eat.  Don’t forget to be careful and remember about cross contamination  

    A Sit-down Gluten-Free Breakfast
    For your sit down breakfast you want to make sure they cook your entire meal ala cart.

    • Cook your eggs in a fresh pan.
    • Use olive oil or real butter to cook them not the spray can of oil.
    • Have your Chef Daniel's restaurant paper or gluten-free restaurant card that tells the cooks about you and your illness and let them know how to cook your food.
    • Tell them in great detail how to prepare your food,
    • Ask them to use a fresh fork to grab items if need to be..
    • Not to use garnish or spice on your food.
    • Don’t be afraid to ask for a clipping of the ingredients from the box if you want to check to see if you can have the sausage or ham.
    • Tell them about the cross contamination from cutting boards, knives, tongs and the table they work on.
    I can’t emphasize this enough—you have to judge for yourself how busy the place is.  This is the most important thing you have to remember.  As humans under stress do stupid things and the cook could fall under that.  Just think of how you would do if you were working there.  Would you, for example, have enough time to get part of a box that you threw away two hours ago when you started breakfast?  The type of restaurant matters to.  Is this a Motel or is it a very successful chain that pays well and has good benefits.  This usually means the staff is very good.

    These tips can help you but you do have to make sure that you inform the staff, waitress, manager and hopefully the person who is cooking your meal.  It doesn’t do any good if you tell one person and they forget because they got busy.  That is why I always try to tell the manager when I enter.  In your Chef Daniel's restaurant paper make sure you give them exactly how to cook your meal.  Don’t assume they will do it because you told them you get very sick.  As a chef myself, if I read something and it told me to use olive oil and not salad oil—I would do as it said.  If it said use oil I would grab the closest product or even margarine.  Even when busy if you read something it should stay in your head.  When you’re busy and someone tells you that table #22 has celiac and needs gluten-free food…well it could get lost if I am busy listening to 20 different orders, so bring a form or gluten-free restaurant card that they can read.

     

    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.

    Keep the comments coming and together we will get rid of the Gluten Monster!

    Chef Daniel P

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    Guest Joan Terry

    Posted

    Your articles are great! I am a seasoned traveler on cruise ships. However, my husband and I are taking a river cruise on the Danube on a small vessel in June. I do very well on the larger cruise ships, as I am assigned to a sous chef . Thanks for your wise advice. Keep it coming!!

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    Guest Peggy Corra

    Posted

    Just wanted to mention that in Brazil an ordinary, everyday food on breakfast buffets is 'pao de queijo,' a little cheese-bread ball that is naturally gluten-free because it is made with tapioca flour, not wheat flour. It is such a treat to have a bread item that I know is safe for me to eat.

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    I use Google maps when I'm traveling to find out if there's a Whole Foods anywhere on my route or in the city to which I'm traveling. I then pick up some gluten free biscuits, quick bread, or cereal and take it with me to the breakfast buffet. I put my bread in a napkin on a plate and heat it in the microwave or else I make a bowl of the cereal I brought. Sure I'm paying for it, but I know it's something I can eat. If we're staying somewhere for more than a couple of nights, I try to book a suite or condo where I'll have access to at least a semblance of a kitchen and a frig in which to store some gluten free goodies.

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    Guest old dame reporter

    Posted

    Gluten-free pals... we are all so glad to be well (I had 50 years of pain)... even so... should we have a write-in campaign, thanking the manufactures but encouraging them to make the products a bit larger? Half a loaf and tiny pizzas, yes great quality and healthy for us, but wishing for the full loaf and big pizza for the price. Just an idea.

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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.


    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.
    In preparation for this trip, I first made a list of the top 20 rated hotels and bed and breakfasts (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!


    Destiny Stone
    This is the time of year when familiestake vacations and travel the world. Traveling can often be stressfuleven under normal circumstances; packing problems, flight delays,getting lost, are all possible when trying to get from point A topoint B. So imagine how stressful it can be for a celiac orgluten-sensitive person to get ready for a big trip, especially to alocation that doesn't cater to the gluten-free lifestyle.The following tips are geared towardhelping even the most sensitive celiac to have a fun filled andgluten-free vacation while minimizing the stress factor as much aspossible. This article covers the following: preparing for yourgluten-free travel adventure, gluten-free travel by plane,automobile, train or ship, gluten-free accommodations, gluten-freemeals and snacks, what to do if you accidentally ingest gluten.
    Before beginning your vacation, thereare many important things you will want to consider, like method oftravel, your destination, and gluten-free options in the city ortown in which you will be staying. To help find gluten-freeaccommodations and eatery's in your location, perform a “Google”search for 'gluten-free restaurants and accommodations' in the areayou will be traveling to.

    Planes Trains and Automobiles-Tips forGluten-Free Travel by Danna Korn Gluten-Free Transportation
    Traveling by car is the best way totravel, if you have a choice. That way you can stop at stores asneeded and load up on your gluten-free snacks. Trains are also good,because they allow and encourage you to bring your own food on the train. Planesand ships are where it starts to get a little trick, especially if you have a long trip ahead of you.
    Airlines are fairly easy to manage,because you can bring your own food aboard the flight. However,there is a limit to what and how much you are allowed to bringaboard, which can be a problem on a long flight. While many airlinesoffer vegetarian or Kosher options for those with special dietaryneeds, most airlines do not have gluten-free menu options for thoseof us with gluten-intolerance. However, Continental Airlinescurrently offers gluten-free food options. Although, if you areextremely sensitive to cross-contamination, it is still safer tobring your own food.

    More Gluten-Free Airline Travel Tips
    Continental Airlines
    However, if you are planning to travela cruise-line, most cruise-lines do not allow you to bring your ownfood aboard. So in this situation it is important to find acruise-line that will accommodate your special needs. RoyalCaribbean Cruise-lines, and Orbridge ships are two cruise-lines thatoffer gluten-free menu options, as well as catering to other dietaryneeds.
    Royal Caribbean Cruise Orbridge
    Gluten-free accommodations
    Most motels or hotels offer acontinental breakfast and that's about it. Short of eating coffee andorange juice for breakfast,there usually isn't much in the way ofmeal options for a celiac. However, many small bed and breakfast'swill accommodate you special dietary needs if you talk to them andset it up in advanced, and some even offer gluten-free options. To find a gluten-free Inn, perform a “Google” search for'gluten-free accommodations' in the area you will be traveling to.
    Staying with family or friends can bestressful if they aren't sensitive to your dietary needs. It can alsobe difficult to explain to your friends and loved ones, what it meansfor you to be gluten-free, and who really wants to spend their entirevacation educating the everyone you meet on what it means to beceliac or gluten-sensitive? That could literally take the entirevacation. If cross-contamination is an issue for you and you areconcerned about eating in a gluten based house, the following linkwill help you determine what you need to be free from gluten whileyou are staying with others. It might be a good idea to print theinformation and share it with your host, maybe even emailing them alink with the information, prior to your visit.

    What to do if you can't have agluten-free kitchen Gluten-Free Meals and Snacks
    Finger foods, gluten-freechips/crackers, veggie sticks, gluten-free sandwiches, these are allwonderful foods to keep with you on a trip. Bring as muchgluten-free, shelf-stable food with you as possible. Find out wherethe local farm market is, for fresh and local, organic produce andbuy fresh produce when you arrive at your location.
    Many people getting ready for a trip,will place an order online in advance and have it delivered to thelocation they will be visiting. The Gluten-Free Mall is veryaccommodating and can ship shelf stable food Nationally andInternationally and frozen goods can be shipped within theContinental US. Having a package of gluten-free food delivered toyour location, gives you one less thing to worry about. No extrapacking, or extra luggage, no worries about your food getting crushedor apprehended at customs or tossed out at an airport. It's assimple as placing an order online or by phone.

    Gluten-Free Mall The National Foundation for CeliacAwareness (NFCA) works very hard to train chefs and kitchen staff allacross the globe, on the dos and don't s of cooking gluten-free fortheir guests with extreme gluten sensitivities. Check out the listthey have compiled of of GREAT kitchens that have the stamp ofapproval from NFCA for a possible location near you.

    NFCA GREAT Gluten-Free Kitchens list Unfortunately, not all restaurants havethe GREAT seal of approval from NFCA and the likelihood of one beingat your chosen destination is pretty slim, and finding a dedicated gluten-free restaurants are also rare depending on where you travel. That's why it is important to knowwhat to do when you go out to eat with a group of gluten-eaters.There is a great deal of information on this subject, but here aresome links to get you started.

    How to eat a gluten-free breakfastwhile traveling Eating gluten-free when traveling What to do if you Accidentally Ingest Gluten
    There are varying opinions of what thebest thing to do is when you accidentally ingest gluten, drink gingertea, take laxatives, hot water bottle on the abdomen; there really isno right answer, as everybody is different and has differentreactions to gluten. However, here are some tips that might help ifyou accidentally ingest gluten.

    Accidental Gluten Ingestion What to do if you accidentally eat gluten
    The most important thing you can do for yourself is to have fun. Stress can affect how youdigest your food, and then it won't matter if you avoid gluten, you stillwon't feel good. 
    Happy and safe travels everyone!


    Melissa Reed
    Celiac.com 07/24/2014 - People that have celiac disease know one of the main concerns is avoiding gluten when they have meals. Their second biggest concern is the possible co-mingling of ingredients that can contaminate otherwise gluten-free food! So how do you eat at restaurants when you have celiac and still have peace of mind?
    Here is how:
    Before you are to go out to a restaurant call ahead and ask for the manager, find out if they do offer gluten-free meals that are carefully prepared for people with food allergy (If you are unable to call ahead go online and look the restaurant up to see if they offer a gluten-free menu or gluten-free meal selections, if need be email them). Also ask if the restaurant prepares gluten-free meals in a separate area, and if the restaurant uses different cooking utensils for gluten-free meal preparation. When you arrive at the restaurant that you have confirmed has gluten-free meals, let your server know you have a "Gluten Allergy" (ok, you can use different terms, and this isn't correct, but it conveys necessity instead of trend) and must eat gluten-free. Ask for a gluten-free menu, if they did not offer one to you. If you feel comfortable ask to speak with the manager or chef at your table, so they know that you have a medical need for a gluten-free diet. Let your favorite restaurants know that you want gluten-free meal selections and a gluten-free menu if they do not offer that yet. Do not be afraid to ask! Also, online there are cards you can print out and take to restaurants that you can give to server, manager or chefs to let them know that you are in need of a gluten-free diet. Some restaurants are now getting trained for gluten-free food preparation through National Foundation for Celiac Awareness (NFCA) and Great Kitchens, so that all the staff is fully prepared and educated on how to handle safe preparation of meals for celiac and gluten intolerant individuals.
    Talk about peace of mind; if a restaurant has had the gluten-free food training, know you are safe to eat gluten-free meals there!

  • Recent Articles

    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

    Jefferson Adams
    Celiac.com 04/17/2018 - Could the holy grail of gluten-free food lie in special strains of wheat that lack “bad glutens” that trigger the celiac disease, but include the “good glutens” that make bread and other products chewy, spongey and delicious? Such products would include all of the good things about wheat, but none of the bad things that might trigger celiac disease.
    A team of researchers in Spain is creating strains of wheat that lack the “bad glutens” that trigger the autoimmune disorder celiac disease. The team, based at the Institute for Sustainable Agriculture in Cordoba, Spain, is making use of the new and highly effective CRISPR gene editing to eliminate the majority of the gliadins in wheat.
    Gliadins are the gluten proteins that trigger the majority of symptoms for people with celiac disease.
    As part of their efforts, the team has conducted a small study on 20 people with “gluten sensitivity.” That study showed that test subjects can tolerate bread made with this special wheat, says team member Francisco Barro. However, the team has yet to publish the results.
    Clearly, more comprehensive testing would be needed to determine if such a product is safely tolerated by people with celiac disease. Still, with these efforts, along with efforts to develop vaccines, enzymes, and other treatments making steady progress, we are living in exciting times for people with celiac disease.
    It is entirely conceivable that in the not-so-distant future we will see safe, viable treatments for celiac disease that do not require a strict gluten-free diet.
    Read more at Digitaltrends.com , and at Newscientist.com