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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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    THE GREAT GLUTEN-FREE DEBACLE


    CPT B. Donald Andrasik


    • Journal of Gluten Sensitivity Spring 2013 Issue


    Celiac.com 06/02/2017 - Though I tried to avoid eating with locals, it seemed to come up over and over again. Military duties frequently required me to work and meet with the locals to facilitate contracts we had in place and ensure work was done properly. At various times and locations, I traveled with a small group of other soldiers among a larger population of Afghans. Many of the Afghans carried weapons, such as the AK-47, and had them slung over their shoulders. We were able to strike a chord with the locals, creating an atmosphere of camaraderie. The U.S. government was paying them to do a job; they were collecting a wage, and everyone left satisfied. At times, this relationship felt like any manager/employee relationship, and at other times it felt like we were paying the mafia to keep them from doing harm. The situation could be tough and would get tougher as our relationship with the locals became strained due to regional politics.


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    An example of this strain occurred in February 2012, when a group of Afghan workers near Kabul (a few hundred miles away) were angered by the sight of Korans in a burn pile. The Koran is the religious text of Islam, which Muslims consider the word of God. An Arabic Koran is cared for in a special manner, and the sight of these sacred texts in a burn pit was enough to incite violence and riots throughout the country. Unlike the United States, where news travels instantly, news in Afghanistan travels slowly, mostly by word of mouth, and it took several days before Afghans in Kandahar heard about the incident. They began to protest, and we were all instructed to be on high alert with loaded weapons. Meanwhile, in Kabul, the riots took the lives of American soldiers. This included a friend of mine, a fellow Maryland Guardsmen and Army officer. He had been working with the Afghan National Army (ANA) in the Kabul region. Bob was a good man, and I will remember him fondly.

    Work did not stop, even with the angry protests. Along with a small group of soldiers, I found myself at the local Kandahar Transshipment Yard, roughly two miles from the main post of KAF. The group of about twelve U.S. soldiers was there, mixed with over one hundred local Afghans and Pakistanis, most of whom were working as truck drivers delivering supplies. The atmosphere was abnormally quiet as we went about our business and talked with the Afghans. They stared at us but made no ill gestures as we walked up to them. Someone nearby started yelling. There was a scuffle. Silence followed. One of the locals stepped out from his group and walked over to me. He spoke no English but reached out his hand and offered me food. This seemed intended as a gesture of friendship. I could eat it and risk a variety of potential side effects to include a gluten reaction, or I could turn it down, which may have been considered an insult in what was already shaping up to be a tense situation.

    What do you do? I did what any leader would do, and made the best of the situation in spite of my diet. I imagine anyone would. Why risk violence just to avoid eating gluten? Yet the ramifications are clear for anyone considering joining military service. They may be putting themselves in a compromising position. Those of us out there make the best of it and do not mind the selfless service when required.

    Yet even at home in our day-to-day lives, where violence is not a factor, I see celiacs and gluten-free dieters compromising their dietary standards due to social pressures. Maybe they do it to fit in, or rub elbows with a supervisor at work, or maybe just to avoid seeming difficult. We may be given a salad with croutons and quietly brush them out of the way rather than be an inconvenience. And when we do this we are not only harming ourselves but each other. The more vocal celiacs are about their diet, the easier it will be for the next celiac who will follow in their footsteps, or are seated in the same restaurant later on.

    While it may seem curt, or perhaps crass, I politely reject any food that I am not confident is gluten-free, while ensuring that the server knows I am concerned about gluten. It does not matter to me if it is at a social event, a work event, or just casual dining. While I do know some gluten-free dieters who will only eat food from their own kitchen, I am not quite so stringent and am willing to go out to eat. However, I am also known for bombarding servers and cooks with a host of questions until I'm reasonably assured that my meal will not be cross contaminated or contain gluten. Several of the vignettes I include in Gluten Free in Afghanistan tell my story of difficult times eating gluten-free, both at home and abroad.

    While war-time scenarios do not unfold too often, and are probably far from your mind while eating at a restaurant, you may want to remember the above story when your gluten-free meal comes with wheat toast on top of it, or the crouton crumbs are scattered on top of your salad. Is it likely that the person who handed it to you is heavily armed and going to be offended? If they are, I would recommend you leave the area immediately for your safety and the safety of those around you. If they are likely not armed, politely explaining why this food is not healthy for gluten-free dieters will not only benefit you, it will benefit any celiac who is there after you. Stay safe out there.

    An excerpt from his book Gluten Free in Afghanistan.


    Image Caption: Image: CC--DVIDSHUB
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    Guest Anna Hamer

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    Thank you for your service and for touching on the subject that is so hard for me to explain to my loved ones. Eating out is such a social and common event that the fact that I'm not safe in an environment that is not completely in my control does not compute to my friends. I have gotten so sick now in restaurants that I thought were safe for me in the past that I AM going to be safe. I make dinner at my house or bring stuff over to a friend´s house and we have a meal together. More work but worth it.

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    Guest Laura

    Posted

    This is a concerning article. A person's action depends on the gluten re-action. Is yours abdominal pain, headache or celiac dermatitis? Or is it of the extreme that includes 4 hours of repeated, explosive diarrhea. If I were recruited to the army, I'd probably be on my death bed within a month and definitely prior to deployment.

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    Destiny Stone
    Memorial Day is fast approaching. Once known as, "Decoration Day", Memorial Day commemorates the men and women who have died while serving their Country during military service. Not only is Memorial Day a day of remembrance, it is also a day to spend quality time with your family and loved ones. Most Memorial Day activities center around a picnic, BBQ, or sporting events, so get ready to have a gluten-free Memorial Day!
    If you are gluten sensitive, you will want to make sure your are included in the festivities by preparing gluten-free foods you can eat and share with others. Many of your favorite picnic and BBQ foods are naturally gluten-free, but the condiments and preparation of the dish is what can render your meal inedible. Remember to use gluten-free sauces for your marinades, and avoid using condiments that have been dipped into by gluten laden utensils, as cross contaminates are readily found in jars of mayonnaise and mustard. Keep yourself safe this year and make sure to have your own condiments when going to a group event. Many gluten sensitive people use squeeze tops for their condiments to avoid the proverbial "gluten contaminated knife in the condiments" routine. Included are some Memorial Day tips and recipes, but with a gluten-free twist.

    Gluten-Free Condiments and Marinades Hot Dogs are generally not gluten-free. The fillers they pump into hot dogs usually contain gluten or a sub-ingredient of gluten, such as caramel color, artificial colors or flavors, and even some spices. If you are a hot dog lover, don't despair, there are gluten-free hot dogs on the market. The link below is for all natural gluten-free buffalo hot dogs-check it out!
    Gluten-Free Hot Dogs Don't forget the buns! Being gluten-free doesn't mean you can't enjoy a bun like everyone else-just make sure your buns are gluten-free. You may want to abstain from grilling your buns on the BBQ if there are gluten products on the grill. Try toasting your buns in a clean toaster oven, or putting your buns on a piece of aluminum foil to avoid contamination. There are even some gluten-free buns on the market that are good enough to eat without toasting. The link below is a good place to start looking for gluten-free buns.
    Gluten-Free  Buns Shish kabobs are an all-time favorite at any Memorial Day event. Shish kabobs are easy to make and gluten-free; just make sure to use gluten-free soy sauce and marinades for your kabobs. Here are some ideas for home made, low-fat, gluten-free Shish kabobs.
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    1 lemon, zested, then juiced, remainder discarded 1 orange zested, then Juiced, remainder discarded 1 lime, zested, then juiced, remainder discarded 4 cloves fresh garlic, minced  1 tablespoon fresh tarragon leaves 1/4 cup gluten-free soy sauce 1/4 cup olive oil 1/2 teaspoon salt 1/2 teaspoon freshly ground black pepper 1 pound boneless, skinless gluten-free chicken breasts, cut into 1-inch cubes (use free-range, organic chicken without fillers if possible).
    Gluten-Free Veggie Kabobs
    Bell peppers Onions Cherry tomatoes Mushrooms Italian squash Zuchinni Sweet potato chunks Tofu
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    Gluten-Free Balsamic Vinaigrette (for veggie marinade)
    1/4 cup olive oil 2 tablespoons balsamic vinegar salt and pepper to taste
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    Thoroughly mix together all of the citrus-tarragon chicken ingredients (except the chicken) in a bowl. Toss the chicken in the mixture until evenly coated. Cover and marinate in refrigerator for 2 hours. Cut vegetables into bite-size pieces. Puree balsamic basting vinaigrette ingredients in a blender for 30 seconds. Grill kabobs directly over heat source for about 10 to 15 minutes, turning 1/4 rotation every 2 to 3 minutes, or until it's cooked throughout. Gluten-Free Salads and Side Dishes:
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    Old Fashioned Hot German Potato Salad (Gluten-Free)
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    Being gluten-free doesn't  mean you can't enjoy a cold beer on Memorial day like everyone else. There are many beer companies that now make gluten-free options. There are quite a few really amazing gluten-free beers on the market, so you shouldn't have to settle for a gluten-free beer you don't like, though you may have to sample many gluten-free beers before you find one that suits your tastes. However, finding a market that carries your favorite gluten-free beer is another issue all together. You may want to discuss options with your favorite grocery store. Many stores will offer to carry products for you if they know you will buy them regularly. The following list of beers are some of the top sellers and can be found at many specialty stores, grocery stores, and liquor stores.Gluten-Free Beers:

    Greens Gluten-Free Beer Redbridge Gluten-Free Beer New Grist Gluten-Free Beer Gluten-Free desserts are certainly not sparse. Although, finding gluten-free, sugar-free, egg-free, dairy/casein-free, corn-free desserts are a bit trickier. Pecan pie is an all American favorite, and no Memorial Day should be without pecan pie. The following pecan pie recipe is raw, and requires no cooking, and contains almost none of the usual food allergens-unless of course you are allergic to pecans.
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    2 cups raw almonds, soaked and drained 35 pitted dates, soaked for 1 hour and drained 1 tablespoon fresh squeezed lime juice 1/2 teaspoon ground cinnamon 1/2 teaspoon vanilla extract 2 cups raw pecans, soaked and drained pinch salt Olive oil, to grease your pan To Make:
    Note: If you are not familiar with the process of soaking nuts, please review the following information before attempting this recipe.
    Soaking Nuts and Seeds After soaking and drying the pecans complete the recipe as follows:
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    Jefferson Adams
    Celiac.com 01/08/2015 - The Israeli Defense Forces has announced plans to provide gluten-free meals for its troops with celiac disease.
    The IDF will soon provide its soldiers with gluten-free battle rations, which means that combat service will be an option for Israelis who suffer from celiac disease.
    Until last September, Israelis with celiac disease were exempted from army service, but permitted to volunteer in non-combat roles.
    That all changed in June, when Defense Minister Yaalon announced changes to the rules, which now permit soldiers with celiac disease to receive a 97 profile ranking, the highest possible, allowing them to join combat units.
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    Source:
    Jewish Press

    Yvonne Vissing Ph.D.
    Celiac.com 07/11/2016 - People with celiac disease know that going gluten free isn't a choice—it is a health necessity. It is also a human rights issue. Food and nutrition should be seen as a citizen's human and social right. People who fail to be attentive to the health needs of people with celiac disease may be violating their rights. Like many rights issues, people may not realize they've violated someone's rights by doing, or not doing, something. But when you are the one whose rights have been violated, you know. The violation is serious for you, even when others may be oblivious to the larger context of the violation. Thinking about being gluten-free in this context may be different from the way most people view celiac disease. But it is a point of view that is well worth considering.
    When you've got celiac disease and people aren't attentive to making sure you can eat gluten-free foods that are safely prepared and not contaminated, you can end up very sick in the short-run. The short-term effects may include symptoms such as gastrointestinal upset, migraines, fuzzy brain, sweats, and general malaise. As a fundamental right, what one eats should ensure people's access to a healthy, dignified and full life. People who have been "glutened" do not feel dignified as they writhe in pain, wrestle with fears of embarrassment, or modify their lifestyle and social schedules to accommodate the illness. In the long-run, if someone is continually exposed to gluten in foods, a variety of serious preventable health conditions may result. Unlike a peanut allergy that can directly kill you, exposure to gluten may result in morbidity and early mortality for people in an indirect fashion. Adhering to a gluten-free diet is of paramount importance to avoid health problems such as compromising one's weight and pubertal development, fertility, bone mineral density, and deficiencies of micro and macronutrients, not to mention the increased risk of developing malignancies, especially in the gastrointestinal system. Because the health effects of ingesting gluten for someone with celiac disease are less visible to those who don't experience them, they have been easier to ignore. Thanks to vocal advocates who now know that going gluten-free can save their lives, it is obvious that the lack of attention to making sure people can eat safely is a violation of their rights.
    Let's put the issue of gluten into a larger rights context. The United Nations Declaration of Human Rights (UDHR) was adopted in 1948 after World War II and it is the first global document that codified rights to which all human beings are inherently entitled. It contains a wide range of rights and is regarded as the foundation upon which other rights documents have been built. Its Article 25 states that "Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control" (www.un.org/en/universal-declaration-human-rights/). The right to health and well-being are directly linked to food. Conditions like celiac disease, which are genetic in nature, are thus beyond one's control and necessary to be addressed through appropriate care and management.
    In another rights treaty document that pertains directly to the rights of children and youth, the UN Convention on the Rights of the Child (UNCRC) addresses in Article 3 that "In all actions concerning children….the best interests of the child shall be a primary consideration", that individuals responsible for them are required to ensure that they receive the services and protections they need, particularly in the areas of safety (and) health…". Article 24 "recognizes the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. States Parties shall strive to ensure that no child is deprived of his or her right of access to such health care services". It goes on to emphasize the importance of disease prevention and primary health care "through the provision of adequate nutritious foods" (http://www.ohchr.org/en/professionalinterest/pages/crc.aspx). This implies that nutritious foods are linked with disease prevention and well-being, and making sure children (and adults) get the proper foods is in their best interests. If a child has celiac disease and the responsible adults are inattentive to making sure they can eat safely, they are in fact violating the child's rights. There are, then, international treaties that link food and nutrition directly with human rights.
    Juliana Nadal at the Department of Nutrition, Food Quality and Nutrition at the Federal University of Parana in Brazil reviews in her journal article, "The principle of human right to adequate food and celiac disease" (Demetra; 2013; 8(3); 411-423), a variety of ways that people who have celiac disease have their rights violated. Because celiac disease can be considered the most common food intolerance in the world, it is one that both individuals and social structures need to address as a mainstream issue. From how laws and consumer protections are designed at the macro level, to how food is made available and prepared at the micro level, rights of people with celiac disease hang in limbo. Some places and people are very attentive to their rights protections while others are not. Nadal contextualizes food and nutrition insecurity that afflicts individuals with celiac disease with specific regard to the principle of the Human Right to Adequate Food (HRAF).
    Diet is the single most secure treatment form for people with celiac disease. Managing one's diet enables one to control the magnitude of the disease. Laws, standards, practices and policies are necessary to secure HRAF for people with celiac disease. It is therefore important that the public be educated regarding this. By protecting individual fundamental human right to food availability in both quantity and quality, it reflects the value of society to protect the welfare of this group of people. Ultimately, rights protections promote and improve the health of the entire population.
    Rights violations may also be seen through the limited availability of products intended for celiac individuals in the market. Whether looking at gluten-free food as a local, state, regional, national or global issue, there are certain countries and areas that do not have access to the same quantity and variety of gluten-free foods as in other areas. Online shopping may make it easier for some people to access foods they need, but this option is not necessarily available to everyone. If foods essential for good diets are not accessible, this forces people to make dietary compromises that may not be in their best interest.
    Another area of rights violations for people who have to go gluten-free is the high cost of products. Simply put, gluten-free foods tend to cost more than other foods. People who have celiac disease have to use more of their scarce dollars to pay for food. This means there is less money available to pay for other necessities. Because gluten-free foods tend to be more expensive, this creates a social class barrier, especially for poor people or financially-strapped people with celiac disease. Poorer people will have their right to safe nutrition compromised because they can't afford the same foods as more affluent people who have celiac disease.
    The issue of gluten contamination contributes to a constant situation of food and nutritional insecurity to holders of this special dietary need. The celiac diet must be completely gluten-free, which allows people to have a life relatively free of major pathological complications. Maintaining a totally gluten-free diet is not an easy task because the violation of the diet may occur voluntarily or involuntarily, and range from incorrect information on food labels to the gluten contamination of processed products. Difficulties in the availability and access to food without gluten violates the principle of the human right to adequate food. The condition of being a celiac individual exposes one to permanent food and nutrition insecurity, which could cause loss of quality of life, socialization, and health of the individual, both in the short and long term.
    The problematic situation of food and nutritional insecurity that afflicts individuals with celiac disease can productively be addressed with regard to the principle of the human right to adequate food (HRAF) from the perspective of Food and Nutrition Security (FNS). It is important to know and recognize the real need of the people who live in some way under threat of food insecurity, how it impacts their health and lifestyle. Constructing, implementing and improving health policies in order to meet their needs is imperative to provide access to adequate food of nutritional quality. and to ensure that food, biological, social and cultural needs are achieved.
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    Jefferson Adams
    Celiac.com 01/24/2017 - Coming from homes where gluten-free food is abundant and taken for granted, many college students struggle with maintaining their diets during their time on campus.
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    Read more at: smudailycampus.com.

    Jefferson Adams
    Celiac.com 07/01/2017 - Calgary University's Faculty of Arts and Markin Undergraduate Student Research program is designed to give recipients a leg up on research projects that can help advance their academic goals.
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    Tang says, "The purpose of this research is to help individuals to effectively self-manage celiac disease and follow a strict gluten-free diet, by teaching people evidence-based strategies."
    Ms. Tang presented an update on her research at a mini-symposium on April 7, 2017.
    Read More at Calgary University's UToday

    Jefferson Adams
    Celiac.com 07/24/2017 - Are many non-celiac gluten-free eaters actually treating unkown medical conditions? Is the gluten-free movement less a fad than we imagine?
    Currently, about 3 million Americans follow a gluten-free diet, even though they do not have celiac disease. Known colloquially as "PWAGs," people without celiac disease avoiding gluten. These folks are often painted as fad dieters, or hypochondriacs, or both.
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    Non-celiac patients with gluten sensitivity often complain of symptoms similar to those of celiacs, such as intestinal problems, fatigue, stomachaches and mental fogginess. And while researchers don't know the reason, clinical studies have shown that these symptoms are often relieved by eliminating dietary gluten.
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    Meantime, the number of people who suspect they have non-celiac gluten sensitivity, and who seek improvement in their symptoms by eliminating gluten from their diets, continues to grow.
     Source:
    DailyTribune.com

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    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764

    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

    BIOPSY
    Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide.

    WHY A GLUTEN-FREE DIET?
    Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. 
    A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years.
    For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease.
    WHAT ABOUT ENZYMES, VACCINES, ETC.?
    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center

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