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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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    GOING GLUTEN FREE AS A HUMAN RIGHTS ISSUE


    Yvonne Vissing Ph.D.


    • Co-author: Christopher Moore-Vissing. Journal of Gluten Sensitivity Summer 2016 Issue


    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.


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    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.

    By understanding food as a basic human right, it is easy to understand that the absence of safe foods that address the needs of celiac individuals represents a concrete case of a group of people who often may have their rights to adequate nutrition violated. As a result, many live in a state of food and nutrition insecurity. Food must be viewed as a constitutional right of all citizens, including those with special needs which require a special diet.


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    Good work. I've often wondered if I were in prison could I eat safely...without the risk of cross contamination. And colleges need to quit viewing this as a choice rather provide safe meals or safe kitchens. On the note of being poor. There are plenty of gluten-free foods naturally, rice, corn, potatoes, beans, sweet potatoes and others which can even be made into flours. Really a good read here. Print and give to your favorite restaurant owner.

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    Guest Sharon Herzog

    Posted

    I have been concerned about the hospital setting. The medical community seems quite ignorant about cross-contamination. And a nurse online said she has big problems with the hospital pharmacy over it.

     

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    Forget about prison Lisa, what about during a natural or man made disaster to an area that's only getting relief food?

     

    This was a very well written article, thank you. I work for a large airline and my job requires me to travel for 2-4 days at a time with no options for or access to safe meals forcing me to pack a cooler each and every time I have to go to work, while my fellow colleagues are contractually offered meals at the appropriate times. Once we get to the hotel there's hardly enough time to sleep and shower, never mind venture out tens of miles to find, if I am lucky, that one "dedicated gluten free restaurant" that's usually closed at hours I need them to be open.

     

    Restaurants around airports and airports themselves have absolutely no safe options for eating gluten free. Over a year ago I have stopped eating at establishments that are not 100% gluten free because I was tired of getting sick all of the time and trying to figure out why.

     

    Hopefully restaurant owners and future investors will read this article and take gluten free seriously. But sadly, until 'they' are forced to plan their day around the meals they have to eat nothing will likely change.

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    Guest Linda

    Posted

    Is it possible that I could send this to my local newspaper? I have heard many times "well just a little gluten couldn't hurt". Well it can and does. Restaurants especially do not understand cross contamination. And, most importantly, when traveling as I just was, I was captive on a train with no way to get anything safe for me to eat.

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    Guest Audrey Honkanen

    Posted

    I like the article. I'm also concerned for the people who have serious consequences from gluten, but do not have the gastrointestinal markers for celiac disease. For instance, my very sick daughter was diagnosed by genetic testing, but did not have a positive blood test or villious atrophy.

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    Guest Zana Weber

    Posted

    It was a great article. I have celiac disease so I know the importance of eating a safe meal and the stress of trusting that your getting that safe meal outside the home.

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    Great article! In addition to the issue of gluten free food is pharmaceutical companies that can't say their products are gluten free. I was prescribed three antibiotics and went without medicine for three days for an ear infection because I needed a gluten free antibiotic. Crazy!

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    Guest Kelvin S.

    Posted

    While the issue of a GFD is serious for those who need it, I'm not sure that rights language is the best way to approach it. There are two kinds of "rights:" negative rights, which confer protection against interference (freedom of religion, speech, assembly, and the like), and positive rights, which confer an obligation to be provided (right to counsel in a criminal trial, trial by jury, handicap accessibility). Considering a GFD a human right is conferring a positive right, which raises the question: Who is responsible? gluten-free foods typically cost more than non-gluten-free; does a farmer have to sell quinoa at the same price as wheat, or are taxpayers responsible to provide subsidies? The first is a recipe for food shortages (quinoa is more expensive to produce and can't be grown everywhere), and the latter will be difficult to limit to those who really need it, which means yet another open-ended demand on an already out-of-control government budget, placing ever-greater burdens on both current and future taxpayers. Seeing everything in the language of "rights" can easily devolve into a grasping battle of all against all; it's not clear that it's really going to help improve the situation.

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    Guest mahnelson

    Posted

    Human rights issues? No one has to eat out, so, where is the human rights issue? That we have to pay big money for gluten-free food, now that I get. That sucks for sure. Please help me understand why celiac disease is a human rights issue. I must be missing something for sure.

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    Guest Sandy

    Posted

    Human rights? If a person with diabetes is in a hospital, rehab center, or nursing home, every effort is made to accommodate that person for their "diet". If a child or adult is in the same situation and they have a peanut allergy, it is the same - every effort is made to accommodate that person's diet. However, in the case of those diagnosed with celiac disease, I have found NONE of the above-mentioned institutions can accommodate me with a gluten free diet..... let alone have it be free of cross-contamination! WHY NOT? I was told upon my diagnosis of celiac disease that we were covered by the Americans With Disabilities ..... but have not seen or heard any more about that in the ensuing 6+ years.

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    To summarize what they do, at the beginning of each school year parents are sent a form requesting them to inform the principal, homeroom teacher, and other relevant school personnel about health conditions and allergies. This includes children who have celiac disease and gluten issues. If a child changes schools, or if a student in an existing school gets a new health diagnosis or has newly identified health needs, this information should be made known to school personnel.
    A photograph of the student is taken and put on a card with the health condition so that others in charge may know that a particular child has gluten issues. In the cafeteria, workers have the photos of the children posted in the kitchen where they can see them so that they can know that brown-haired Lucinda in fifth-grade has celiac disease and should be served only foods that are safe for her. Children may not know what foods have gluten in them and which do not, so they may not always be the best informants for identifying which foods being served are safe for them and which are not.
    Given that additives may vary according who is doing the cooking or what ingredients are used, a food like macaroni and cheese may be made with wheat pasta, making it unsafe, or corn, rice or quinoa pasta, rendering it acceptable. Both may look identical to the naked eye, but they aren't so it is a food service worker's obligation to know whether Lucinda can have the dish or not. Likewise, teachers may be given the photograph and health card so that they remember when Billy brings in cupcakes for his birthday celebration, that there are gluten-free ones available (hopefully!) in the cafeteria freezer that can be pulled out and given to Lucinda so she is not left out. The photograph technique is especially helpful when there are new cafeteria workers or substitute teachers or other personnel who may not know a child's food allergy situation like someone who interacts with the child every day might.
    The Lester B Pearson schools' Food and Nutrition Policy is based in Canada's Food Guide and Policy on Health Eating and Active Living. All schools in Canada are to adhere to the same set of standards. This means that a celiac child living in Vancouver should be just as safe eating at school as one in Ottawa or one in Halifax. Having national standards that are uniformly enforced helps to make all children safe. Making sure that children's food consumption is safe for all of them, especially in public institutions like schools, is part of their human rights according to the Convention on the Rights of the Child. It is the responsibility of adults who are in local parent organizations to be in charge of the oversight and safety of all children and to think through food risk and safety policies.

    Jefferson Adams
    Celiac.com 08/16/2017 - Colonial Williamsburg prides itself on educating both children and adults in the rich history of life in colonial America. That's why claims that Colonial Williamsburg kicked an 11-year-old boy on a school field trip out of one of its restaurants earlier this year are drawing attention and sharp comment.
    The incident happened May 11, during a field trip for about 30 students and 30 adults. The trip, which included a meal at Shields Tavern, was the culmination of a yearlong research project.
    The boy, identified in court documents only as "J.D.," suffers from a medical condition that prevents him from eating the same food as his classmates, and the restaurant's policy specifically forbids outside food. The lawsuit claims that, even after a teacher tried to persuade the manager to let him stay, the manager forced J.D. out of the restaurant, where he ate his lunch in the rain.
    "J.D. was crying openly as he was removed from Shields Tavern in front of his peers," the lawsuit said. In speaking with management, the teacher learned that the restaurant "permits toddlers to eat outside food, including goldfish and Lunchables inside the restaurant."
    When J.D. eats gluten, he experiences "precipitous drops in blood pressure that result in him losing consciousness," the lawsuit said. "Doctors haven't determined whether it is celiac disease or a "Non-Celiac Gluten Sensitivity," but multiple specialists at Johns Hopkins have concluded that it is critical J.D. not ingest gluten, even in trace amounts," the suit said.
    "Before his exclusion, J.D. was able to participate fully with his peers with confidence," the suit said. "After his exclusion and because of Defendant's callous and discriminatory conduct, J.D. felt less worthy than other children and embarrassed by his disability."
    The family's attorney, Mary Vargas, said in a statement that "Children with disabilities that require strict adherence to special diets often find themselves on the outside of school parties and social events, but here this child was quite literally removed to the outside in a way that left him feeling humiliated and unworthy."
    She goes on to call the actions by Williamsburg's management "…despicable behavior by any adult but especially by an organization that professes to offer educational programming for children."
    The lawsuit seeks unspecified damages and attorney fees, as well as changes to how Colonial Williamsburg handles people with disabilities.
    The Colonial Williamsburg foundation has declined to comment on the suit.
    Source:
    pilotonline.com

    Jefferson Adams
    Celiac.com 02/20/2018 - Party City has pulled a controversial advertising spot that provoked outrage in gluten-free community by tagging gluten-free dieters as 'gross.'
    Moreover, both Party City, and the advertising firm behind the pre-Super bowl ad, Hill Holliday, have issued public apologies in an effort to mitigate the outrage caused by its obviously insensitive ad.
    The ad starred two women attending a Super Bowl party and standing in front of an "inflatable snack stadium."
    When one of the women points out the gluten-free options, the other asks "Do we even know people that are like that?"
    The first woman answers: "Tina."
    To which, the second woman says: "Oh, gross, yeah."
    Perhaps unsurprisingly, furious viewers wasted no time in launching the Twitter hashtag #IAmTina, which called out both Party City and Hill Holliday for insensitivity toward people with celiac disease or gluten-sensitivity.
    Party City apologized via Instagram, and also clarified that celebrity Sunny Anderson played no part in the campaign.
    The company statement reads, in part: "Party City values its customers above all else, and we take your feedback extremely seriously. We recognize that we made an error in judgment by running the recent Big Game commercial, which was insensitive to people with food allergies…We will also be reviewing our internal vetting process on all advertising content to avoid any future issues. In addition, Party City will be making a donation in support of Celiac Disease research."
    Read more at: Adweek.com

  • Recent Articles

    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

    Jefferson Adams
    Celiac.com 04/16/2018 - A team of researchers recently set out to investigate whether alterations in the developing intestinal microbiota and immune markers precede celiac disease onset in infants with family risk for the disease.
    The research team included Marta Olivares, Alan W. Walker, Amalia Capilla, Alfonso Benítez-Páez, Francesc Palau, Julian Parkhill, Gemma Castillejo, and Yolanda Sanz. They are variously affiliated with the Microbial Ecology, Nutrition and Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), C/Catedrático Agustín Escardin, Paterna, Valencia, Spain; the Gut Health Group, The Rowett Institute, University of Aberdeen, Aberdeen, UK; the Genetics and Molecular Medicine Unit, Institute of Biomedicine of Valencia, National Research Council (IBV-CSIC), Valencia, Spain; the Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire UK; the Hospital Universitari de Sant Joan de Reus, IISPV, URV, Tarragona, Spain; the Center for regenerative medicine, Boston university school of medicine, Boston, USA; and the Institut de Recerca Sant Joan de Déu and CIBERER, Hospital Sant Joan de Déu, Barcelona, Spain
    The team conducted a nested case-control study out as part of a larger prospective cohort study, which included healthy full-term newborns (> 200) with at least one first relative with biopsy-verified celiac disease. The present study includes 10 cases of celiac disease, along with 10 best-matched controls who did not develop the disease after 5-year follow-up.
    The team profiled fecal microbiota, as assessed by high-throughput 16S rRNA gene amplicon sequencing, along with immune parameters, at 4 and 6 months of age and related to celiac disease onset. The microbiota of infants who remained healthy showed an increase in bacterial diversity over time, especially by increases in microbiota from the Firmicutes families, those who with no increase in bacterial diversity developed celiac disease.
    Infants who subsequently developed celiac disease showed a significant reduction in sIgA levels over time, while those who remained healthy showed increases in TNF-α correlated to Bifidobacterium spp.
    Healthy children in the control group showed a greater relative abundance of Bifidobacterium longum, while children who developed celiac disease showed increased levels of Bifidobacterium breve and Enterococcus spp.
    The data from this study suggest that early changes in gut microbiota in infants with celiac disease risk could influence immune development, and thus increase risk levels for celiac disease. The team is calling for larger studies to confirm their hypothesis.
    Source:
    Microbiome. 2018; 6: 36. Published online 2018 Feb 20. doi: 10.1186/s40168-018-0415-6