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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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    ELITE COLLEGES TREAT GLUTEN-FREE STUDENTS TO EXCLUSIVE EATERIES


    Jefferson Adams

    Celiac.com 07/13/2015 - Gluten-free students at two elite liberal arts colleges in suburban Philadelphia, Pennsylvania, are now able to enjoy exclusive gluten-free dining areas.


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    Photo: CC--Montgomery County PlanningBoth Haverford College and Bryn Mawr College have created dedicated, exclusively gluten-free dining areas for their students with celiac disease or gluten intolerance, according to a report by Campus Reform.

    Bryn Mawr opened their gluten-free dining area in 2013, and Haverford followed in 2014.

    The exclusive eating areas are the brainchild of Bernie Chung-Templeton, executive director of dining services at both schools.

    Each of the gluten-free dining areas has signage clearly warning students to refrain from bringing in food from outside, including the main school cafeteria.

    What do you think? Do students with celiac disease or gluten intolerance deserve dedicated, exclusively gluten-free dining options?

    Read more in Campus Reform.


    Image Caption: Train station, Bryn Mawr, Pennsylvania. Photo: CC--Montgomery County Planning
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    Guest Susan Copeland

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    This is such good news. I hope that this concept takes off and spreads around the country to all colleges and universities. For those of us who must be gluten free a safe place to eat is not a luxury but a necessity. Thank you for sharing this article.

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    Amy Leger
    Celiac.com 10/29/2008 - Equality.  That’s all any parent wants for his or her child.  In this case I’m talking about food at school.  Are you completely frustrated that you can’t get a gluten-free lunch for your child at school?   According to a recent survey by the American Celiac Disease Alliance, many parents of celiac children may feel the same way.  The survey conducted during the summer of 2008, found of 2,200 respondents, 90% had to regularly pack gluten-free lunches for their celiac child. I used to be one of them and was stuck feeling like I was banging my head against a wall trying to get a few hot lunches for my child.  That goal of equality saw me through a journey — years in the making — that would eventually pay off.
    Just before my celiac daughter’s kindergarten year began, I thought I covered all my bases.  I talked to the school nurse, Emma’s teacher, and the head of the cafeteria about her condition and her diet.  I found there was very little she could have at school except beef tacos, which she loved.  Eventually that one menu item, which made my daughter feel just like the rest of the kids, vanished; a near tragedy for her, sheer frustration for me.  I would ask myself “Why do the schools have to serve up so much food with gluten?” I also didn’t feel like I was taken seriously by the cafeteria employees.  I housed some small gluten-free food items in the freezer at school in case of emergency.  That expensive food was thrown away, with no one even realizing they did it.  That told me, they weren’t paying attention.  And I was done.  It seemed as though Emma was destined for cold lunches until she graduated from high school.  
    Honestly, school lunches may not be the perfect meals for our children, but suddenly many parents feel an urgency to feed them school food when their celiac child starts to feel left out.
    The good news is: times may be changing.  Sherri Knutson, Student Nutrition Services Coordinator for the Rochester, Minnesota School District, and her staff have developed a monthly gluten-free, menu for students.   “We’re making it come together…to meet the needs of the student,” Knutson said.  It is more like students!  As many as 20 children every day order from this menu which actually mirrors the “regular” monthly menu, including gluten-free chicken nuggets, spaghetti and hamburgers WITH a bun.  Knutson says they started slow in 2004, offering only a few gluten-free options each week and then expanded from there.
    Offering the menu comes at a cost – to the district.  Officials with the US Department of Agriculture (USDA), which oversees the school lunch program, say schools cannot charge parents more for specialized, expensive diets.  A regular school lunch in that district costs $2.05, but the gluten-free lunch costs about double.  Knutson’s district essentially “eats” the cost.  “Cost is not one of the factors that should impact [implementing this diet in schools].”  But she admits they look into finding ways to cut costs, like baking their own gluten-free goodies.
    Now word is spreading about this groundbreaking menu.  Knutson says she is getting calls from school districts across the country asking her how she does it.  Her answer is simple, start small and do what you can.  She also asks parents to be understanding and patient; accommodating the gluten-free diet is very new for most school districts. 
    My conversation with Knutson was enlightening and empowering, but back at home I was struggling with my own district.  There were times in the last four years, where I wondered if the district even cared about my daughter’s health and nutrition needs.  After months of many unanswered emails and phone calls with my district nutrition department in late 2007 and early 2008, I finally called my school board member to get some attention.  That one phone call got the ball rolling.  In the six months since, I have had several meetings with key employees in the district and school.  My district also appointed a coordinator for specialized diets who works directly with schools that have special food requirements for certain students.  In October of 2008, I saw a first draft if it’s two-week, gluten-free menu.  The nutritionist I work with tells me it is just the beginning.  I am so pleased and proud of them for finally taking some much-needed action.
    It is amazing how far you can come with a lot of work, tenacity and passion for equality.  If you are in the same situation that I was, I urge you to take action.  If your school cook won’t help you, go to the district nutrition director, if they won’t help you go to the superintendent, if they won’t help you go to the school board, and if they won’t help you, contact the education department in your state.  That group may oversee statewide compliance of USDA rules.  I was able to get this done without a 504 plan for my child.  Simply put, a 504 plan is detailed paperwork which gets you the needed accommodations for your child and their diet.  You may need to create a 504 plan to push along the lunch changes for your child.  Watch for much more on this important issue in upcoming posts.
    I cannot guarantee you will get drastic changes in lunch offerings from your district, so if you are still in a slump, check out the American Celiac Disease Alliance.  Serving specialized diets in school is a hot topic right now and the ACDA is trying to advocate for all of us.  Your child has a right to eat school food.  And this is one food fight – worth getting in on!
    *For much more information on the Rochester, MN School District’s Gluten Free menu, see this article I wrote for FoodService Director Magazine in September 2008.


    Jefferson Adams
    Celiac.com 01/03/2011 - Thanks to motivated food staff, students at the University of Connecticut will now be able to enjoy gluten-free menus in all of their dining halls, convenience stores and in the food courts.
    To better serve those students who suffer from celiac disease or are gluten-intolerant, the students have teamed with dining director Dennis Pierce and culinary development manager Robert Landlophi, to transform UConn’s menus.
    An estimated 75-100 students on a meal plan have celiac disease.
    The social and medical challenges and stigmas that can follow sufferers of celiac disease make it difficult to eat outside the home, particularly in a college dining hall.
    Medical advances in recent years have allowed for doctors better diagnose patients leading to a spike in the popularity of gluten-free diets. Pierce notes that the demand for a greater variety of gluten-free foods in grocery stores and restaurants is growing.
    As the author of the website, “The Gluten-Free Chef” and cookbook, Gluten-Free Everyday Cookbook, Landlophi knows the gluten-free lifestyle incredibly well after his wife was diagnosed with celiac disease. By sharing his family’s personal story, he has helped shed a brighter light on the solution that has brought relief to thousands: gluten-free for life.
    The culinary brain-child of Pierce and Landlophi comes as part of a joint effort to bring a gluten-free diet into the mainstream. Their menu, which took a few months to rework, already contained about 20% naturally gluten-free items, and needed only modest adjustments. As the country’s third largest residential student food program, serving nearly 180,000 meals each week, the menu stands out as national model for other schools.
    Pierce is also joining forces with Boston’s Children’s Hospital, who have implored his expertise in gluten-free lifestyles, to create a series of informational training videos and reading materials for those who suffer from celiac disease and other food service professionals. It is the hope of those involved that this information will also be utilized by parents of gluten-intolerant children to help insure a lifelong commitment to remaining gluten-free.
    Landlophi will be joining Pierce who will be attending the National Association of College and University Food Service Conference in Dallas, Texas. The two plan on making a presentation that addresses the growing need for gluten-free awareness on campuses across the country. Attendants can expect to hear about UConn’s self-imposed strict cooking protocols that are adhered to in order to avoid contamination with wheat products. UConn has taken it a step further to ensure that each student with a meal plan gets personal attention from the dining service staff which includes a detailed assessment of food allergies and dietary requirements.
    The selection and quality of gluten-free products available to the public is steadily improving, and the organizers have invested a great deal of time to guarantee that the best possible products are served to UConn’s students.
    Congratulations to UConn for forging a clear path for gluten-free students!


    Jefferson Adams
    Celiac.com 01/25/2012 - Perhaps due to a combination of public information efforts and higher diagnosis rates, but awareness of celiac disease, gluten-free and other food sensitivities is slowly spreading to schools across the nation. This reality, coupled with general student interest in a greater variety of healthier food options is driving a change in both vocabulary and offerings at campuses around the country.
    Go to many schools today, and you may hear terms like 'gluten-free,' 'celiac-friendly,' or 'allergen-free' thrown around liberally with more common standbys like 'kosher,' 'organic,' 'vegetarian,' and 'vegan.'
    Students are "becoming more sophisticated customers," says Joe Wojtowicz, general manager of Sodexo, Inc.'s Crossroads dining room at Concordia University Chicago in River Forest. These days, it's common for staff to field questions about food options before students even arrive on campus, especially questions about celiac disease, gluten-intolerance, food allergies and vegetarian preferences.
    For these students, access to accurate nutritional information is all the more important given their need to avoid foods that trigger allergies, Wojtowicz says. "All our menus are on the Web, and they click through an item to learn the nutritional content," he adds. "And we make sure we label our offerings if they contain nuts." These benefits extend to students with celiac disease and gluten intolerance, as well.
    Overall, more students are requesting foods that are more nutritious and healthful than in the past, says Travis Orman, senior director of dining services with Chartwells Educational Dining Services at Elmhurst College in Elmhurst, which serves up to 3,200 meals a day. Students are also demanding more options. That means a change in even the most basic offerings.
    For example, many colleges are finding that students enjoy ethnic specialities. Orman says authentic Mexican is a favorite on his campus. "We honed in on the authentic cuisine and developed 8 to 10 options where the flavors just burst in your mouth. We launched Serranos Mexican Grill in September, and it's been very well received." Offerings include a burrito bowl taco, taco salad and barbacoa, a beef slow braised in garlic, lime, chiles and spices, then shredded, Orman says.
    Many college students prefer meat-free options, says Wojtowicz, so Crossroads always offers at least two to four vegetarian menu options, including cheese pizzas, grilled cheese sandwiches and cheese quesadillas. Other items, such as grilled Provencal vegetable sandwich or black bean and cheese quesadilla also appear.
    At CUC, Wojtowicz has responded to a growing interest in Mediterranean dishes with items like paella, spanakopita, Spanish tapas and other regional favorites.
    Some schools are taking food offerings to the next level by serving vegetables grown in local community gardens. North Central College in Naperville is among schools that has turned to harvesting a community garden to supply a portion of the produce for its dining operation.
    The North Central College Community Garden is now in its second year, and benefits from the efforts of nearby residents, who tend their own plots of land. Because of that support, those gardens "produce some of the fresh vegetables and fruits used in the college's salad bar and deli bar," says director of residence life Kevin McCarthy. The school then labels those items at the dining hall so that students know they are choosing sustainable options grown at the Community Garden.
    Source:

    http://www.chicagotribune.com/special/educationtoday/chi-edtoday-dining-110311,0,7648384.story

    Jefferson Adams
    Celiac.com 07/09/2012 - These handy tips will help you to better navigate the challenges of gluten-free living in both dorm rooms and shared housing. Having the right tools, and adopting some wise practices will help you eat gluten-free week-in and week-out, without breaking your bank account, or risking gluten exposure.
    Having a few tools can help your efforts come together much more easily, and keep your eating consistent over the semester.
    Helpful tools:
    Rice Cooker Small Crock Pot Microwave Blender Fridge/freezer (even a miniature one will come in handy) Resealable freezer bags Sharpie permanent marker Shop wisely by making lists
    What's the old saying? Proper prior preparation prevents poor performance? Nowhere is this more true than with a gluten-free diet. Planning your meals in advance can save you time, money, stress, and, of yes, the pain of an adverse reaction to gluten. This practice starts with shopping, and shopping starts with planning.
    Make lists and use them. Check out Asian, Mexican, and other ethnic markets in your area. They often have good, gluten-free food at reasonable prices.
    Cook your food in advance
    You can make the most of your smart shopping practices by planning and preparing your meals in advance.
    Consider spending one day each week, or at least a good block of time, cooking and prepping food. Just a few hours of gluten-free cooking can prepare you to sail smoothly through the week ahead. Use all the tools at your disposal. Use your crockpot, use your rice cooker, your freezer bags, and your markers.
    Keep your own shelf and label your foods
    Package and label the food you make, then store it in your fridge or freezer. By packaging and labeling food, your housemates are less likely to "accidentally" eat it. If they do, you'll likely be on top of the situation.
    Keep gluten-free dry goods on hand
    Having a drawer full of gluten-free food that does not require a fridge or freezer is also helpful. Good items to have include microwaveable rice, gluten-free pretzels, crackers, chips tuna fish, fruit snacks, and beef jerky.
    Gluten-free Condiments
    Keep a collection of spices and sauces to help keep your snacks from getting boring. Good things to keep on hand include honey, gluten-free tamari, mayonnaise, ketchup, mustard, and hot sauce.
    Cover the Basics
    Make sure you keep simple items that are rich in protein and carbohydrates on hand, so that you won’t go hungry and will always have gluten-free food available.
    Avoid the Dining Hall
    Unless your dining hall is one of the more progressive campus dining halls that offer a variety of good, reliable gluten-free foods, you should avoid it.
    Some good foods to prepare in advance or keep on hand include:
    Fried rice - Frying rice is a good way to use leftover food, and it's easy to pack and take with you to campus. Try it with lots of veggies, meat, eggs, and any other items that seem tasty.
    Grilled or roasted chicken, or other meats cut into small slices - These are great items to add to your fried rice, or to your pasta sauce.
    Stews, soups or casseroles - Stews, soups and casseroles freeze easily and age well. They can be prepackaged and frozen ahead of time. They can be easily thawed in the bag by placing them in the microwave, or in lukewarm water.
    Sauces - Making sauces in advance and freezing them can cut your food prep time during the week. They can give you plenty of room for adjustment and broaden your options. Ideas include: Pasta sauce, pizza sauce, sweet and sour sauce, teriyaki sauce,
    Pizza - Use your favorite gluten-free pizza crust to make gluten-free pizza. Then place it in individual bags, label and freeze. If you have hungry roommates with boundary issues, consider numbering the bags to keep track of them.
    French toast - Making French toast with your favorite gluten-free bread is a great way to have a quick, reliable breakfast ready to go.
    Fruit - cutting up fruit and putting it in bags for the week ahead is a great way to be ready to make quick breakfast smoothies, or to have a great fruit salad ready to go.
    Yogurt and kefir are also good to have on hand. They are excellent for making fruit smoothies, or for giving you much needed protein and fat with that fruit smoothie.
    Dessert items - Chocolate chip cookies, brownies, and cakes are a great way to enjoy dessert when you want it without being forced to choose from the often dismal gluten-free selection at the local coffee shop, or the over-priced frozen section of your local grocery store.
    Lastly, compile a list of reliable local eateries where you can get good, safe gluten-free food when you are in a pinch, or need to dine on the spur of the moment.

    Jefferson Adams
    Celiac.com 01/24/2014 - To create a gluten-free, allergen-free station in a dining hall that serves about 10,000 to 14,000 students each week, and offers a different daily menus for each meal, Lehigh University in Bethlehem went the distance. The result was Simple Servings.
    Lehigh's earlier dining hall offered gluten-free cereals, soups, pastas and breads via their Your Choice station. That original station has been incorporated into Simple Servings, and Lehigh students with gluten intolerance can now experience the same range of choices as their non-sensitive counterparts.
    Joseph Kornafel, Lehigh's executive chef, says that the school has really paid attention to details, from getting the right equipment when the station was being built, to maintaining a database of allergen-free recipes,
    Lehigh has also reached out to coaches and student-athletes to make sure they understand how the system works and to always get a clean plate before taking food from the station to avoid cross-contamination.
    Purple is the color adopted to designate allergen-free items in the food industry, and Lehigh uses purple to designate all gluten-free food preparation items, including utensils, carts and cutting boards.
    All gluten-free preparation equipment is dedicated, and never leaves that station to prevent cross-contamination. All chefs working that station are specially trained, and and all ingredients are clearly labeled for each dish.
    Source:
    Lehigh Valley Live

  • Recent Articles

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.

    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
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    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