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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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    FOOD MANUFACTURERS SLOW TO DEFEND WHEAT


    Jefferson Adams

    Celiac.com 01/17/2014 - What's up with wheat producers and product manufacturers? Wheat sales are flat, gluten-free is through the roof, and the industry is mum.


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    Photo: CC--jimmywayneThough under 1 percent of Americans suffer from celiac disease, nearly one in three people say they are eating gluten-free, according to NPD Group. Consumption of flour in the U.S. is at a 22-year low, says the U.S. Department of Agriculture.

    And rather than leaping to the defense of wheat, or loudly touting its benefits, companies including General Mills (GIS) and Kellogg (K) are creating pricier gluten-free versions of their products, while leaving industry groups to defend their regular fare. The U.S. market for gluten-free foods will climb from $4.2 billion in 2012 to $6.6 billion by 2017, according to researcher Packaged Facts.

    Overall sales of the seven Chex varieties without gluten are up by at least 10 percent in each of the past three fiscal years, while the $6 billion breakfast cereal category has remained flat.

    The combination of flat sales of traditional wheat-containing cereal products, and the dramatic rise in sales of gluten-free products has presented a challenge for manufacturers that make both products that contain gluten, and other products that are gluten-free.

    If they are too loud about touting the benefits of gluten-free products, they risk slippage on their wheat based products, and vice versa.

    When it comes to dealing with flash trends, says Mark Lang, a food marketing professor at Saint Joseph’s University in Philadelphia, the manufacturing industry typically has "nothing to gain, and you have everything to lose.”

    So, at the same time General Mills has been careful not to push wheat, it has also been careful not to align itself with any of the anti-gluten figures.

    When asked if General Mills has been slow to respond to the incursion of gluten into traditional wheat territory, company spokeswoman Kirstie Foster says that the company is responding as they think best.

    If you think about it, General Mills' strategy might not be too bad. If they can sell more gluten-free grains and products at premium prices, then the decline in wheat consumption might not have such a negative impact on their bottom line.

    Still, the lukewarm defense of wheat by grain producers comes as a surprises to Michael Pollan, author of The Omnivore’s Dilemma and other books on nutrition.
    “The industry has been flat-footed in their response,” he says. “They should be reminding people that gluten is protein, generally thought of as a healthy nutrient compared to fats or carbs.”

    Source: Businessweek 


    Image Caption: Photo: CC--jimmywayne
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    Paul Smith
    Celiac.com 12/14/2009 - Soy is a food allergen and there are several main issues. Firstly, soy proteins, especially the trypsin inhibitor enzymes, along with the proteins in dairy products, wheat, peanuts, eggs, sesame seeds, shellfish and crustaceans, have a tendency to produce allergic reactions in susceptible individuals. However, all my reading and experience of soy, over 50 years, suggests that soy protein is somewhat milder in its action than the proteins in peanuts, eggs and sesame seeds. From a toxicological point of view and as reported by FSANZ, the presence of soy at less than 88 p.p.m. (parts per million) does not register for the vast majority of the population, whereas in susceptible individuals and by comparison, gluten, eggs and peanuts can all register adversely at or at less than 1 - 3 p.p.m. There is no history of severe anaphylaxis and sudden death associated with soy that I am aware of. However, there are a very few people who may experience flu and chronic fatigue and fuzzy headedness like symptoms from exposure to soy and these people are probably best to totally exclude soy from their diets. There are also some people who have a negative attitude towards soy who decline to eat soy, often without ever having tasted it or in response to a single bad experience. For many people brought up on cow’s milk soy is a difficult to acquire taste. Most people eat soy without any awareness of having done so.
    It is my belief that for most people a modest level of soy intake, including its protein provides a valuable addition to the diet without undue side effects. There are many people who tolerate soy, who experience difficulties with gluten, dairy, peanut and egg proteins, especially if the soy is introduced into their diets gradually. In commercial food production, soy protein is often used at fairly low levels as a dairy powder, cheese, egg and nut extender/substitute, for price, functionality, natural preservative/anti-oxidant/emulsification properties, natural colour and for nutrition reasons.
    Secondly, soy and other legumes contain natural oligosaccharides or complex sugars – principally stachyose, raffinose and vacchyose which consist of various combinations of galactose and glucose molecules – which human beings lack the enzymes to digest. These sugars ferment in the gut, rather than digest, producing gas, flatulence, stomach pains, bloating, diarrhoea and sometimes acute discomfort especially if the fermentation process occurs in the more restricted upper digestive tract. This is often crudely referred to as the “fart factor” and it is often far worse when there has been a rapid change of diet or an overly large amount consumed. There is also some evidence that fructose mal-absorption, for example, can lead to depression and interfere in menstrual cycles in young women. I believe this sugar factor in Soy may be of greater concern than the soy protein issue and one best considered within the FODMAPS (Fermentable Oligosaccharides (fructans, stachyose, raffinose), Disaccharides (lactose), Mono-saccharides (fructose), and Polyols (sorbitol, mannitol and xylitol)) Concept explored in Sue Shepherd’s recent PhD Thesis. Sue, who is both a celiac and a dietician, has taken a strong interest in this field because, along with diabetes, the fermentable sugars issue often overlaps and is associated with gluten sensitivity and celiac disease. These fermentation issues can appear in conjunction with or independently of any gluten issues. The gluten induced gut damage and nutrient mal-absorption exacerbating and feeding off the fermentation issue and vice versa. As with the reaction to gluten there is a wide range of sensitivity and responses to and between these different sugars with some people reacting adversely to all these sugars while others react to some and not others. The degree of and cumulative effects of exposure are also an issue. The response can also depend upon where in the gut the fermentation process occurs: there appears to be more pain if the fermentation occurs in the stomach or the small bowel rather than the colon. The fermentation may occur in one part of the gut, in all three parts or various combinations thereof. There is also some conjecture about the gut-brain axis over sending and misinterpreting the gut nerve signals. While Soy also contains a small percentage of fructose there is not sufficient present for this to become an issue. The fructose content of such staples as onions and garlic, for example, is of far more concern.
    Interestingly, neither the protein nor fermentable oligosaccharides appear to be an issue in tofu consumption, where only some of the protein and sugars are extracted from the soy. The fermentation processes used in the manufacture of miso and tempeh, two other traditional soy foods, also seem to overcome the soy protein and fermentable oligosaccharide issues. It appears that the protein and sugar hydrolysis processes that take place in the fermentation that occurs during the manufacture of these products breaks the proteins and sugars down to simpler, more digestible and assimilable forms making these foods easier to digest than, for example, a more minimally processed soy flour. It is also possible and may be desirable to look at fermentable sugar extraction or modification or enzyme or acid hydrolysis during the processing of many ingredients and products.
    The third issue with soy is the concentration of the naturally occurring soy phyto-estrogens or isoflavones (plant derived mimic female hormones) which may occur, particularly in the processing of soy isolates where the oil is extracted prior to precipitation of the protein and the skimming off of the carbohydrate/dietary fibre fraction. This produces a product with protein at 86%, moisture at 6% with low ash, fat, dietary fibre and carbohydrate levels where sometimes the isoflavones or phyto-estrogens are also extracted and sometimes not. Where soy isolates are being considered as the base for an infant formula it is extremely important to limit the intake of the phyto-estrogen or plant derived hormone to the absolute minimum. It is also important to note that dairy derived infant formulas also need to be highly modified to make them suitable for human babies.
    On another occasion, I was contacted by a young man who was using soy isolate (a concentrated protein) as a body building aid and his protein intake was equivalent to four times the recommended daily protein intake. He was depositing unwanted fat on his thighs and buttocks, his beard growth was patchy and thin – he was demonstrating female characteristics due to the high levels of female type plant hormones he was ingesting - and he was also experiencing genital and irritable bowel type symptoms and from what he said, I also suspect kidney problems. It is my belief that he was consuming excessive levels of protein and using a form of soy isolate which had concentrated rather than removed the phyto-estrogens. There is much to recommend moderation, diversity and balance in all areas of life: an informed dietary restraint enabling the body to take what it wants from the diet and to reject or handle the rest. Over consumption of any particular food has always been problematic no matter how innocuous that food may seem. We and our health reflect our eating and lifestyle habits.
    A fourth issue, is that the introduction of genetically modified organism (GMO) foods has brought further complications into this equation. Internationally, various crops including soy, cotton, canola and maize have been genetically engineered to resist the application of glysophate, a weed killer commonly known as “Roundup”, and to kill predatory insects through a built in pesticide in every plant. The writer believes there are serious moral, ethical, logic and safety issues involved in the use of such engineered foods, the benefits of which convey no positive health or nutritional value to the end consumer and which may yet prove detrimental to the consumers’ health and the environment.
    For example, Bt pesticide, which is produced from the natural soil bacteria Bacillus thuringiensis, is a potent poison which ruptures the stomachs of and kills any insects which may attack any crop engineered or treated with it. As an integral part of the plant what do these toxins do to the human intestinal tract? In the USA, there are concerns about possible genetically modified gut bacteria as a result of eating such genetically modified foods: about new and difficult to identify and trace immune system health issues. Fortunately, Australia has been slower in its adoption of these genetically modified crops and no genetically modified soybeans have either been allowed into or grown in Australia. Our company only processes Australian grown soy beans, and other non-GMO gluten-free grains and legumes.
    However, there are vast differences between the use of Bt spray and the far more concentrated systemic, engineered versions of this pesticide. The latter is an integral part of the plant and, unlike the spray, it cannot be washed off. In whatever form, Bt is a toxin and irritant with allergenic properties. Personally, I have serious reservations about these types of genetically engineered foods: the concept is obscene and I believe that such foods are inherently dangerous.
    Genetically modified soy and corn each contain two new proteins with allergenic properties. genetically modified soy has been found to contain higher levels of trypsin inhibitor enzymes (which are a known soy allergen) than conventional soybeans. Skin prick tests, in the UK and USA, have also revealed a more than 50 % increase in allergic reactions to genetically modified soy compared to the traditional product.
    There is an enormous, untested and long term potential for such genetically modified crops to create a host of poisoning, allergen, immune system, genetic aberration, genital deformity, fertility, genetically modified gut bacteria, digestive, eczema, inflammation and nutrition problems not to mention the possibility of new types of diseases. These genetically modified foods have been introduced by the same companies which developed DDT and Thalidomide. The fundamental question lingers: “have they got it right this time?” Unfortunately, it may take several generations for these associated problems to manifest themselves and to be identified, just as it did with DDT. Tracing the causes of and the treatment of these insidious problems may be difficult and expensive. In introducing these products we have ventured into the unknown, not only health-wise but nutritionally and legally.
    Despite all the above negatives, I still believe that whole bean soy foods eaten sparingly have an important place in a well balanced diet. Many other staple foods including eggs, wheat, gluten, peanuts, dairy products are equally, if not more, problematic just as some fruits and vegetables can be. At the end of day it is usually a question of the balance, of the degree of tolerance for and degree of exposure to each of these foods that is critical and this may vary from individual to individual. It is also my belief that a modest level of exposure is better than total exclusion. For example, I have a mucus issue with milk fat if I over indulge in dairy products but consumed sparingly I can enjoy a thin sliver of cheese without problem.

    Jefferson Adams
    Celiac.com 07/11/2012 - Sometimes, it's the small, local stories that help to capture the larger picture. More and more, community food banks are making efforts to accommodate people with celiac disease and gluten intolerance by stocking gluten-free foods. However, many of those food banks are tight on funds and shelf space, so finding the right balance between the needs of the majority of their clients and the few who need gluten-free foods can be a challenge.
    Recently, the Pictou County Celiac Support Group in Pictou County, Nova Scotia sought to help tip that balance with a $500 donation to the local food bank. The donation will help to ensure that the food bank will have gluten-free food available for people who need it.
    After being diagnosed with the disease 10 years ago, Kim McInnis of Trenton went on to found the Pictou County Celiac Support Group. She notes that more and more people are diagnosed with celiac disease each day, and that she plans to work with the food bank to help volunteers make the right selection of foods for the bank.
    "If I lost my job tomorrow and had to go to the food bank," says McGinnis, "I don't think there is anything I can eat there right now. We just want to help people get the food they need."
    Eliminating gluten may seem easy enough to people who do not have celiac disease, but to those learning about it for the first time, the process of eating right and getting the proper foods can be overwhelming, McGinnis says.
    Food bank director, Tom Foley, said signs will be placed in the food bank to let people know that gluten-free products are available and it will also be updating its database to determine how many of its clients need such foods.
    In addition to the recent donation, the Pictou County Celiac Support Group will also be hosting its annual walk on May 27 from 1-3 p.m. at the Parkdale track.
    Source:
    http://www.ngnews.ca/News/Local/2012-04-08/article-2950246/Celiac-support-for-food-bank/1

    Jefferson Adams
    Celiac.com 10/02/2014 - Most people have heard about kidney stones, or gall stones, due to calcium build up. Others may know that calcium deposits can affect the heart, and even the brain. However, until now, it was not known that, in certain cases, celiac disease can trigger calcification in the brain.
    Doctors examining a 24-year-old Brazilian man with a history of recurrent headaches revealed a rare condition known as the CEC syndrome, a combination of celiac disease, epilepsy, and cerebral calcification, commonly referred to as ‘brain stones.’
    The man had been treated for migraine headaches over a period of 10 years, with little response. Standard blood tests showed a mildly decreased folate level (2.2 ng per milliliter [5.0 nmol per liter]; compared to a reference range of 3.1 to 17.5 ng per milliliter [7.0 to 39.0 nmol per liter]). A computed tomographic scan of his brain showed bilateral occipital calcification, or ‘brain stones.’ Laboratory testing showed normal cerebrospinal fluid and elevated levels of serum IgA antitransglutaminase antibodies (45 U per milliliter).
    The man received an endoscopy, and his jejunal-biopsy specimen showed crypt hyperplasia, villous atrophy of the jejunal mucosa, and an increased number of intraepithelial lymphocytes; all classic indications of celiac disease. Doctors started treatment with a gluten-free diet, folic acid supplementation, and carbamazepine, and the patient's symptoms disappeared and his condition improved.
    In this case, there was no indication that the man suffered from epilepsy. The likely culprit is folate malabsorption, because cerebral calcification has been seen in other conditions related to folate deficiency, such as treatment with methotrexate, congenital folate malabsorption, and the Sturge–Weber syndrome.
    So, physicians treating celiac patients with low folate levels may want to keep an eye out for any indications of cerebral calcification, and to make sure that patients receive appropriate supplemental folate.
    Source:
    New England Journal of Medicine

    Jefferson Adams
    Celiac.com 04/15/2015 - The steep costs of getting food onto the shelves at major grocery chains has claimed another notable start-up, the Charlotte-based gluten-free foods company, Bumbalooza.
    The quick, promising rise and rapid demise of Bumbalooza still troubles sisters-in-law Holly Paeper and Monique Prato. In just two short years, their Charlotte-based gluten-free foods company, Bumbalooza, rose to prominence in the specialty foods community, winning fans, customers and awards.
    Their promising start looked even rosier when, against stiff competition, the team won the Charlotte Chamber's Power Up Challenge, complete with a check for $25,000. The Power Up award is bestowed on small-business owners who provide innovative products, earn $1 million or less in revenue.
    But just months later, Bumbalooza was facing dire straights due to high shelving costs for their products. Soon, the duo had to give up their distribution warehouse, and their office, and quickly stopped selling gluten-free baking mixes altogether.
    They say they spent thousands and paid grocery chains more than $20,000 each in "slotting fees" to get Bumbalooza products on store shelves, only to face delayed and partial payments. They declined to name the large grocers involved.
    Faced with high costs and impaired revenue, Prato and Paeper decided that closing was their best option.
    Sadly, Bumbalooza is not the first, nor likely the last, food company to tumble as a result of high shelving costs.
    Source:
    The Charlotte Observer.

  • 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