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      Frequently Asked Questions About Celiac Disease   04/07/2018

      This Celiac.com FAQ on celiac disease will guide you to all of the basic information you will need to know about the disease, its diagnosis, testing methods, a gluten-free diet, etc.   Subscribe to Celiac.com's FREE weekly eNewsletter   What are the major symptoms of celiac disease? Celiac Disease Symptoms What testing is available for celiac disease?  Celiac Disease Screening Interpretation of Celiac Disease Blood Test Results Can I be tested even though I am eating gluten free? How long must gluten be taken for the serological tests to be meaningful? The Gluten-Free Diet 101 - A Beginner's Guide to Going Gluten-Free Is celiac inherited? Should my children be tested? Ten Facts About Celiac Disease Genetic Testing Is there a link between celiac and other autoimmune diseases? Celiac Disease Research: Associated Diseases and Disorders Is there a list of gluten foods to avoid? Unsafe Gluten-Free Food List (Unsafe Ingredients) Is there a list of gluten free foods? Safe Gluten-Free Food List (Safe Ingredients) Gluten-Free Alcoholic Beverages Distilled Spirits (Grain Alcohols) and Vinegar: Are they Gluten-Free? Where does gluten hide? Additional Things to Beware of to Maintain a 100% Gluten-Free Diet What if my doctor won't listen to me? An Open Letter to Skeptical Health Care Practitioners Gluten-Free recipes: Gluten-Free Recipes
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    HOW OFTEN DO YOU GET EXPOSED TO GLUTEN?


    Jefferson Adams

    Celiac.com 09/05/2016 - Currently, a gluten-free diet is the only recommended treatment for celiac disease. But, researchers don't know much about how effective the actually diet is, or exactly what constitutes the normal range of responses among persons with celiac disease on a gluten-free diet.


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    To get a better idea, a team of researchers recently set out to study a group adults with biopsy proven, newly diagnosed celiac disease. The research team included J. A. Silvester, L. A. Graff, L. Rigaux, J. R. Walker & D. R. Duerksen, variously affiliated with the College of Medicine, University of Manitoba, Winnipeg, MB, Canada, the Celiac Research Program at Harvard Medical School in Boston, MA, USA, and the St Boniface Hospital, Winnipeg, MB, Canada.

    The team had each patient complete a survey related to diet adherence and reactions to gluten at entry and 6 months. To measure celiac disease symptoms and gluten-free diet adherence, the team used the Celiac Symptom Index, Celiac Diet Assessment Tool (CDAT) and Gluten-Free Eating Assessment Tool (gluten-free-EAT), and they assessed a total of 105 participants, 91% of whom reported gluten exposure less than once per month, and showed an average CDAT score was 9 (IQR 8–11), consistent with adequate adherence.

    Two-thirds of the subjects reported suspected symptomatic reaction to gluten. For 63% of subjects, gluten consumption was only suspected after a reaction occurred. For nearly 30%, gluten consumption was the result of eating in a restaurant. Gluten consumed came from cross-contamination in 30% of cases, and from gluten as a major ingredient in 10% of cases. On average, symptoms began an hour after gluten consumption, running from 10 minutes on the low end to 48 hours on the high end.

    On average, when symptoms did occur, they lasted about 24 hours, on average; though they ranged from 1 hour to 8 days. Common symptoms included abdominal pain in 80%, diarrhea in 52%, fatigue in 33%, headache in 30% and irritability in 29% of patients.

    Adverse gluten reactions are common in people with celiac disease on a gluten-free diet. Eating away from home, especially at restaurants and other homes, carries the greatest risk for gluten exposure.

    The team encourages doctors who treat people with celiac disease to question their patients about adverse gluten reactions as part of their assessment of gluten-free diet adherence.

    How often do you get exposed to gluten? What happens?

    Source:


    Image Caption: People with celiac disease might get dosed with gluten more often than they realize. Photo: CC--Allen McGregor
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    Guest Thomas Hessley

    Posted

    This was a very good article, and the results found in the study mirror my experiences over 22 years of being gluten-free.

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    Guest Jennifer

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    I become violently ill after gluten exposure (think worst case of food poisoning you can imagine). I no longer eat out at restaurants at all, it's just too big of a risk. I'm hoping beyond hope that completely gluten free restaurants and cafes will become common. I believe hospitals and nursing homes will need to eventually have dual kitchens and dual staff, with color coded plates/trays so you can trust your food came from the proper kitchen. Gluten free needs are growing by leaps and bounds each day. This illness will not be going away any time soon.

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    My 11 year old son was "glutened" last month for the first time in 2 years. Yes, it was at a restaurant that assured me the grilled chicken, and fries from a dedicated fryer were gluten-free!

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    I become violently ill after gluten exposure (think worst case of food poisoning you can imagine). I no longer eat out at restaurants at all, it's just too big of a risk. I'm hoping beyond hope that completely gluten free restaurants and cafes will become common. I believe hospitals and nursing homes will need to eventually have dual kitchens and dual staff, with color coded plates/trays so you can trust your food came from the proper kitchen. Gluten free needs are growing by leaps and bounds each day. This illness will not be going away any time soon.

    Funny you should say this illness is not going away anytime soon. Just the other day on the news they said cases of gluten sensitivity are decreasing. I thought...HA! What a crock!

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    Guest Carleen Koller

    Posted

    You may not know the answer to this. 19 years ago I was told I had a bad case of Celiac Sprue. I have done great on the diet. I had to have the gallbladder out as it stopped working. For a few years now I complained of feeling of stomach up set after eating. The doctor did the stomach emptying test which failed. In 3 hours the food had only gone down 20 percent. So now I have that problem. So can this be related to celiac sprue?

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    Guest admin

    Posted

    You may not know the answer to this. 19 years ago I was told I had a bad case of Celiac Sprue. I have done great on the diet. I had to have the gallbladder out as it stopped working. For a few years now I complained of feeling of stomach up set after eating. The doctor did the stomach emptying test which failed. In 3 hours the food had only gone down 20 percent. So now I have that problem. So can this be related to celiac sprue?

    This would be a great question to ask your doctor. Also ask him to re-test you for celiac disease, as it does not go away, so you likely still have it. A gluten-free diet is the only treatment.

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    By Jessica Mahood , M.S. Bacteriology
    Celiac.com 09/28/2004 - A very good question: what is gliadin and why does it survive a bath in hot oil? I am a little hesitant to answer because I am not a protein chemist who specializes in such things. However, I was a bacteriologist with many years of exposure to biochemical concepts, so Im probably better equipped than most to give this a go.
    First of all, a protein primer: As someone mentioned, proteins are made up of building blocks. We generally call these amino acids. Sometimes amino acids are represented in the scientific literature as a single letter--you will see something like PQQLL (pay attention to this because it will come up again later). Each of those letters stands for an amino acid that is linked to the next. So, imagine the amino acids to be beads in a necklace. This configuration--the beads of amino acids connected in the necklace--is called the primary structure.
    Now, imagine this necklace to be twisted around itself in some fashion. This is generally known as the secondary structure of the protein and often looks like a helix. Next, take that twisted necklace and bend it around into a 3-D blob. This is known as the tertiary structure. If you were to take several different necklaces compressed into this tertiary structure and combine them, you would have a quaternary structure.
    So, there are four basic levels of protein structure, primary through quaternary. Of course, the actual chemistry is a bit more complicated, because many amino acids have a chemical charge to them that can influence how they respond to their neighbors, or to the outside environment. Think of a magnet--like repels like, attracts opposite. If they are attracted or repelled, its going to effect the ultimate structure of that protein. Amino acids, as molecules, are also different sizes. One amino acid may be like a small bead that fits easily between the others, while the next amino acid could be huge and practically hanging off of the necklace. Imagine this as a lump in our necklace that prohibits it from fitting neatly against another necklace in our blob.
    There is also the fact that not all proteins have all four of the levels of structure. Some proteins simply exist as a secondary structure or tertiary structure. So, there are many different types of protein structures in nature. Often times, these depend on the job of the protein.
    Hopefully I havent thoroughly confused you by now. Suffice it to say that there are many factors involved in determining the properties of a certain protein. So much so that there are actually a set series of tests that scientists use to classify proteins. It is a very complex discipline.
    Now, back to your original question. Proteins cannot be killed, per se, as they are not alive. HOWEVER, they can be damaged or destroyed. This is a process that is called denaturation. Denaturation can be irreversible, such as when you burn something to a crisp. Its as if you melted the strand of that necklace and all of the shapes that it made were lost. Denaturation can also be somewhat temporary. You denature your hair, to some extent, when you use a curling iron. You are slightly unraveling a higher structure of the hair protein, but it can be righted over time (unless the curling iron is too hot!).
    The ease with which a protein denatures depends on many things. Think back to our necklace. If we have, say, five necklaces clustered together to form a single protein, it would probably take a lot of chemical disruption to fully destroy that protein. However, if we had one tiny necklace twisted up slightly, it would be a lot less work to break it apart. There are many other factors involved in this--the size and charge of the beads, for example.
    Gliadin is a fragment of the protein gluten. Gliadin is NOT a single amino acid. Gliadin is simply a subset of a larger protein. Think of it as one necklace within a jumble of many. According to a Stanford research website (http://www.friedli.com/research/PhD/Predict/discuss.html), gluten has the basic structure of:
    MKTFLILALLAIVATTATTAVRVPVPQLQPQNPSQQQPQ
    EQVPLVQQQQFLGQQQPFPPQQPYPQPQPFPSQQPYLQLQ
    PFLQPQLPYSQPQPFRPQQPYPQPQPQYSQPQQPISQQQQ
    QQQQQQQQQQQQQQQIIQQILQQQLIPCMDVVLQQHNIV
    HGKSQVLQQSTYQLLQELCCQHLWQIPEQSQCQAIHNVVH
    AIILHQQQKQQQQPSSQVSFQQPLQQYPLGQGSFRPSQQ
    NPQAQGSVQPQQLPQFEEIRNLARK
    What do these letters mean? Again, they are amino acids. Each one of those letters stands for an amino acid. Its like a code. If the same letter is used, the same amino acid is in those two parts. Within that larger sequence, you see:
    RPQQPYPQPQPQ
    This smaller list of letters is the amino acid code for gliadin. So just for a start, in denaturing our gliadin, we have to destroy all of the rest of the gluten protein that is around it. The next issue is that this sequence contains the letter Q several times. This letter Q represents the amino acid glutamine. This is probably what the person meant when they said that gliadin was an amino acid. They were most likely thinking of glutamine. In any case, as far as amino acids go, glutamine is fairly large and pretty hearty.
    At this point in time, go to the following website: http://www.chemie.fu-berlin.de/chemistry/bio/aminoacid/glutamin_en.html
    Look at the picture of glutamine next to the name at the top--it looks like a couple of groups of letters connected by black lines. If you look to the far left, you see the letters H2N. A certain chemical process in the body changes that H2N into a different chemical group. This is called deamidation, and you hear about it a lot in reference to the Celiac response. It is the deamidated protein within the gliadin fragment of the gluten protein that is believed to be the big trigger for the antibody response that causes damage. What a mouthful, eh?
    Back to gliadin and hot oil, the original question. Okay, so now we know that proteins are pretty complicated. They can have big structures and lots of chemical interactions. Gluten is such a protein. The gliadin fragment of the gluten protein is tough to get to. You must also destroy the properties of the amino acids in the gliadin fragment to truly nullify the immune-irritating properties of gliadin to Celiacs.
    So, for various chemical reasons, gliadin is not easy to denature. According to that Stanford website (http://www.friedli.com/research/PhD/chapter8.html), gliadin is tough stuff. Many changes made to the protein are reversible.
    Researchers are still exploring the properties of gliadin and trying to find a way to use the molecules interactions to stop the Celiac response. It gives me a hope. For now, we have to resign ourselves to being suspicious of those soupy vats of oil in the back of bars and restaurants.


    admin

    Celiac.com 02/27/2006 - Gluten Intolerance Group (GIG) applauds McDonald’s for providing proof that their French fries are safe for persons with celiac disease and gluten intolerances, states Cynthia Kupper, RD, Executive Director of GIG. Kupper, who has worked with large corporate chain restaurants for many years to provide gluten-free menu options, states McDonald’s took the best action possible by having the fries tested by one of the leading independent laboratories in food allergens. McDonald’s has provided the reassurance those persons with celiac disease need, to feel confident they can eat the fries without getting sick. Outback Steak House was the first large restaurant chain Kupper worked with to develop gluten-free menus. “We definitely made some new friends!” stated Thomas C. Kempsey, Director of Culinary for Cheeseburger in Paradise, speaking of the gluten-free menu Kupper helped the chain launch in February. Cameron Mitchell’s Fish Market, Bone Fish Grill, Carrabba’s, Bugaboo Creek, and many others have worked with GIG to develop gluten-free menus. The program has been very successful for restaurants involved with GIG’s outreach project, states Kupper. The patrons are happy and the restaurants see a growing number of loyal customers.
    GIG promotes safe and healthy dining through education of restaurants and consumers. Many restaurants have developed gluten-free menu options. Some individual restaurants are part of a program GIG will soon manage called the Gluten-Free Restaurant Awareness Program (www.glutenfreerestaurants.org). Both this program and GIG’s corporate program have strict guidelines for inclusion. Many restaurants have the potential to meet the needs of persons with food sensitivities, however not all are willing to take the extra steps necessary to do so.
    Many people with celiac disease are afraid to eat away from home for fear of getting sick according to research. To know that restaurants offer gluten-free choices, verified by trusted sources is a big deal for these people. For people who travel, places like McDonalds and Outback become their safety nets and they will not eat anywhere else, states Kupper. Parents want their children to have options like other kids, so McDonald’s is a perfect fast food choice. Not all fast food restaurants use dedicated fryers and some use fries that are treated with wheat flour – an absolute ‘must avoid’ for celiacs.
    Unlike other acute allergies, such as peanut allergies, celiac disease is a chronic condition that can cause damage to the intestines, malabsorption and malnutrition by eating gluten (proteins found in wheat, rye, barley and hybrids of these grains). Celiac disease is a life-long disease that can be diagnosed at any age. The only treatment for the disease is the strict avoidance of gluten. Celiac disease affects nearly 3 million people in the US and 1:250 people worldwide, yet it is the most misdiagnosed common disorder today.
    The Gluten Intolerance Group, based in Seattle WA, is a national nonprofit organization providing support and education to persons with gluten intolerances in order to live healthy lives. GIG is the leading national organization for gluten intolerances with a dietitian on staff daily to work with consumers. Gluten Intolerance Group (GIG) works with restaurants to offer gluten-free dining options for persons with celiac disease.

    Joanne Bradley
    Celiac.com 06/17/2008 - Water, water, everywhere! That is what I woke up to one day in August of 2007. It seems a big storm had lodged over a certain area of the Midwest – and I was in it. Wow, was I in it! A flash flood had raised the water level of a nearby lake to the point where it was in my town house–almost 3 feet of it. It happened overnight and we had to leave immediately. I was able to grab only a couple of things.
    Eating out being gluten intolerant is quite difficult. Eating emergency food rations at a Red Cross Evacuation station is quite another. Fortunately, the local college food service took over the meals for the evacuees and I was able to eat gluten-free at that point. I learned a lot in those few days that I would like to share with anyone who has food intolerances.
    It is very important to have a food emergency kit that you can grab quickly on your way out the door. Natural disasters can happen anywhere–wouldn’t it be nice if you were prepared? This food may be a great source of comfort if you ever experience evacuation from that fine place you call home.
    Please keep in mind that in a disaster you may not have personal transportation. You may also lack monetary resources or not be able to return to your home for days or weeks. Once allowed back into your home, you will be cleaning up in an unsanitary environment. The electricity may be off, or you may lack running water. The free meals dropped off at disaster sites usually have gluten in them. I relied on gluten-free meal replacement liquid in cans and gluten-free energy bars because of the sanitation issue.
    Here is a list of ideas you may want to consider:

    Create a food emergency kit and store it up HIGH in a temperate place, like the upper shelf of a coat closet near your most used door. The kit should be small enough, and light enough, that with food you are able to carry it a good distance. A knapsack or small, light rolling duffle are some ideas. I use an inexpensive plastic pencil box (new, not used) to store plastic utensils, a paring knife, and a can opener. A box of disinfectant wipes or hand cleaner is essential. As are some sort of paper wipes in a plastic bag. Remember that everything in this kit may get wet at some point in an actual emergency, so pack items in airtight waterproof bags. Canned goods are heavy so limit them to items like gluten-free canned chicken, tuna, or meal replacement drinks. Dried gluten-free meats in airtight bags are very good. Stock a variety of gluten-free energy bars. Add dry mixes for soups, broth, etc. A plastic bag of dry milk replacement might be something you would like. An assortment of dried fruits and rollups; dried nuts (if tolerant). A small bag of first aid supplies. Essential vitamins and medications. And, if you think you have room, a small 3-cup rice cooker and rice. You can cook anything in a rice cooker - I practically lived off mine in temporary housing. Don’t forget, every 3-4 months change out everything in the kit. Refill your kit with fresh products. (Eat anything that is not expired.)  In an actual emergency, you will want good quality food to eat.
    Until gluten-free dining becomes more commonplace, you do need to plan for unusual occurrences. Even with planning, there is no guarantee that you will be able to grab your food kit. If you can, it will be a great comfort in many different situations. It is my most sincere wish that you never have to use your emergency kit. Be well and happy in your gluten-free lifestyle.

    Wendy Cohan
    Celiac.com 09/25/2008 - Even after identifying yourself as having a wheat or gluten allergy and asking for a specially prepared meal, it is a common mistake to have a server deliver soup with crackers, or the entree with a side of Texas toast.   I get frustrated just thinking about the number of times my salad has arrived with croutons.  However, getting upset, or pointedly reminding the server can ruin the ambiance of the meal, as well as leave a bad impression with your dinner companions. It is helpful to remember that you are in the very small minority of their customers, and simply consider it an honest mistake.  Do not remove the croutons, crackers, cheese, etc. and eat your contaminated food—SEND IT BACK TO THE KITCHEN—politely, please.  State that you cannot eat what they have brought you, and repeat that you are allergic to the offending food.  Use the opportunity to gently remind your server and educate them about gluten.  Hopefully the next time they will be more conscientious.
    If you are wheat or gluten intolerant, and have the genetic component that leads to celiac disease, there is no going back to gluten.  As your body heals, you may think that you will be able to cheat once in a while, and that your sensitivity to gluten will decrease once you are not getting "too much".  In fact, the opposite seems to be true.  Once the body begins to get rid of its toxic load, heal damaged tissues, and regain health, it becomes more sensitive to gluten.  I see this over and over again in the clients I counsel, and in my cooking class students.  You will know right away if you cheat, or if you are accidentally "glutened".  Your body, fortunately or unfortunately, will tell you.  It is important to learn techniques to sooth your symptoms as much as possible until recovery takes place.
    Symptoms of gluten exposure in a gluten-intolerant person can vary widely, but some commonly reported ones are abdominal discomfort, bloating, pain, swelling (sometimes extreme) and cramping, followed by diarrhea, or loose stools.  For those with Dermatitis Herpetiformis (DH), even very minor exposure can provoke itching and a return of a healed or nearly healed rash.  Others report headaches, or experience a sudden decrease in alertness and clarity of thought.
    Short-term treatment strategies for gluten exposure include taking an over-the-counter anti-histamine (check with your pharmacist for gluten ingredients), drinking nettle leaf tea (a natural anti-histamine), and using a warm castor oil pack over your upper or lower abdomen, wherever the pain and cramping are centered.
    Longer-term strategies include rebuilding your intestinal health through following an anti-inflammatory diet, taking supplements like L-Glutamine, coconut oil, fat-soluble vitamins A, E, D, and K, Calcium, Magnesium, B-Vitamins, Essential Fatty Acids (EFA's), and probiotics.  Dr. Thomas O'Bryan, a nationally recognized speaker on celiac disease and gluten sensitivity, also recommends Carnitine, an amino acid, in the treatment of celiac/gluten intolerance.  L-Carnitine helps in the absorption and transport of essential fatty acids into cells, and also helps to protect nerve membranes from free-radical damage.
    You may have good results with the tummy rescue smoothie recipe below, which I developed in response to a "gluten emergency" of my own.  The healing properties of each ingredient are also listed.  Puree in blender until smooth, and slightly thickened.  It is most soothing when consumed while still warm from the hot tea
    Tummy Rescue Smoothie:
    1 cup hot freshly brewed nettle leaf tea (anti-histamine, anti-spasmodic) ¼ cup Santa-Cruz pear juice (flavoring/sweetener - pears are the least allergenic of fruits) ¼ - ½ teaspoon whole fennel seed (reduces gas & bloating) 2 Tablespoons slippery elm powder (healing & soothing to mucous membranes and the gut) 1 Tablespoon flax seed oil (soothing, anti-inflammatory) ¼ - ½ cup rice milk (hypoallergenic, use to thin to desired consistency) This smoothie is best consumed in small sips over an hour or so.  Magnesium also helps with pain and relaxes muscle spasms, so taking a little extra magnesium may be of benefit. For severe symptoms, drink the smoothie while reclining in bed, with a warm castor oil pack over the abdomen, covered by a heating pad set on low.  Do not leave the pack in place for more than an hour.
    There is also an enzyme coming on the market that may help reduce some symptoms of gluten exposure, although this product is in no way meant to replace the gluten-free diet.  Use it only for emergencies.

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    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.
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    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