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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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    MORE THAN HALF OF ALL CHAIN RESTAURANTS TO OFFER GLUTEN-FREE DISHES


    Jefferson Adams

    Celiac.com 11/06/2014 - The results of restaurant supply-chain co-op SpenDifference’s menu price survey indicate that more than half of all restaurant chains plan to offer gluten-free menu items in 2014.


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    Photo: Wikimedia Commons--CW221The third menu price survey said nine percent of surveyed restaurants are already offering organic products, 36 percent use local products, 53 percent offer light- and low-calorie options, and 55 percent have gluten-free items.

    The report echoes earlier reports that the strong and steady uptick in the demand for gluten-free foods, and is reinforced by SpenDifference president and chief executive officer Maryanne Rose, who says that the growing demand for low-calorie and gluten-free menu items will “be with us for a long time.

    Many specialty restaurants, now offers gluten-free menus. To get an idea of your gluten-free options, Gluten-free Guide HQ offers a good list of 75 Essential Gluten Free Restaurant Menus from a number of major food purveyors that runs the gamut from fast food and casual to more upscale.


    Image Caption: Photo: Wikimedia Commons--CW221
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    A gluten-free menu is not enough. Many restaurants have so contaminated their kitchens that gluten-free is no help. Example Red Lobster. I used to eat there no problem. They brought in new chefs put in a gluten free menu and any thing I eat sickens me. Nothing I like is on the gluten-free menu.

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    Still need to be vigilant for cross-contamination. Many of these have offered a gluten-free menu, but don't necessarily understand the need to cook separately with separate (and clean) cooking surfaces and utensils.

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    Guest Dana "aka Galley Wench Tales" Greyson

    Posted

    Awesome.

     

    Now if only that happens internationally. We're about to spend the next 2 years sailing from Florida to Australia and can only carry so much food from the States.

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    I'd like to know which of these restaurants keeps a gluten free section in their kitchens in order to stop cross contamination. Just having gluten free foods on the menu isn't enough.

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    I'm pretty tired of restaurants offering "gluten free items" without also guaranteeing gluten-free preparation.

     

    This article was really no help at all.

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    Joanne, I hope this means that awareness of proper preparation is also increasing--a few years back most restaurants didn't offer anything. It is nice to have more options.

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    Some gluten-free menus have disclaimers on them noting that cross-contamination can occur, often in the fine print. Some menus don't say, so it's always good to ask and to play it safe. I agree with others here who have pointed out that more gluten-free chains is not necessarily going to help those of us who require gluten-free because of gluten intolernace or allergy, unless there is a commitment by those restaurants to proper training of staff. It would be helpful if restaurants made a point of distinguishing whether they are following GIG or similar training and whether they have separate prep areas, etc. I wish there was a required certification system for Gluten Free safety for restaurants, similar to the "certified gluten free" label that some of us look for on foods. Right now it seems like many restaurants that offer Gluten Free are just catering to the casual gluten-avoider.

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    Its nice to see gluten-free menus or options, however, proceed with caution. I don't think many, if any, restaurants understand what gluten-free really means, or know about cross contamination. You should expect cross contamination when ordering a gluten-free item at a restaurant. Disclaimers to that effect are usually found on gluten-free menus. Asking a few questions about food preparation will reveal that they don't know what they are doing.

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    Guest Mary Jane

    Posted

    Most non-gluten-free people don't get it! Just start asking questions. Even those in the food business that are supposedly giving you gluten-free. Cross contamination is a problem too.

    And why does our food have to be extra expensive in restaurants, when "Real Food" is naturally gluten-free and they don't have to use lots of ADDED things to make our stuff? Food For Thought... AND there ya go...

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    Some gluten-free menus have disclaimers on them noting that cross-contamination can occur, often in the fine print. Some menus don't say, so it's always good to ask and to play it safe. I agree with others here who have pointed out that more gluten-free chains is not necessarily going to help those of us who require gluten-free because of gluten intolernace or allergy, unless there is a commitment by those restaurants to proper training of staff. It would be helpful if restaurants made a point of distinguishing whether they are following GIG or similar training and whether they have separate prep areas, etc. I wish there was a required certification system for Gluten Free safety for restaurants, similar to the "certified gluten free" label that some of us look for on foods. Right now it seems like many restaurants that offer Gluten Free are just catering to the casual gluten-avoider.

    I agree with this comment. The government should start to regulate restaurants somehow... you can't just say something is allergy free or gluten free and it's not.

    GIG is great! I've gotten sick at the GIG rated places too but at least it's usually safer.

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    Guest Ariana Rodriguez

    Posted

    Sure, it's great that restaurants are offering a gluten-free menu but they do not care or take any precautions to avoid cross-contamination. If they offer these gluten free menus.... shouldn't they follow the new FDA regulations that went into effect as of August 2014?

     

    Even with the new regulations I have not seen an improvement and the chefs just laugh at me when I ask them detailed questions about the preparation of my meals. Until they learn to have some respect towards the Celiac community and have proper gluten free training on kitchen preparations to avoid cross contamination, I refuse to believe anything like this. I want to see a "certified gluten free" label in order for me to feel safe.

     

     

    Example, I took a trip to New York and they have a truly gluten free pizza place called Mozzarelli's that had a giant sign in their establishment that read "gluten free certified"...and you know what, I didn't get sick for weeks on end. No place should throw the gluten free label around if they cannot actually keep it safe for our sake.

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    Guest Melissa

    Posted

    Always educational to ask if their gluten free food is safe for celiacs. Some outright say no, others take more precautions if they know you need gluten-free in order to not get sick. And always, if something goes wrong with your order, or there's any mix up at all, don't eat it. Even the safest restaurants on the list will occasionally mix something up (unless they are 100% gluten free).

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    Guest Kristin

    Posted

    To the person who thinks Mozzarelli's on 23rd street in Manhattan is totally gluten-free, you're wrong. The gluten-free slices/pies are up top. The "regular" pies are on the bottom. Elon and the other chefs there are a godsend to a celiac, and an example of doing gluten-free right in a not fully gluten-free environment. They have been doing gluten-free for a few years now, and used to to "gluten free Sunday" where once a month all the food was gluten-free. They even made Zeppoles. Mozzarelli's is a case of a dedicated chef and we'll trained staff and defined gluten-free procedures/utensils/dedicated space. I believe they started because a family member was diagnosed as Celiac. A good resource to find gluten-free options is "find me gluten free". I've used it nationwide and it's been really helpful when I'm not at home. Its a free app, I have it on my galaxy. I don't know if it's in Itunes or not. The app has accurate celiac reviews and places are rated "Celiac Safe" or just gluten free. I've found some new places to eat, and avoided others because of that app. Anyway, while this article isn't really helpful, it could be worse.

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    Guest jacquie

    Posted

    The only restaurant I trust is Pizzeria Uno that get their gluten-free pizzas frozen, and they reheat them sealed. There's also a seafood restaurant in Chatham that only offers gluten-free, all their fried foods are dipped in corn flour, and deep fried, so there's no contamination at all,

    Cannot trust any other place

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    Most of these "gluten free' options are just a matter of telling us to order a burger without a bun, to not have anything with breading or pasta, or other such self-obvious things. In no way does having a "gluten free" menu mean that they go the extra mile to offer gluten-free bread, pasta, or take a single step into giving us good options. I cannot get excited over a restaurant that expects me to conform to their menu.

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    Guest carlene

    Posted

    It's just not safe to eat anywhere gluten free, I ask for the manger and I still get sick. Really Scary when you are traveling and have to stop and eat. We went to Cracker Barrel. And I only had a salad and within 10 minuets , I was sick...my husband wanted to leave me there I was so sick and we were 10 hours from home. I ate at Apple Bees, they promised me everything would be Gluten free and I was sick for 3 days....wrote to main office, no one did anything. Didn't even offer my $9.99 back. No one cares...I own my Own Bakery that is Not gluten free but I bake some stuff and tell my customers I bake in a different part of my bakery and try to be very very careful. I ask them Not to eat my gluten-free baked gooks if they are super sensitive. I work with flour everyday...I have had my own bakery for over 20 years so I have to just hope things don't get worse for me because at 59 I don't want to go,out and work for anyone else..I wish everyone that claims to serve gluten-free would be more careful, it scares the hell out of me to go out and eat. I tell the waitress 20 times to ask the cooks in the kitchen to please be very careful not to make me sick from cross containamatin and ruin the next three days for me. Most don't care..and the price increase for us is just awful...I wish the government would step in and stop the madness...we can afford it. Thanks for listening to my rant...so tired of us gluten-free people getting abused day after day...

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    I agree with all the comments above. I am thankful for how far we have come, but we still need to move farther into educating the food industry that cross-contamination is serious. I am tired of being sick most often when I eat out. I am tired of the disclaimers of "gluten friendly". What does that even mean? If I told someone I had a peanut allergy you can bet they would definitely ensure that peanuts do not touch my meal - why is gluten any different. I would prefer the food industry to be honest with me and say I can not promise so that I can make an informed decision. Again we have come along ways but please continue to advocate to address cross contamination. I would be very interested to know if the study included a survey on the individuals that ate at the restaurant and what their experience was. This would ensure that they are truly able to meet the needs of gluten free diets.

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    Still need to be vigilant for cross-contamination. Many of these have offered a gluten-free menu, but don't necessarily understand the need to cook separately with separate (and clean) cooking surfaces and utensils.

    I so agree...for those folks who just avoid gluten they have no problem, but for those of us who have celiac cross-contamination is a huge issue!

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    Still need to be vigilant for cross-contamination. Many of these have offered a gluten-free menu, but don't necessarily understand the need to cook separately with separate (and clean) cooking surfaces and utensils.

    Excellent advice-thanks for reminding!

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    Yeah, not surprised at all that over half of restaurants these days have **BULL$---** Gluten Free Menus! 99% percent of supposed gluten-free menus are a lie. Of those that claim to have a gluten-free menu, 1% or less can actually deliver a safe meal to a celiac.

     

    I'm also tired of this crap. We should be able to eat out and lead a normal life. I'm sick of being sick and told how ' "easy" I have it because of all these damn poseurs when the truth is that it's anything BUT easy. In fact after 9 years, the more popular the gluten-free diet gets and the more dietary backlash we get for suffering from this disease, the harder it gets to eat out, travel, etc. UGH.

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    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