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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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    SUBWAY STORES IN OREGON FIRST TO OFFER GLUTEN-FREE OPTIONS STATEWIDE


    Jefferson Adams

    Celiac.com 03/09/2012 - Subway stores in Oregon are in the process of rolling out gluten-free sandwich buns and gluten-free brownies as regular menu items statewide, according to Subway spokesperson Cathie Ericson.


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    Photo: CC--zyphbearFor millions of Americans who avoid gluten, due to celiac disease or gluten sensitivity, eating out can be a constant challenge. Having easy access to a safe, tasty, low-cost gluten-free sandwich is like the Holy Grail for some of those folks. For many, being able to grab a gluten-free Subway sandwich would be a major step toward vanquishing the challenges of eating gluten-free.

    Subway understands that being gluten-free "…really cuts down on fast-casual dining options, particularly sandwiches,” said Michele Shelley, Subway board member and owner.

    Many people were excited to read about Subway's early testing of gluten-free products in selected areas. Many were equally excited to hear about Subway's commitment to getting their gluten-free sandwich offerings right, from start to finish.

    For example, Subway’s wheat-free sandwich rolls and brownies are produced in a dedicated gluten-free facility and are individually packaged. Subway staffers are trained to prevent cross-contamination during the sandwich-making process.

    Moreover, a single employee will prepare a gluten-free sandwich order from start to finish. Other features to Subway's gluten-free process include single-use knives and eliminating contact between traditional sandwich rolls and other ingredients including meat, cheese and vegetables.

    Oregon is one of a handful of states where Subway first tested gluten-free products in selected areas. The current statewide roll out in Oregon comes after a successful test in Bend and Portland, Subway restaurants, and seems to signal Subway's desire to offer gluten-free menus to diners.

    “Subway is known for being a leader in healthy fare, and we are excited to embrace these gluten-free menu items for those who can benefit from them,” Shelley told reporters.

    Source:


    Image Caption: Photo: CC--zyphbear
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    I understand that they are taking, what seem to be, great precautions to avoid cross-contamination. However, as a former Subway worker myself (prior to Celiac diagnosis)...I know that there are plastic tops that go over the stainless steel of the counters, where the bread is slid across for sandwich-making. This is obviously a porous material, which would not be completely rid of its gluten by just wiping it down. Though the bread is placed on deli paper and slid across, it's going to come into contact with the plastic counter top. Also, there are bread crumbs EVERYWHERE. I can't even imagine how valid a quick wipe-down of them would be before a gluten free sandwich is made. Props to Subway for their effort, but this entire idea sounds dangerous!

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    Guest Joanie

    Posted

    Great effort. But, I too, am very skeptical that it could ever be safe. There is no way they could share ingredients and not contaminate with the gloves touching the standard bread, and then someone else grabbing the same ingredients....just wouldn't work. May be possible if 2 separate kitchen/serving areas could exist. Could be a huge success if done right!

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    Guest Michelle

    Posted

    They should do this in Florida! I have to admit I would try one if they showed up here, but I agree with the fear. I know the workers are very apathetic and don't understand the importance of not even a little crumb. I just don't think a teenager at minimum wage is going to be as careful as someone at a fancy resturant would be who bend over backwards for you. However, I do eat salads at my subway, actually I want one today, and it is a risk, I ask them sometimes to change their gloves but I hate asking cause they give me that look as if it a big deal to change their gloves! I think its a good idea, I just think some workers really don't care or understand.

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    Guest Jerry Hamrick

    Posted

    I am 68 years old and was diagnosed with celiac two years ago after eating a subway sandwich. I still have some problems [weight loss/220 lbs to 140 lbs now] but if Subway offers gluten free sandwiches in Florida, I'll try them...

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    It would be awesome to be able to go to Subway and enjoy a gluten-free sub but like the rest of you, I have my doubts. There is no way that wheat crumbs do not end up in the containers of lettuce, tomatos, onion etc. etc.

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    This article too is years old, and we never had gluten free anything at Subway. These out of date links should be removed or updated.

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    This article too is years old, and we never had gluten free anything at Subway. These out of date links should be removed or updated.

    You can still get gluten-free rolls at Subway in Oregon.

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    Lionel Mugema
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    Tina Turbin
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    Jefferson Adams
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    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.
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    NO SYMPTOMS
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    There are four main differences between celiac disease and non-celiac gluten sensitivity:
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    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
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    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

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    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