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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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    SURVEY OF TEA SHOWS LIMITS OF GLUTEN-SCREENING PROCEDURES


    Jefferson Adams

    Celiac.com 09/30/2015 - In 2013, a team from the U.S. Food and Drug Administration conducted a survey of white and green teas, commercially available in the northeastern United States, for the presence of gluten in the form of undeclared wheat.


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    Tea in bowls. Photo: CC--A Girl with TeaThe survey team included EA Garber, R Panda, and KF Shireen. They are variously affiliated with the Office of Regulatory Science, U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, and the Office of Compliance, U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition in College Park, Maryland, USA.

    Initially, none of the test results show the required concurrence between the RIDASCREEN gliadin (R5) enzyme-linked immunosorbent assay (ELISA) and the Morinaga Institutes of Biological Science (MIoBS) wheat protein ELISA.

    So, just based on that, it would appear that none of the 20 products included in the survey tested positive for wheat, rye, barley, or gluten.

    Moreover, eight of the teas generated responses indicative of the presence of gluten with the RIDASCREEN gliadin (R5), AgraQuant gluten G12, and Aller-Tek (Skerritt) sandwich ELISAs. Five of the eight teas generated responses indicative of >20 ppm of gluten using the RIDASCREEN and AgraQuant ELISA test kits, and all eight had ≥ 20 ppm based on the Aller-Tek ELISA.

    Extracts prepared using the RIDASCREEN validated protocol and the MIoBS validated sodium dodecyl sulfate plus β-mercaptoethanol (overnight) protocol were analyzed using both test kits. The extracts prepared using the RIDASCREEN protocol tested positive for gluten with both test kits.

    Western blot analyses of the two sets of extracts using the R5 and MIoBS antibodies to visualize the bands revealed the presence of antigenic proteins in both sets of extracts, although the profiles and band intensities were different and inconsistent with the ELISA results.

    Right now, there's no need for alarm. The researchers are not saying that these types of tea contains gluten. Technically these teas are not failing a gluten test.

    What the researchers are saying is that there needs to be a review of gluten screening procedures and how the observation of a homologous antigenic element is defined, so that the tests are accurate and reliable.


    Source:


    Image Caption: Tea in bowls. Photo: CC--A Girl with Tea
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  • Related Articles

    Dyani Barber
    Celiac.com 04/12/2011 - Paul Seelig was found guilty today of 23 counts of obtaining property by false pretense after a two-week trial in Durham, NC. The jury found that he illegally represented baked goods as gluten-free, but they actually contained gluten. Mr. Seelig received an 11 year prison sentence for his crimes, which included the sickening of more than two dozen customers, one of whom had a premature delivery that was possibly caused by her involuntary gluten consumption.
    Seelig's company, Great Specialty Products, purchased regular gluten-containing items from companies in New Jersey such as Costco, and then repackaged them in his home kitchen and sold them as "gluten-free" at the NC State Fair, various street fairs and via home delivery. Seelig claimed that his baked items were homemade in his company's 150,000-square-foot commercial kitchen, and that his company raised its own grains on its 400-acre farm. High gluten levels were detected by both customers and investigators in Seelig's supposedly gluten-free bread, even though he claimed that he tested his bread weekly for gluten and found none. Mr. Seelig could not produce any of his test results at trial.
    Source:

    http://www.newsobserver.com/2011/04/12/1123724/bread-seller-lied-jurors-find.html

    Tina Turbin
    Celiac.com 01/23/2012 - After their diagnosis, celiac patients are put on the gluten-free diet, which is the only treatment option currently available. The diet requires total elimination of gluten, a protein found in wheat, barley, and rye, which when ingested causes an autoimmune reaction in celiacs which results in damage to the absorptive finger-like projections that line the small intestine, which are called villi. As diligent as celiacs can be, avoiding gluten can be a challenge, and slip-ups can happen, especially when eating out. In my research, I've come across gluten-digesting enzymes as a new medical treatment option for later down the line and have shared this good news with the gluten-free community. However, gluten-digesting enzymes are already available over the counter to help celiacs and gluten-sensitive people with managing their gluten-free diet. Dr. Nan Kathryn Fuchs, who helped to formulate the Advanced Bionutritionals product, Gluten Sensitivity Formula, shares some information regarding these enzymes and clears up a couple of misconceptions regarding their use.

    Furthermore, not all enzyme formulas containing DPP-IV are the same in terms of strength. Dr. Fuchs had her supplement creators formulate a gluten-digesting enzyme that was stronger than the other ones available on the market. The result was Gluten Sensitivity Formula. In her pamphlet, "How to Tell If You're Gluten Sensitive.And What to Do About It If You Are," Dr. Fuchs offers advice on how to take the supplement.
    Dr. Fuchs emphasizes that Gluten Sensitivity Formula isn't intended to replace a gluten-free diet; it is, however, designed to reduce or get rid of a reaction to "small amounts" of what would presumably be unintentionally ingested gluten, such as one may encounter at a restaurant or a dinner party due to cross-contamination. She also recommends taking one or two capsules of the formula "as insurance" before eating meals that might possibly be contaminated with gluten.
    Dr. Fuchs also clears up a myth regarding hydrocholoric acid (HCl), which has been believed to counteract digestive enzymes; this misconception has led to the incorrect advice that one shouldn't take hydrochloric acid and enzymes together. Hydrochloric acid is taken, according to Dr. Fuchs, in order to help with digesting proteins and minerals, for example calcium and iron. She says the supplement is more common among people over the age of 50. In fact, enzymes can only cancel out the benefits of hydrochloric if they alter the pH of the stomach by neutralizing its acids. Dr. Fuchs says that while animal-based enzymes can accomplish this, they are usually formulated with a protective coating or in a form that will prevent this from occurring. What's more, many enzymes, especially gluten-digesting ones, are made from plants. "So you can take them with HCl," Dr. Fuchs says.
    According to Dr. Fuchs, taking gluten-digesting enzymes "can make the difference between being successful on a gluten-free diet and failing." When used correctly, it can help alleviate the symptoms of a reaction caused by accidental gluten ingestion or prevent the reaction from occurring. As a celiac myself, I can say that inadvertent gluten ingestion is still a challenge I face on the gluten-free diet, even though I've been on the diet for years. Dr. Fuch's Gluten Sensitivity Formula is thus a welcome product that will make the lives of the gluten-free community a lot easier.
    Resources:
    Fuchs, Nan Kathryn, PhD. "How to Tell If You're Gluten Sensitive.And What to Do About It If You Are." Advanced Bionutritionals, 2010. "Digest This: Enzymes Can Help Your Food Intolerance." Living Without: August/September 2010. Food Reactions: Food Intolerance http://www.foodreactions.org/intolerance/index.html

    Jefferson Adams
    Celiac.com 03/23/2012 - Most parents of gluten-free children can attest to the challenges of making certain that the food the kids are eating is, in fact, gluten-free.
    Many of those parents can also be comforted by the fact that more public schools are recognizing the need for gluten-free lunches for certain children, and are making an effort to provide nutritious gluten-free alternatives for those children.
    Well, in a development that may interest all parents of gluten-free children, the BBC is reporting that schools in Northamptonshire, UK, have been to ordered to discontinue two particular "gluten-free" meals after the meals were found to contain unacceptable levels of gluten. Gluten from wheat, rye or barley triggers an immune reaction in certain people, requiring them to avoid eating food containing even trace amounts of those grains.
    Nutritionists overseeing the gluten-free meals discovered gluten in a supplier's shepherd's pie and beef Bolognese. These meals are served to gluten-free children at schools across the county.
    The BBC report says the county council has about 20 pupils registered with gluten-intolerance or celiac disease, but that no children had shown an adverse reaction.
    Unacceptably high levels of gluten were detected in a gravy powder used to make the two meals, according to the local authority contacted by the BBC.
    The report cites Councilor Andrew Grant as saying that nutritionists regularly monitor the ingredients used by companies that supply food to the schools, and that one such check found that food labeled as gluten-free in fact continued gluten.
    In many gluten-sensitive individuals, even a small amount of gluten can trigger an adverse reaction. So, even if the even if the contamination is slight, Grants notes, it is nevertheless completely unacceptable for a child with allergies to be exposed to this risk.
    According to the article, county officials wants to make certain that the problem is confined to these two particular products, so it has asked for a full investigation into the cause of the problem. 
    Are problems such as this to be expected as we transition gluten-free food into new areas, such as public schools? Are even these problems a sign that celiac disease and gluten-sensitivity awareness is increasing? Are such issues a sign that more and better gluten-free food options lie just around the corner? Let us know your thoughts.


    Jefferson Adams
    Celiac.com 05/27/2014 - Here are seven common myths people have about celiac disease and gluten-free eating.
    Myth #1: Rice contains gluten, and people with celiac disease and gluten-intolerance shouldn’t eat it.
    Status: FALSE.
    People with celiac disease and gluten-intolerance have adverse immune reactions to gluten proteins in wheat, rye and barley.
    Rice does contain gluten, just not the kind that causes adverse reactions in people with celiac disease and gluten-intolerance. Plain rice is fine for people with celiac disease.
    Myth #2: A little gluten is okay for people with celiac disease and gluten-intolerance to eat.
    Status: MOSTLY FALSE.
    Gluten levels above 20 parts per million can cause adverse immune reactions and chronic damage in people with celiac disease.
    Current medical research defines gluten-levels below 20 parts per million as safe for people with celiac disease, and the FDA and other official organizations use that standard in labeling, those levels are so close to zero as to be “gluten-free.”
    The tiniest crumbs of bread far exceed 20ppm, so eating “a little” gluten is only possible by eating “gluten-free” food. In fact, the only properly recognized treatment for celiac disease is a gluten-free diet.
    Myth #3: Food made with gluten-free ingredients is safe for people with celiac disease.
    Status: FALSE
    Just because food is made with gluten-free ingredients, it is not necessarily safe for people with celiac disease. Case in point, Domino’s Pizza recently introduced gluten-free pizza crusts. However, these pizzas are prepared in the same areas and ovens as Domino’s regular pizzas, and are likely contaminated with gluten from wheat flour. These pizzas are not safe for people with celiac disease. There are many similar cases in the restaurant world. Contamination is a serious issue for some celiacs, so buyers be aware and be wary.
    Myth #4: Celiac disease is a food allergy.
    Status: FALSE
    Celiac disease is not a food allergy or an intolerance, it is an autoimmune disease. People with celiac disease suffer damage to the lining of the small intestine when they eat wheat, rye or barley. They also face higher risks for many other auto-immune conditions.
    Myth #5: Celiac disease only affects people of European ancestry
    Status: FALSE
    Celiac disease is more common in people of northern European ancestry, but it affects all ethnic groups and is found in southern Asia, the Middle East, North Africa and South America.
    Myth #6: Celiac disease is a children’s condition
    Status: FALSE
    Celiac disease can develop at any age. In fact, celiac disease is most commonly diagnosed in people aged 40-60 years old.
    Myth #7: Celiac disease can be painful, but isn't life-threatening.
    It’s true that classic celiac disease symptoms, like stomach pain, bone pain, fatigue, headaches, skin rash, and digestive issues, won’t kill patients outright. However, undiagnosed or untreated, celiac disease can trigger other autoimmune disorders, and leave patients at much greater risk of developing certain types of deadly cancer.

  • Recent Articles

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
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    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
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    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    fdfworld.com

    Jefferson Adams
    Celiac.com 04/19/2018 - Previous genome and linkage studies indicate the existence of a new disease triggering mechanism that involves amino acid metabolism and nutrient sensing signaling pathways. In an effort to determine if amino acids might play a role in the development of celiac disease, a team of researchers recently set out to investigate if plasma amino acid levels differed among children with celiac disease compared with a control group.
     
    The research team included Åsa Torinsson Naluai, Ladan Saadat Vafa, Audur H. Gudjonsdottir, Henrik Arnell, Lars Browaldh, and Daniel Agardh. They are variously affiliated with the Institute of Biomedicine, Department of Microbiology & Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; the Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden; the Department of Pediatric Gastroenterology, Hepatology and Nutrition, Karolinska University Hospital and Division of Pediatrics, CLINTEC, Karolinska Institute, Stockholm, Sweden; the Department of Clinical Science and Education, Karolinska Institute, Sodersjukhuset, Stockholm, Sweden; the Department of Mathematical Sciences, Chalmers University of Technology, Gothenburg, Sweden; the Diabetes & Celiac Disease Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden; and with the Nathan S Kline Institute in the U.S.A.
    First, the team used liquid chromatography-tandem mass spectrometry (LC/MS) to analyze amino acid levels in fasting plasma samples from 141 children with celiac disease and 129 non-celiac disease controls. They then crafted a general linear model using age and experimental effects as covariates to compare amino acid levels between children with celiac disease and non-celiac control subjects.
    Compared with the control group, seven out of twenty-three children with celiac disease showed elevated levels of the the following amino acids: tryptophan; taurine; glutamic acid; proline; ornithine; alanine; and methionine.
    The significance of the individual amino acids do not survive multiple correction, however, multivariate analyses of the amino acid profile showed significantly altered amino acid levels in children with celiac disease overall and after correction for age, sex and experimental effects.
    This study shows that amino acids can influence inflammation and may play a role in the development of celiac disease.
    Source:
    PLoS One. 2018; 13(3): e0193764. doi: & 10.1371/journal.pone.0193764

    Jefferson Adams
    Celiac.com 04/18/2018 - To the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service animals.
    If you’ve flown anywhere lately, you may have seen them. People flying with their designated “emotional support” animals. We’re not talking genuine service animals, like seeing eye dogs, or hearing ear dogs, or even the Belgian Malinois that alerts its owner when there is gluten in food that may trigger her celiac disease.
    Now, to be honest, some of those animals in question do perform a genuine service for those who need emotional support dogs, like veterans with PTSD.
    However, many of these animals are not service animals at all. Many of these animals perform no actual service to their owners, and are nothing more than thinly disguised pets. Many lack proper training, and some have caused serious problems for the airlines and for other passengers.
    Now the major airlines are taking note and introducing stringent requirements for service animals.
    Delta was the first to strike. As reported by the New York Times on January 19: “Effective March 1, Delta, the second largest US airline by passenger traffic, said it will require passengers seeking to fly with pets to present additional documents outlining the passenger’s need for the animal and proof of its training and vaccinations, 48 hours prior to the flight.… This comes in response to what the carrier said was a 150 percent increase in service and support animals — pets, often dogs, that accompany people with disabilities — carried onboard since 2015.… Delta said that it flies some 700 service animals a day. Among them, customers have attempted to fly with comfort turkeys, gliding possums, snakes, spiders, and other unusual pets.”
    Fresh from an unsavory incident with an “emotional support” peacock incident, United Airlines has followed Delta’s lead and set stricter rules for emotional support animals. United’s rules also took effect March 1, 2018.
    So, to the relief of many bewildered passengers and crew, no more comfort turkeys, geese, possums or other questionable pets will be flying on Delta or United without meeting the airlines' strict new requirements for service and emotional support animals.
    Source:
    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
    Celiac disease is an autoimmune condition that affects around 1% of the population. People with celiac disease suffer an autoimmune reaction when they consume wheat, rye or barley. The immune reaction is triggered by certain proteins in the wheat, rye, or barley, and, left untreated, causes damage to the small, finger-like structures, called villi, that line the gut. The damage occurs as shortening and villous flattening in the lamina propria and crypt regions of the intestines. The damage to these villi then leads to numerous other issues that commonly plague people with untreated celiac disease, including poor nutritional uptake, fatigue, and myriad other problems.
    Celiac disease mostly affects people of Northern European descent, but recent studies show that it also affects large numbers of people in Italy, China, Iran, India, and numerous other places thought to have few or no cases.
    Celiac disease is most often uncovered because people experience symptoms that lead them to get tests for antibodies to gluten. If these tests are positive, then the people usually get biopsy confirmation of their celiac disease. Once they adopt a gluten-free diet, they usually see gut healing, and major improvements in their symptoms. 
    CLASSIC CELIAC DISEASE SYMPTOMS
    Symptoms of celiac disease can range from the classic features, such as diarrhea, upset stomach, bloating, gas, weight loss, and malnutrition, among others.
    LESS OBVIOUS SYMPTOMS
    Celiac disease can often less obvious symptoms, such fatigue, vitamin and nutrient deficiencies, anemia, to name a few. Often, these symptoms are regarded as less obvious because they are not gastrointestinal in nature. You got that right, it is not uncommon for people with celiac disease to have few or no gastrointestinal symptoms. That makes spotting and connecting these seemingly unrelated and unclear celiac symptoms so important.
    NO SYMPTOMS
    Currently, most people diagnosed with celiac disease do not show symptoms, but are diagnosed on the basis of referral for elevated risk factors. 

    CELIAC DISEASE VS. GLUTEN INTOLERANCE
    Gluten intolerance is a generic term for people who have some sort of sensitivity to gluten. These people may or may not have celiac disease. Researchers generally agree that there is a condition called non-celiac gluten sensitivity. That term has largely replaced the term gluten-intolerance. What’s the difference between celiac disease and non-celiac gluten-sensitivity? 
    CELIAC DISEASE VS. NON-CELIAC GLUTEN SENSITIVITY (NCGS)
    Gluten triggers symptoms and immune reactions in people with celiac disease. Gluten can also trigger symptoms in some people with NCGS, but the similarities largely end there.

    There are four main differences between celiac disease and non-celiac gluten sensitivity:
    No Hereditary Link in NCGS
    Researchers know for certain that genetic heredity plays a major role in celiac disease. If a first-degree relative has celiac disease, then you have a statistically higher risk of carrying genetic markers DQ2 and/or DQ8, and of developing celiac disease yourself. NCGS is not known to be hereditary. Some research has shown certain genetic associations, such as some NCGS patients, but there is no proof that NCGS is hereditary. No Connection with Celiac-related Disorders
    Unlike celiac disease, NCGS is so far not associated with malabsorption, nutritional deficiencies, or a higher risk of autoimmune disorders or intestinal malignancies. No Immunological or Serological Markers
    People with celiac disease nearly always test positive for antibodies to gluten proteins. Researchers have, as yet, identified no such antobodies or serologic markers for NCGS. That means that, unlike with celiac disease, there are no telltale screening tests that can point to NCGS. Absence of Celiac Disease or Wheat Allergy
    Doctors diagnose NCGS only by excluding both celiac disease, an IgE-mediated allergy to wheat, and by the noting ongoing adverse symptoms associated with gluten consumption. WHAT ABOUT IRRITABLE BOWEL SYNDROME (IBS) AND IRRITABLE BOWEL DISEASE (IBD)?
    IBS and IBD are usually diagnosed in part by ruling out celiac disease. Many patients with irritable bowel syndrome are sensitive to gluten. Many experience celiac disease-like symptoms in reaction to wheat. However, patients with IBS generally show no gut damage, and do not test positive for antibodies to gliadin and other proteins as do people with celiac disease. Some IBS patients also suffer from NCGS.

    To add more confusion, many cases of IBS are, in fact, celiac disease in disguise.

    That said, people with IBS generally react to more than just wheat. People with NCGS generally react to wheat and not to other things, but that’s not always the case. Doctors generally try to rule out celiac disease before making a diagnosis of IBS or NCGS. 
    Crohn’s Disease and celiac disease share many common symptoms, though causes are different.  In Crohn’s disease, the immune system can cause disruption anywhere along the gastrointestinal tract, and a diagnosis of Crohn’s disease typically requires more diagnostic testing than does a celiac diagnosis.  
    Crohn’s treatment consists of changes to diet and possible surgery.  Up to 10% of Crohn's patients can have both of conditions, which suggests a genetic connection, and researchers continue to examine that connection.
    Is There a Connection Between Celiac Disease, Non-Celiac Gluten Sensitivity and Irritable Bowel Syndrome? Large Number of Irritable Bowel Syndrome Patients Sensitive To Gluten Some IBD Patients also Suffer from Non-Celiac Gluten Sensitivity Many Cases of IBS and Fibromyalgia Actually Celiac Disease in Disguise CELIAC DISEASE DIAGNOSIS
    Diagnosis of celiac disease can be difficult. 

    Perhaps because celiac disease presents clinically in such a variety of ways, proper diagnosis often takes years. A positive serological test for antibodies against tissue transglutaminase is considered a very strong diagnostic indicator, and a duodenal biopsy revealing villous atrophy is still considered by many to be the diagnostic gold standard. 
    But this idea is being questioned; some think the biopsy is unnecessary in the face of clear serological tests and obvious symptoms. Also, researchers are developing accurate and reliable ways to test for celiac disease even when patients are already avoiding wheat. In the past, patients needed to be consuming wheat to get an accurate test result. 
    Celiac disease can have numerous vague, or confusing symptoms that can make diagnosis difficult.  Celiac disease is commonly misdiagnosed by doctors. Read a Personal Story About Celiac Disease Diagnosis from the Founder of Celiac.com Currently, testing and biopsy still form the cornerstone of celiac diagnosis.
    TESTING
    There are several serologic (blood) tests available that screen for celiac disease antibodies, but the most commonly used is called a tTG-IgA test. If blood test results suggest celiac disease, your physician will recommend a biopsy of your small intestine to confirm the diagnosis.
    Testing is fairly simple and involves screening the patients blood for antigliadin (AGA) and endomysium antibodies (EmA), and/or doing a biopsy on the areas of the intestines mentioned above, which is still the standard for a formal diagnosis. Also, it is now possible to test people for celiac disease without making them concume wheat products.

    BIOPSY
    Until recently, biopsy confirmation of a positive gluten antibody test was the gold standard for celiac diagnosis. It still is, but things are changing fairly quickly. Children can now be accurately diagnosed for celiac disease without biopsy. Diagnosis based on level of TGA-IgA 10-fold or more the ULN, a positive result from the EMA tests in a second blood sample, and the presence of at least 1 symptom could avoid risks and costs of endoscopy for more than half the children with celiac disease worldwide.

    WHY A GLUTEN-FREE DIET?
    Currently the only effective, medically approved treatment for celiac disease is a strict gluten-free diet. Following a gluten-free diet relieves symptoms, promotes gut healing, and prevents nearly all celiac-related complications. 
    A gluten-free diet means avoiding all products that contain wheat, rye and barley, or any of their derivatives. This is a difficult task as there are many hidden sources of gluten found in the ingredients of many processed foods. Still, with effort, most people with celiac disease manage to make the transition. The vast majority of celiac disease patients who follow a gluten-free diet see symptom relief and experience gut healing within two years.
    For these reasons, a gluten-free diet remains the only effective, medically proven treatment for celiac disease.
    WHAT ABOUT ENZYMES, VACCINES, ETC.?
    There is currently no enzyme or vaccine that can replace a gluten-free diet for people with celiac disease.
    There are enzyme supplements currently available, such as AN-PEP, Latiglutetenase, GluteGuard, and KumaMax, which may help to mitigate accidental gluten ingestion by celiacs. KumaMax, has been shown to survive the stomach, and to break down gluten in the small intestine. Latiglutenase, formerly known as ALV003, is an enzyme therapy designed to be taken with meals. GluteGuard has been shown to significantly protect celiac patients from the serious symptoms they would normally experience after gluten ingestion. There are other enzymes, including those based on papaya enzymes.

    Additionally, there are many celiac disease drugs, enzymes, and therapies in various stages of development by pharmaceutical companies, including at least one vaccine that has received financial backing. At some point in the not too distant future there will likely be new treatments available for those who seek an alternative to a lifelong gluten-free diet. 

    For now though, there are no products on the market that can take the place of a gluten-free diet. Any enzyme or other treatment for celiac disease is intended to be used in conjunction with a gluten-free diet, not as a replacement.

    ASSOCIATED DISEASES
    The most common disorders associated with celiac disease are thyroid disease and Type 1 Diabetes, however, celiac disease is associated with many other conditions, including but not limited to the following autoimmune conditions:
    Type 1 Diabetes Mellitus: 2.4-16.4% Multiple Sclerosis (MS): 11% Hashimoto’s thyroiditis: 4-6% Autoimmune hepatitis: 6-15% Addison disease: 6% Arthritis: 1.5-7.5% Sjögren’s syndrome: 2-15% Idiopathic dilated cardiomyopathy: 5.7% IgA Nephropathy (Berger’s Disease): 3.6% Other celiac co-morditities include:
    Crohn’s Disease; Inflammatory Bowel Disease Chronic Pancreatitis Down Syndrome Irritable Bowel Syndrome (IBS) Lupus Multiple Sclerosis Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Psoriasis Rheumatoid Arthritis Scleroderma Turner Syndrome Ulcerative Colitis; Inflammatory Bowel Disease Williams Syndrome Cancers:
    Non-Hodgkin lymphoma (intestinal and extra-intestinal, T- and B-cell types) Small intestinal adenocarcinoma Esophageal carcinoma Papillary thyroid cancer Melanoma CELIAC DISEASE REFERENCES:
    Celiac Disease Center, Columbia University
    Gluten Intolerance Group
    National Institutes of Health
    U.S. National Library of Medicine
    Mayo Clinic
    University of Chicago Celiac Disease Center