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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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    TED CRUZ DECLARES WAR ON GLUTEN-FREE SOLDIERS


    Jefferson Adams

    Celiac.com 02/19/2016 - Did senator Ted Cruz just declare war on gluten-free soldiers? It kind of looks like that.


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    Photo: CC--Matt JohnsonIn an attempt to show he can be tough on American servicemen and women with celiac disease, the Republican presidential hopeful declared that, in the event the American people find him serving as their president and commander-in-chief, there will be no gluten-free MREs for soldiers anywhere under his command.

    Campaigning in South Carolina, and courting pro-military voters, the Texas senator seemed to believe he was striking a blow against what he describes as a culture of "political correctness" in the Pentagon.

    Speaking in broad strokes, Cruz said that "…the last thing any commander should need to worry about is the grades he is getting from some plush-bottomed Pentagon bureaucrat for political correctness or social experiments -- or providing gluten-free MREs;" the shorthand term for Meal, Ready-to-Eat.

    According to Ted Cruz, it's a bad thing to be in favor of soldiers with celiac disease having a gluten-free meal when they're in the field—while they might be putting their lives on the line in service to our country.

    Should American servicemen and women with celiac disease or gluten intolerance have their medical treatment made into a political issue? Apparently Cruz thinks so.

    However, since celiac disease is a bona fide medical condition, and a gluten-free diet is the only currently recognized treatment, regardless of whether you are Democrat or Republican, Ted Cruz, or anyone else who aspires to be commander-in-chief of the armed forces, should simply not be treating them like second-class citizens.

    All soldiers with medical conditions deserve proper treatment, that includes service men and women with celiac disease and medical conditions that require treatment with a gluten-free diet.

    Let the senator from Texas know what you think: Ted Cruz on Twitter @tedcruz

    Source:


    Image Caption: Ted Cruz is against gluten-free meals for US troops. Photo: CC--Matt Johnson
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    This is complete and totally misleading and inaccurate.

    He did not say at all that no gluten free meals would be served and you know it. How shameful of you to publish this so blatantly false information.

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    Guest Kristin Beal

    Posted

    As the wife of a Marine and Mom to a son with celiac disease, it does make sense to me. Although my son would make an incredible asset to our military, he should never see the likes of combat oversees or in a hostile environment. By signing up to be a soldier means that he could be stricken for days at a time in locations where his nutritional needs could not be met as opposed to someone who does not suffer from celiac disease. Further, if ever taken hostage his ability to maintain his health could be far more compromised than that of a soldier who could eat an unrestricted diet given by another. It's a lot to consider no doubt with varing views but ultimately I think we can still find ways for intelligent and willing Americans to serve our country without their intake limits hurting them or putting their fellow soldiers in comprised positions.

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    I don't really wish to impugn the motives for authoring this piece. However it is my understanding that the military service policy in this nation is that people with Celiac Sprue if identified as such prior to applying for military duty, can be rejected for same based on this condition. That is my understanding. Now in the real world, I am sure people get into the military who do have Celiac Sprue. The question is salient as to what to do then, plus a lot of other questions along with that. Let's look at history in this regard: A young man who obviously had Celiac, John F. Kennedy, got into the military. Now of course he had to pull strings because his official diagnosis was Addison's Disease, although that was bogus. But because he pulled strings, he got into the Navy and became a war hero in World War II. The rest is history as they say. So there are a bunch more issues here than meets the eye based on this article is my point.

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    This is complete and totally misleading and inaccurate.

    He did not say at all that no gluten free meals would be served and you know it. How shameful of you to publish this so blatantly false information.

    Please tell us what part is inaccurate? Ted Cruz said MRE's, and that is what this article said...

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    Please tell us what part is inaccurate? Ted Cruz said MRE's, and that is what this article said...

    I think what you should be up in arms about is the fact that people, including in this case Ted Cruz, use the term gluten-free as shorthand for trendy, or pampered, or whatever disparaging remark they want to make. I sincerely doubt Cruz actually wants to deny soldiers medically necessary items if they are feasible to provide. Please keep the campaign snark off this page.

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    I think what you should be up in arms about is the fact that people, including in this case Ted Cruz, use the term gluten-free as shorthand for trendy, or pampered, or whatever disparaging remark they want to make. I sincerely doubt Cruz actually wants to deny soldiers medically necessary items if they are feasible to provide. Please keep the campaign snark off this page.

    Donna, while we agree with your comment that Cruz's use of "gluten-free" was probably calculated and aimed at his base, once he made this comment it became a fair topic for this site to cover, as Celiac.com's aim is to cover all news and information related to celiac disease, gluten sensitivity, and the gluten-free diet. Any time someone with Cruz's stature comes out with an anti-gluten-free position, Celiac.com will be here to shed light on it, and hopefully make them reconsider their position.

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    What if Cruz said that when he is president you can't get any more tax deductions for gluten-free food, or that it would never be considered a disability? A person who is running for president and targeting people on a gluten free diet is definitely a topic for this site.

     

    It seems like the army needs to wake up to the fact that over 25% of Americans now say they are on a gluten free diet, and if they want to be able to recruit enough people they will need to offer gluten free meals.

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    Please tell us what part is inaccurate? Ted Cruz said MRE's, and that is what this article said...

    DID HE WAGE WAR???? REALLY?

    This problem has been a long standing one with the military LONG before Ted Cruz. You are apparently ill informed.

    Clearly you just wanted to make your political statement and get people enraged. You did exactly as you intended.

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    DID HE WAGE WAR???? REALLY?

    This problem has been a long standing one with the military LONG before Ted Cruz. You are apparently ill informed.

    Clearly you just wanted to make your political statement and get people enraged. You did exactly as you intended.

    Actually it is Cruz who is ill informed and made a political statement that was intended to get people enraged, we are just reporting it.

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    Guest janet anderson

    Posted

    Actually it is Cruz who is ill informed and made a political statement that was intended to get people enraged, we are just reporting it.

    I agree. It IS in celiac.com's purview to bring these topics up for all of us. Then, we all do what we want with the information.

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    Guest Gail Rothenberger

    Posted

    Tell Ted Cruz and the Justice Department to stop speaking out of ignorance and read the medical evidence. While sending people into harms way, they can protect them by serving them food that won't kill them.

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    Thank you for bringing up a topic that is totally relevant to your site. Cruz has definitely been quoted as you stated -- he did say what you claim, that cannot be denied. This is a microcosm of how he believes people who are "different" should be treated. Politics aside, does anyone want this mentality in the White House? He is not only ill-informed, but open to his own form of politically correct! It's time things like this were out in the open. I find it difficult to believe that any celiac or gluten-sensitive person can defend him on any level.

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    I went back and looked at multiple reporting of this incident and it appears to me that Sen. Cruz was using gluten-free food for his tough guy act. It also seems to me that he is ignorant about the medical necessity for a gluten free diet for someone with celiac disease. Else, why would you say such a thing. Very imprudent!

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    This is complete and totally misleading and inaccurate.

    He did not say at all that no gluten free meals would be served and you know it. How shameful of you to publish this so blatantly false information.

    He's using the "dog-whistle" tactic of silently coupling "gluten-free" with "liberal politically-correct wussy" in the minds of those who are listening. Why else single it out? He's shamelessly playing to the crowd with that comment and it is worthy of derision. How can a candidate who plugs his "faith" so shamelessly be so callous to the medical needs of those he can't seem to wait to put in harm's way? Rafael Eduardo looks forward to the creation of many thousands of brand new war veterans.

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    To be fair.....have you done an article critical of Michelle Obama's interference with the nation's school lunch program?

    Maybe I just missed it.

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    Please tell us what part is inaccurate? Ted Cruz said MRE's, and that is what this article said...

    This article, like the whole blown up issue, is absurd. Cruz was commenting on what a commander should be worried about and what they should not be worried about - and they most certainly should NOT be worried about what those under their command are eating. They have much larger issues to be in control of. But since many in the gluten-free community have chosen to twist his comments to mean that he feels those with celiac should not be in the military, let's talk about that.

    Brain fog, extreme fatigue, joint pain, diarrhea, vomiting...these are just a few of the symptoms that might occur if someone with celiac disease accidentally consumes gluten. In a combat situation, there is NO way to guarantee without a shadow of a doubt that accidental gluten consumption might not occur. So there will always be the possibility of gluten. No way should someone who may experience any of the above symptoms be trusted with weapon, trusted to care for others under high stress conditions, trusted with the safety of the sons and daughters of our country and other countries, or be trusted to make sound judgement calls under already strained conditions - namely combat! I can't believe anyone with any experience with celiac disease would see anything wrong with keeping those with celiac disease out of these situations. The way some (you included) have spun this is EXACTLY what Cruz was referencing. Our country has become one of complete political correctness - even at the expense of common sense. What's next?? Insisting that accommodations be made so that quadriplegics can man the front lines? This country needs to quit making every issue personal and turning everything into how it's wronged so and so.

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    DID HE WAGE WAR???? REALLY?

    This problem has been a long standing one with the military LONG before Ted Cruz. You are apparently ill informed.

    Clearly you just wanted to make your political statement and get people enraged. You did exactly as you intended.

    I agree, Linda!

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    I was married to a Marine who fought in Viet Nam. It would've been impossible in a combat setting to provide for any dietary special need. I don't think anyone with a life threatening or possibly debilitating disease should be allowed in combat settings. It wouldn't be safe for them or even possibly their unit. That's not to say someone with Celiac shouldn't be allowed to serve - they should be, but in a more controlled setting where their special dietary needs can be taken care of on a regular basis.

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    I don't really wish to impugn the motives for authoring this piece. However it is my understanding that the military service policy in this nation is that people with Celiac Sprue if identified as such prior to applying for military duty, can be rejected for same based on this condition. That is my understanding. Now in the real world, I am sure people get into the military who do have Celiac Sprue. The question is salient as to what to do then, plus a lot of other questions along with that. Let's look at history in this regard: A young man who obviously had Celiac, John F. Kennedy, got into the military. Now of course he had to pull strings because his official diagnosis was Addison's Disease, although that was bogus. But because he pulled strings, he got into the Navy and became a war hero in World War II. The rest is history as they say. So there are a bunch more issues here than meets the eye based on this article is my point.

    Jeff, that is my understanding as well. And when you think about it, someone suffering with GI issues, vomiting and fatigue while serving on the battlefield is EXTREMELY ill advised! Hell, it is hard enough leaving my own home for extended periods of time, not to mention heading to the Middle East for months at a time!!

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    Guest Ski Mom

    Posted

    Actually it is Cruz who is ill informed and made a political statement that was intended to get people enraged, we are just reporting it.

    admin: you are right. Is he ready to stop pampering guys with insulin shots?

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    This article, like the whole blown up issue, is absurd. Cruz was commenting on what a commander should be worried about and what they should not be worried about - and they most certainly should NOT be worried about what those under their command are eating. They have much larger issues to be in control of. But since many in the gluten-free community have chosen to twist his comments to mean that he feels those with celiac should not be in the military, let's talk about that.

    Brain fog, extreme fatigue, joint pain, diarrhea, vomiting...these are just a few of the symptoms that might occur if someone with celiac disease accidentally consumes gluten. In a combat situation, there is NO way to guarantee without a shadow of a doubt that accidental gluten consumption might not occur. So there will always be the possibility of gluten. No way should someone who may experience any of the above symptoms be trusted with weapon, trusted to care for others under high stress conditions, trusted with the safety of the sons and daughters of our country and other countries, or be trusted to make sound judgement calls under already strained conditions - namely combat! I can't believe anyone with any experience with celiac disease would see anything wrong with keeping those with celiac disease out of these situations. The way some (you included) have spun this is EXACTLY what Cruz was referencing. Our country has become one of complete political correctness - even at the expense of common sense. What's next?? Insisting that accommodations be made so that quadriplegics can man the front lines? This country needs to quit making every issue personal and turning everything into how it's wronged so and so.

    So you do realize that our Jewish and Muslim combat troops can get Kosher and Halal MRE's, right? (https://www.troopsupport.dla.mil/subs/rations/programs/rel/relabt.asp) Apparently some past Commander in Chief or Congress has believed that religious dietary issues are important enough to accommodate US service men and women in combat, so why not accommodate those who need a special diet for medical reasons?

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    To be fair.....have you done an article critical of Michelle Obama's interference with the nation's school lunch program?

    Maybe I just missed it.

    When she advocated for healthier school lunches? That topic doesn't relate directly to celiac disease or a gluten-free diet, but if the First Lady did address a gluten-free diet in any way it would certainly be news here.

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    Guest Jefferson

    Posted

    The US military currently provides kosher meals to Jewish troops. What if Ted Cruz said that US generals shouldn't have to worry about providing kosher meals to our Jewish troops? Would that be news? Would that be considered acceptable public policy?

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    Guest Jefferson

    Posted

    I don't really wish to impugn the motives for authoring this piece. However it is my understanding that the military service policy in this nation is that people with Celiac Sprue if identified as such prior to applying for military duty, can be rejected for same based on this condition. That is my understanding. Now in the real world, I am sure people get into the military who do have Celiac Sprue. The question is salient as to what to do then, plus a lot of other questions along with that. Let's look at history in this regard: A young man who obviously had Celiac, John F. Kennedy, got into the military. Now of course he had to pull strings because his official diagnosis was Addison's Disease, although that was bogus. But because he pulled strings, he got into the Navy and became a war hero in World War II. The rest is history as they say. So there are a bunch more issues here than meets the eye based on this article is my point.

    People with known, diagnosed celiac disease are not admitted into the military. However, we have many servicemen and women who are diagnosed after they begin their service. My understanding is that, once discovered, celiac troops are moved to positions where their medical meal needs can be accommodated, i.e., non-combat positions. Still Cruz's comments are legitimate targets for questions or criticism, at least from the standpoint of a celiac disease and gluten-free information site, such as celiac.com.

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    Wow. Just wow. I read this article for medically relevant information to help my daughter. Seeing political bashing is disgusting and a shame that you would ABUSE your access to this platform. Shame on you Celic.com for publishing such trash. This "quote" could have been relayed in an objective manner. Your personal opinions of political candidates needs to STAY OUT of this forum!! What a shame!

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    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