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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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    TIPS FOR ENSURING A GLUTEN-FREE HOSPITAL STAY


    Jefferson Adams

    Celiac.com 03/05/2009 - Nurse Cynthia Kupper, RD, celiac disease, and the good folks over at Gluten Intolerance Group (GIG) recently circulated a helpful checklist to help you and your loved ones ensure a successful gluten-free hospital visit. Here's a summary of their recommendations:

    1. Be sure to make a copy of this checklist, distribute it to your family members, and keep it with you during your hospital visit.
    2. Keep this checklist with your chart of current medications, along with the names and addresses of each of your health care providers.
    3. Present a copy of this checklist to the managing nurse of the ward where you will be staying. It's also a good idea to make sure a copy goes to the pre-admission staff to ensure the information is placed at the front of your chart or documented in your computerized medical record. Be sure to ask that it be made easily visible to anyone inspecting your chart.
    4. Arrange for a written note from a doctor mandating a gluten-free diet. Be sure that the note clearly labels your condition as an allergy, so that there is no confusion among the staff about your dietary needs. If your visit requires you to be admitted, then, prior to your admission, arrange to meet with a representative from the departments that will be involved in your stay, such as pre-op, surgery, medical/surgery, pharmacy, nutrition services-dietitian, rehabilitation, etc.
    5. Ask for a allergy alert wristband, and consider requesting that the following words be printed in BOLDFACE on your chart, near your bed, or on the outside of your door: Celiac Disease: All foods and medications must be verified gluten-free!
    6. See if you can bring food and medicines you know to be gluten-free. If permitted, clearly label all food and medicine containers with your full name, date and room number.
    7. If your visit is unplanned, then arrange to speak with the hospital's Registered Dietitian as soon as you can. If you're unable, then make sure your family or care-giver knows in advance to make this arrangement. Since some dietary staff members may be unfamiliar with the intricacies of the gluten-free diet (Diet Technicians, Nutrition Assistants, Meal Assistants, etc.), it's good practice to speak directly with the Dietitian.
    8. Work with the Dietitian. Find out how the hospital chooses its gluten-free foods, and how those foods are processed in the kitchen. Find out who is in charge of for approving the hospital's gluten-free offerings.
    9. Bring some non-perishable gluten-free back-up snacks as rules permit. Gluten-free favorites like cookies, crackers, condiments, and cereal are easy to store. Label all food with your full name and room number.
    10. For a scheduled visits, see if you can get the dietary department to order some special gluten-free pasta, muffin mix, cake mix, or bread to make during your stay. Ask if you can supply your own. If a dietary staff offer to make shop for you, remind them not to select food from bulk bins.
    Source: Gluten Intolerance Group
    Cynthia Kupper, RD, celiac disease


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    Destiny Stone
    Memorial Day is fast approaching. Once known as, "Decoration Day", Memorial Day commemorates the men and women who have died while serving their Country during military service. Not only is Memorial Day a day of remembrance, it is also a day to spend quality time with your family and loved ones. Most Memorial Day activities center around a picnic, BBQ, or sporting events, so get ready to have a gluten-free Memorial Day!
    If you are gluten sensitive, you will want to make sure your are included in the festivities by preparing gluten-free foods you can eat and share with others. Many of your favorite picnic and BBQ foods are naturally gluten-free, but the condiments and preparation of the dish is what can render your meal inedible. Remember to use gluten-free sauces for your marinades, and avoid using condiments that have been dipped into by gluten laden utensils, as cross contaminates are readily found in jars of mayonnaise and mustard. Keep yourself safe this year and make sure to have your own condiments when going to a group event. Many gluten sensitive people use squeeze tops for their condiments to avoid the proverbial "gluten contaminated knife in the condiments" routine. Included are some Memorial Day tips and recipes, but with a gluten-free twist.

    Gluten-Free Condiments and Marinades Hot Dogs are generally not gluten-free. The fillers they pump into hot dogs usually contain gluten or a sub-ingredient of gluten, such as caramel color, artificial colors or flavors, and even some spices. If you are a hot dog lover, don't despair, there are gluten-free hot dogs on the market. The link below is for all natural gluten-free buffalo hot dogs-check it out!
    Gluten-Free Hot Dogs Don't forget the buns! Being gluten-free doesn't mean you can't enjoy a bun like everyone else-just make sure your buns are gluten-free. You may want to abstain from grilling your buns on the BBQ if there are gluten products on the grill. Try toasting your buns in a clean toaster oven, or putting your buns on a piece of aluminum foil to avoid contamination. There are even some gluten-free buns on the market that are good enough to eat without toasting. The link below is a good place to start looking for gluten-free buns.
    Gluten-Free  Buns Shish kabobs are an all-time favorite at any Memorial Day event. Shish kabobs are easy to make and gluten-free; just make sure to use gluten-free soy sauce and marinades for your kabobs. Here are some ideas for home made, low-fat, gluten-free Shish kabobs.
    Gluten-Free Citrus Tarragon Chicken Kabobs
    1 lemon, zested, then juiced, remainder discarded 1 orange zested, then Juiced, remainder discarded 1 lime, zested, then juiced, remainder discarded 4 cloves fresh garlic, minced  1 tablespoon fresh tarragon leaves 1/4 cup gluten-free soy sauce 1/4 cup olive oil 1/2 teaspoon salt 1/2 teaspoon freshly ground black pepper 1 pound boneless, skinless gluten-free chicken breasts, cut into 1-inch cubes (use free-range, organic chicken without fillers if possible).
    Gluten-Free Veggie Kabobs
    Bell peppers Onions Cherry tomatoes Mushrooms Italian squash Zuchinni Sweet potato chunks Tofu
    All of the above veggie kabob ideas are optional. Use foods that you like to grill. Make sure your veggies are chunked big enough to hold up well on kabob skewer.

    Gluten-Free Balsamic Vinaigrette (for veggie marinade)
    1/4 cup olive oil 2 tablespoons balsamic vinegar salt and pepper to taste
    To Make Kabobs:
    Thoroughly mix together all of the citrus-tarragon chicken ingredients (except the chicken) in a bowl. Toss the chicken in the mixture until evenly coated. Cover and marinate in refrigerator for 2 hours. Cut vegetables into bite-size pieces. Puree balsamic basting vinaigrette ingredients in a blender for 30 seconds. Grill kabobs directly over heat source for about 10 to 15 minutes, turning 1/4 rotation every 2 to 3 minutes, or until it's cooked throughout. Gluten-Free Salads and Side Dishes:
    Salads are always a welcome gluten-free side dish, capable of complimenting any meal. To make your Memorial Day BBQ complete, here are some ideas for gluten-free side dishes. These side-dishes are gluten-free, easy and sure to be crowd pleasers-even for the gluten eating folks.
    Old Fashioned Hot German Potato Salad (Gluten-Free)
    Gluten-Free Fruit Salad Recipe
    Don't forget the gluten-free chips and snacks!
    Gluten-Free Chips Gluten-Free Snacks
    Being gluten-free doesn't  mean you can't enjoy a cold beer on Memorial day like everyone else. There are many beer companies that now make gluten-free options. There are quite a few really amazing gluten-free beers on the market, so you shouldn't have to settle for a gluten-free beer you don't like, though you may have to sample many gluten-free beers before you find one that suits your tastes. However, finding a market that carries your favorite gluten-free beer is another issue all together. You may want to discuss options with your favorite grocery store. Many stores will offer to carry products for you if they know you will buy them regularly. The following list of beers are some of the top sellers and can be found at many specialty stores, grocery stores, and liquor stores.Gluten-Free Beers:

    Greens Gluten-Free Beer Redbridge Gluten-Free Beer New Grist Gluten-Free Beer Gluten-Free desserts are certainly not sparse. Although, finding gluten-free, sugar-free, egg-free, dairy/casein-free, corn-free desserts are a bit trickier. Pecan pie is an all American favorite, and no Memorial Day should be without pecan pie. The following pecan pie recipe is raw, and requires no cooking, and contains almost none of the usual food allergens-unless of course you are allergic to pecans.
    Gluten-Free, Dairy/Casein-Free, Egg-Free, Corn-Free, Sugar-Free Pecan Pie
    Ingredients:
    2 cups raw almonds, soaked and drained 35 pitted dates, soaked for 1 hour and drained 1 tablespoon fresh squeezed lime juice 1/2 teaspoon ground cinnamon 1/2 teaspoon vanilla extract 2 cups raw pecans, soaked and drained pinch salt Olive oil, to grease your pan To Make:
    Note: If you are not familiar with the process of soaking nuts, please review the following information before attempting this recipe.
    Soaking Nuts and Seeds After soaking and drying the pecans complete the recipe as follows:
    Combine the almonds and 10 of the dates in a food processor, and process until they are coarsely ground and clumping together. Grease the bottom of a 9-inch square brownie pan or a pie plate with a little cold-pressed olive oil to keep the pie from sticking to the plate. Press the almond-and-date mixture evenly into the bottom of brownie pan and up the sides to form a crust. Set aside. Combine the remaining dates, the fresh lime juice, cinnamon, salt, and vanilla in a blender or small food processor, and process until the mixture has a smooth, uniform consistency. Spread the date filling evenly over the crust. Arrange the raw pecans on top of the date mixture and press lightly. Cut the pie into 2-inch squares and serve.
    Gluten-Free  Quick Check:
    Use a clean BBQ grill or use aluminum foil Use gluten-free condiments Make sure your meat is gluten-free Avoid cross contamination Prepare enough gluten-free food to share
    Happy Memorial Day!

    Jefferson Adams
    02/01/2011 - Imagine having a dog that was specially-trained to sniff out even the tiniest amounts of gluten in food and warn you ahead of time. There are scores of people with celiac disease severe enough that the slightest trace of gluten can make them painfully ill. Hollie Scott is one of them. Scott is a University of Missouri College of Veterinary Medicine student is also lucky to have her dog Elias is a champion Beauceron and a gluten-detecter extraordinaire. The handsome Beauceron comes from a 400-year-old breed that became almost extinct serving as messenger dogs in Europe during two world wars. Even though he is just only 2 years old, Elias is the first male Beauceron to receive the title AKC Grand Champion. His full title is: GCH CH Elias Mes Yeux Vigilants RN. But Elias' regular job is working as a gluten-detection service dog for his twenty-two year old owner, Scott, a first-year student in the program.
    To become so accomplished at gluten-detection, Elias spent weeks in Slovenia undergoing intense gluten-detection training, and now he can detect and warn her away from anything containing gluten, hot or cold, in all its many forms. Teaching a dog to be alert to the scent of gluten is more challenging than other scent-detection training, precisely because gluten comes in so many forms. When it's time for Elias to do the sniff test for Scott, she places a cover with holes over the item, and the dog takes a sniff. If Elias smells gluten, he tries to pull the item away from her; if it's safe, he just looks away. To help Elias keep his edge, Scott tests him daily with known gluten-containing foods, and adds in products she hopes are gluten-free.
    Scott was diagnosed with celiac disease about two years ago after spending much time "in and out of hospitals" She's now acutely vigilant about checking labels and trying to avoid cross-contamination. "You can't drop your guard for even a minute," says Scott, who likens an attack to "a really extremely bad case of stomach flu" from which her body doesn't recover fully for nearly three weeks. That's where Elias works like a charm.


    Jefferson Adams
    Celiac.com 12/16/2013 - Numerous popular herbal products may be contaminated or may contain unlabeled substitute ingredients and fillers, meaning that they are not what their labels claim. According to the World Health Organization, adulterated herbal products are a potential threat to consumer safety.
    These revelations came to light after a group of Canadian researchers conducted an investigation into herbal product integrity and authenticity, with hopes of protecting consumers from health risks associated with product substitution and contamination.
    Using a test called DNA barcoding, a kind of genetic fingerprinting that been effective in uncovering labeling fraud in other commercial industries, the researchers found that nearly 60% of herbal products tested were not what their label claimed them to be, and that pills labeled as popular herbs were often diluted or replaced entirely, sometimes with cheap fillers that could be dangerous to consumers.
    In all, the researchers tested 44 herbal products from 12 companies, along with 30 different species of herbs, and 50 leaf samples collected from 42 herbal species.
    The researchers were Steven G. Newmaster, Meghan Grguric, Dhivya Shanmughanandhan, Sathishkumar Ramalingam and Subramanyam Ragupathy. They are variously affiliated with the Centre for Biodiversity Genomics, Biodiversity Institute of Ontario (BIO) at the University of Guelph, the Bachelor of Arts and Science Program at the University of Guelph in Guelph, Ontario, Canada, and with the Plant Genetic Engineering Laboratory, Department of Biotechnology, Bharathiar University in Tamil Nadu, India.
    Their laboratory also assembled the first standard reference material (SRM) herbal barcode library from 100 herbal species of known provenance that were used to identify the unknown herbal products and leaf samples.
    The team recovered DNA barcodes from most herbal products (91%) and all leaf samples (100%), with 95% species resolution using a tiered approach (rbcL + ITS2).
    Nearly 60% of the products tested contained DNA barcodes from plant species not listed on the labels. That means they were not what the label said they were.
    Furthermore, even though 48% of the products contained authentic ingredients, one-third of those also contained contaminants and/or fillers not listed on the label.
    The air data showed clearly that most herbal products tested were not what their labels claim, while most of the rest were poor quality, and often contained unlabeled, possibly dangerous, product substitute, contamination and fillers.
    They note that selling weak, ineffective, or mislabeled herbal supplements reduces the perceived value of otherwise helpful products by eroding consumer confidence.
    The study team recommends that the herbal industry embrace DNA barcoding to ensure authentic herbal products by effectively documenting raw manufacturing materials.
    They suggest that the use of an SRM DNA herbal barcode library for testing bulk materials could provide a method for 'best practices' in the manufacturing of herbal products, and note that this would provide consumers with safe, high quality herbal products.
    What do you think? Should herbal products and supplements be tested, authenticated and verified? Share your thoughts below.
    Source:
    BMC Medicine 2013, 11:222. doi:10.1186/1741-7015-11-222

    Jefferson Adams
    Celiac.com 12/11/2014 - A pampered a Jack Russell terrier is being hailed as Britain’s oldest dog after reaching the ripe old age of 25 years, and gluten-free fish fingers are among the foods that keep her happy and healthy.
    The dog, called Meg, eats whatever she likes theses days, says owner David Abrahams, of Stoke St Michael, Somerset, and that includes roast dinners, gluten-free fish fingers and Peppa Pig-shaped spaghetti in tomato sauce.
    Of course, the pasta includes gluten, so Meg’s diet is not gluten-free, but Abrahams says, the “fish fingers and the Peppa Pig pasta have helped her along the way.”
    Read the whole story at The Daily Mail.
    Does your dog get gluten-free food or treats as part of its diet? How about your cat? Share your gluten-free pet stories below.

  • Recent Articles

    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

    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

    Jefferson Adams
    Celiac.com 04/16/2018 - A team of researchers recently set out to investigate whether alterations in the developing intestinal microbiota and immune markers precede celiac disease onset in infants with family risk for the disease.
    The research team included Marta Olivares, Alan W. Walker, Amalia Capilla, Alfonso Benítez-Páez, Francesc Palau, Julian Parkhill, Gemma Castillejo, and Yolanda Sanz. They are variously affiliated with the Microbial Ecology, Nutrition and Health Research Unit, Institute of Agrochemistry and Food Technology, National Research Council (IATA-CSIC), C/Catedrático Agustín Escardin, Paterna, Valencia, Spain; the Gut Health Group, The Rowett Institute, University of Aberdeen, Aberdeen, UK; the Genetics and Molecular Medicine Unit, Institute of Biomedicine of Valencia, National Research Council (IBV-CSIC), Valencia, Spain; the Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire UK; the Hospital Universitari de Sant Joan de Reus, IISPV, URV, Tarragona, Spain; the Center for regenerative medicine, Boston university school of medicine, Boston, USA; and the Institut de Recerca Sant Joan de Déu and CIBERER, Hospital Sant Joan de Déu, Barcelona, Spain
    The team conducted a nested case-control study out as part of a larger prospective cohort study, which included healthy full-term newborns (> 200) with at least one first relative with biopsy-verified celiac disease. The present study includes 10 cases of celiac disease, along with 10 best-matched controls who did not develop the disease after 5-year follow-up.
    The team profiled fecal microbiota, as assessed by high-throughput 16S rRNA gene amplicon sequencing, along with immune parameters, at 4 and 6 months of age and related to celiac disease onset. The microbiota of infants who remained healthy showed an increase in bacterial diversity over time, especially by increases in microbiota from the Firmicutes families, those who with no increase in bacterial diversity developed celiac disease.
    Infants who subsequently developed celiac disease showed a significant reduction in sIgA levels over time, while those who remained healthy showed increases in TNF-α correlated to Bifidobacterium spp.
    Healthy children in the control group showed a greater relative abundance of Bifidobacterium longum, while children who developed celiac disease showed increased levels of Bifidobacterium breve and Enterococcus spp.
    The data from this study suggest that early changes in gut microbiota in infants with celiac disease risk could influence immune development, and thus increase risk levels for celiac disease. The team is calling for larger studies to confirm their hypothesis.
    Source:
    Microbiome. 2018; 6: 36. Published online 2018 Feb 20. doi: 10.1186/s40168-018-0415-6