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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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    YOUR PARTNER FEELS YOUR GLUTEN-FREE CELIAC PAIN


    Jefferson Adams

    Celiac.com 07/06/2016 - Is celiac disease a burden on your relationship? Many partners of celiacs say yes. Between thirty and forty-percent of people with celiac disease said that their condition was a burden on their relationship, according to a study presented at Digestive Disease Week 2016.


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    In his presentation at Digestive Disease Week 2016, Dr. Abhik Roy, gastroenterologist at New York-Presbyterian University Hospital of Columbia and Cornell, said that his team's recent study "...shows that partner burden is quite common in celiac disease with more than one-third of partners experiencing at least mild to moderate burden."

    Partner burden had been previously reported in cases of irritable bowel syndrome and cancer, but had not been assessed in celiac disease, the researchers wrote.

    To best measure the level of relationship burden in partners and patients with celiac disease, Roy and his colleagues at Columbia University Medical Center surveyed 94 patients, averaging 52.4 years of age, with biopsy-confirmed celiac disease. They also surveyed the partner of each patient. The patients had been with their current partner about 25 years. Patients were 98% white, 93% were college-educated, 85% married, and 65% had had celiac disease for more than 5 years.

    Patients completed the Celiac Symptom Index (CSI) survey, to measure the extent of celiac disease, while their partners competed the Relationship Satisfaction (RS) scale, a measure of relationship quality.

    Partners completed the Zarit Burden Interview (ZBI), which measures the level of partner burden, and answered questions about overall "sexual satisfaction."

    Afterward, the researchers used the data from both portions of the study to assess the relationship between celiac disease and partner burden. When CSI scores were tallied, sixteen percent of celiac patients reported poor quality of life, with 37% reporting a ZBI score that indicated at least mild or moderate burden from celiac disease. At the same time, twenty-three percent of the partners reported an RS score associated with moderate-to-low relationship satisfaction, while 14% reported moderate-to-low sexual satisfaction.

    Overall, the researchers found that ZBI score was associated with CSI score (P = .008) and that ZBI score was inversely associated with RS score (P < .001) as well as sexual satisfaction (P < .001). Basically, the lower the burden, the higher the basic relationship and sexual satisfaction, and vice versa.

    Interestingly, partner's RS score (OR = 17.06; 95% CI, 2.88-101.09) and relationships over 10 years (OR = 14.42; 95% CI, 1.69-123.84) were both significantly associated with mild to moderate patient burden.

    So, for those who do report being dissatisfied, the longer you're together, the more of an issue it seems to become. Also, half of partners report sometimes experiencing "feeling they should be doing more for the patient" and 44% reported that they sometimes experienced "feeling they could have done a better job for the patient." That shows a level of burden, but also a concern by partners for their loved one.

    This study showed similar levels of dissatisfaction to those reported by IBS and cancer patients, the researchers noted. The research implies that patients might be helped by having health care providers address these relationship factors in their care of patients with celiac disease, and the team suggested as much.

    One the upside, you could also say that the great majority of celiac patients and partners seem satisfied, and do no feel any burden from celiac disease. I wonder what the baseline scores for these tests are for non-celiac couples?

    Read more at Healio.com.


    Image Caption: Many partners of celiac patients report feeling burdened. Photo: CC--Brandon Grasley
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  • Related Articles

    Joanne Bradley
    Celiac.com 06/13/2008 - Students embarking on the college path often ride a roller coaster between sheer unadulterated excitement and deep-in-the-stomach dread of meeting new people and challenges. For the gluten free college student, a whole world of eating choices will await them in all sorts of different social situations. It is a new cornucopia of responsible choice.
    Perhaps the first challenge will be establishing a relationship with the people who manage the food services on campus. Although public understanding of Celiac disease and gluten intolerance are on the fast track, the level of training for gluten free food service is still on the slow track. A thorough understanding on the part of food management usually comes through one or more managers having a relative with the condition. Liability issues still concern corporate management of food service. Until the term gluten-free is clearly defined through FDA labeling laws, many companies are hesitant to establish true gluten free programs.
    After 30 years in food service, I can personally attest that most people in the food service profession want to provide good and healthy service to their customers. Many managers work much more than the typical 40 hour work week in just that endeavor. Making customers happy is an integral part of being in the hospitality industry. However, the biggest problem presented by the gluten free dilemma is the widespread contamination of wheat in products where it naturally should not be. The processed food additives in most commercial mixes and flavorings are a huge roadblock to immediate implementation of gluten free programs. Manufacturers are getting the message that customers want gluten free products and will provide them for commercial clients in time.
    Working with food service on cross contamination issues should be a pleasant experience. However, it will be a continual learning process for both food service management and the gluten free student. Campus food service is one of the primary employers for students on, or near, college campuses. Flexible hours and close location form a workforce that is beneficial for both students and employer. The temporary nature of food service staff may result in a different person on a food station much more often than would happen in a restaurant. The server may just be starting their full round of training and may not be knowledgeable in gluten free food handling.
    The gluten free student will have to be vigilant about cross contamination and talk frequently with the food service management. They will also need to have patience in working with service and cooking staff so that all may learn and benefit. The term “gluten free ambassador” is descriptive of being on the front line of changing how food is prepared and served for all gluten free students on college campuses. Just remember, college food service wants you as a customer. They will try to meet your needs and will learn along with you.
    Another opportunity for education and learning interpersonal skills will be with your roommate. I have never seen a spacious dorm room. The high value of real estate on most college campuses extends to the dorm rooms as well. There will not be a lot of room for foods or duplicate cooking appliances for cross contamination purposes. You should plan to discuss your needs well in advance with the University Department responsible for housing.
    The new college student will be presented with daily opportunities to go off the gluten free diet. However, the biggest temptation will be the variety of foods available to you in the college cafeteria. Seeing gluten-laden foods for the first time (for some students) can be a powerful draw to experiment and experience. It would be wise to create an action plan to prevent lapses into the gluten-filled world. Knowing that you have gluten free foods available in your dorm room or apartment to curb a snack attack is essential. You must be firm in your mind that your food choices are the same as any other person – you just actively choose the gluten free items.
    The college experience is a time of tremendous personal growth. It is also a time of great learning and life long friendships that shouldn’t be sidetracked by illness. Gluten free students will continually test and create new facets of a lifestyle that is only beginning to be felt on most campuses. Plan ahead and carry patience in your back pocket.

    Jefferson Adams
    Celiac.com 09/15/2010 - Until the present study, no clinical research had been published regarding the relative effects of clinical and psychosocial variables on outcome in celiac disease.
    A team of researchers examined psychosocial factors that may influence disease activity in celiac patients, such as relationships among demographics, psychosocial factors, and disease activity with health-related quality of life (HRQOL), health care utilization, and symptoms.
    The research team included Spencer D. Dorn, Lincoln Hernandez, Maria T. Minaya, Carolyn B. Morris, Yuming Hu, Suzanne Lewis, Jane Leserman, Shrikant I. Bangdiwala, Peter H. R. Green and Douglas A. Drossman of the Center for Functional GI and Motility Disorders at the University of North Carolina, Chapel Hill, USA.
    The team enrolled 101 adult patients with celiac disease with the goal of charting any relationships among demographics, psychosocial factors, and disease activity with health-related quality of life (HRQOL), health care utilization, and symptoms. All patients were newly referred to a tertiary care center with biopsy-proven celiac disease.
    The team examined: (a) demographic factors and diet status; ( disease measures (Marsh score, tissue transglutaminase antibody (tTG) level, weight change and additional blood studies); and © Psychosocial status (psychological distress, life stress, abuse history, and coping). They then conducted multivariate analyses to predict HRQOL, daily function, self-reported health, number of physician visits, and GI symptoms, such as pain and diarrhea.
    They found that patients with psychological distress and poor coping skills suffered from impaired HRQOL and daily function.
    Patients who reported poorer health generally showed poorer coping, longer symptom duration, lower education, and greater weight loss. Patients with poorer coping, abnormal tTG levels, and milder Marsh classification generally had more physician visits.
    Patients with higher psychological distress and greater weight loss also showed higher pain scores. Patients with greater psychological distress and poorer coping also showed higher rates of diarrhea.
    Their results show that among patients at celiac disease referral centers, psychosocial factors have a greater impact on health status and GI symptoms than does disease activity. Such factors should be considered as part of the patient's treatment and prognosis.
    Source:

    Dig Dis Sci. 2010 Jul 30. DOI: 10.1007/s10620-010-1342-y

    Emma Haan
    I am 15 years old and was diagnosed with celiac disease almost two years ago.  After many years of stomach pains and rheumatoid arthritis I was relieved to finally have an answer.  Even today I still remember the shock that comes with the realization that you will never have another bite of "normal" food again.  After coping with the different emotional struggles that accompany a life changing diagnosis, I still had some difficulties. Most of these had to do with my friends.  Over time I have learned how to handle the awkward social encounters pertaining to my celiac disease.  
    Here are some of the most common:
    Refusal:  I had some friends that flat out refused to eat in front of me, in order to not make me "feel bad.". Although I am flattered that they would sacrifice something for me, this reaction made me feel uncomfortable.  I feel the best way to handle this situation is to be prepared if possible.  If you know that for example, your class is having a party, bring some gluten free cookies.  This will help you avoid an awkward conversation as well as make you feel more comfortable and less alone. Insensitive jokes:  I also found that some of my friends make rude comments about my incapability to eat their food. I urge you to remember that this is a reaction due to a combination of ignorance and not knowing what to say.  I usually use humor or sarcasm to lighten the situation.  If someone continues to be rude after talking to them, it gives me a hint that I probably shouldn't be friends with them.  A true friends will except with or with out celiac disease.  Embarrassment:  When I was first diagnosed with celiac disease I was afraid to tell my friends and eat in front of them.  I was really nervous about bringing my "different" food to school. My mom ended up taking me on a one on one shopping trip to find the best tasting gluten free food we could find (It was really fun.) When I faced my insecurity and ate at school, I was shocked to find that my friends loved the food. I think that because I felt so confident about the food my mom bought me, my friends were more interested in trying it.  Also, just remember your friends care about you and want to help you. Carelessness:  One of the largest problems I have experienced is a friend exposingme to gluten by accident.  For example, a friend drinking out of my water bottle, or sticking their "glutenized" hand in my pretzel bag.  Usually I see them and resolve the situation, but it is still important to talk to your friends about accidentally exposing you to gluten.  Most friends are very understanding, but everyone is human and therefore makes mistakes. Baking:  Soon after I was diagnosed with celiac disease, a boy asked me to the school dance by giving me a homemade gluten free pretzel.  It was really sweet and I felt really bad that I couldn't eat it. Because he was not aware of cross contamination, I could not be sure he took the proper baking precautions.  I someone bakes you gluten free food, politely except it but explain to them that you can't eat it.  Cross contamination is not something to mess around with, and must be taken seriously.  Friends will understand. Disbelief:  Because of my celiac disease and arthritis I missed a lot of school this past year.  I had some friends the refused to believe my reaction to gluten was actually bad.  I found this problem sorted itself out over time.  As a beginner I sometimes messed up my diet, and got violently sick in front of my friends. Eventually all of my peers believed me, I just needed to be patient and understanding with them. Although living with celiac disease is hard, I find that it is a part of my identity that I have learned to like.  After going through embarrassing situations, my confidence has increased and my friendships have strengthened.  When dealing with your friends remember to be patient and know that everyone makes mistakes.  As a teenager these situations can be embarrassing, so remember that you are special and your illness is not something to be ashamed of.  I can honestly say that I am proud to be gluten free!

    Jefferson Adams
    Celiac.com 10/28/2015 - A team of researchers recently set out to review the medical literature for psychological morbidity associated with celiac disease.
    The team included F. Zingone, G.L. Swift, T.R. Card, D.S. Sanders, J.F. Ludvigsson, and J.C. Bai. They are variously associated with the University of Salerno, Department of Medicine and Surgery in Salerno, Italy, the Department of Gastroenterology at University Hospital Llandough in Cardiff, Wales, UK, the Division of Epidemiology and Public Health at The University of Nottingham in Nottingham City Hospital, Nottingham, UK, the Department of Gastroenterology, Royal Hallamshire Hospital & the University of Sheffield, UK, the Department of Pediatrics at Örebro University Hospital in Örebro, Sweden, the Department of Medical Epidemiology and Biostatistics at Karolinska Institutet in Stockholm, Sweden, the Department of Medicine, "C. Bonorino Udaondo" Gastroenterology Hospital, Universidad del Salvador in Buenos Aires, Argentina.
    For their study, the team searched PubMed for all papers on psychological aspects of celiac disease, specifically quality of life, anxiety, depression and fatigue, published between 1900 and June, 2014.
    Their results showed that anxiety, depression and fatigue are common complaints in patients with untreated celiac disease and contribute significantly to lower quality of life. While aspects of these conditions may improve within a few months after starting a gluten-free diet, some patients continue to suffer from significant psychological morbidity.
    These psychological symptoms may have an impact on the quality of life and the dietary adherence for people with celiac disease.
    The team encourages health care professionals to keep in mind any associated psychological burdens when treating patients with celiac disease.
    Source:
     United European Gastroenterol J. 2015 Apr;3(2):136-45. doi: 10.1177/2050640614560786.

  • 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