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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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    G.I.F.T.S. - GLUTEN INTOLERANT FAMILIES TEAMWORK & SUPPORT IN PORTLAND, OR


    Wendy Cohan

    Celiac.com 02/09/2011 - A new group focused on supporting children with celiac disease and non-celiac gluten intolerance will hold its first meeting this month, on February 19th, in Portland, Oregon. G.I.F.T.S. - Gluten Intolerant Families Teamwork & Support (www.gifts-pdx.org) will meet every other month, on the third Saturday, from 2:00 to 4:00 p.m. in the home of group moderator Wendy Cohan, RN.


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    Meeting in a home environment will reduce costs for membership, but also offer the opportunity to hold cooking demonstrations, cupcake decorating contests, and a summer cook-out, all of which are planned for 2011. Each meeting will feature a speaker, with subjects alternating between short health discussions and more kid-friendly holiday themes and cooking and baking with children. Our first speaker will be Krista Anderson-Ross, ND, who will give a short talk on the important topic of "Nutritional Deficits in Children with Celiac Disease", and how best to address them.

    We'll follow that up in April with an Easter-themed party with our guest, small business owner of "Fairy Cakes". Our group website: www.gifts-pdx.org is full of information on celiac and gluten related topics, and it includes a bulletin board for sharing tips, recipes, ideas for school lunches and snacks and other parent peer-support ideas. Bring your child, bring your whole family, and help make this group whatever you want it to be.

    We have a small advisory committee of health professionals and parents of children with celiac disease, but you are welcome to bring your ideas to the table, literally. We plan to hold social gatherings and restaurant outings in addition to regular meetings. For more information, see the website, or email us: info@gifts-pdx.org.


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    Guest Nadine Grzeskowiak

    Posted

    Wendy, you are amazing! Such great work you do for the GI/celiac disease community. GIFTS is a gift to the Portland community! Thank you for being a trail blazer!

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    The History - By Pam King, University of Maryland Center for Celiac Research
    This article originally appeared in the Autumn 2003 edition of Celiac.coms Scott-Free Newsletter.
    Celiac.com 01/20/2004 - One of the primary missions of the Center for Celiac Research (CCR) at the University of Maryland is to increase the awareness of celiac disease, and we are constantly trying to do just that. We have been pitching the celiac story to all sorts of media venues for the past five years. There have been many, many phone calls—sometimes with success. For years, we wanted the big headline, but the media wasnt quite ready. This year everything changed. We had a BIG story to tell, and not even a snowstorm or blackout was going to stop us from making the headlines.
    Lets begin in February, 2003. A major press conference was planned for February 13th, to announce the publication of the Prevalence Study in the Archives of Internal Medicine. We spent seven months of detailed planning with the media, patients and parents, and when the day finally arrived, it was accompanied by a major snowstorm. The press conference did happen, but a number of the press was sidetracked to cover the snowstorm. This, however, did not prevent celiac disease from appearing on the front page of the Washington Post, as well as in numerous other big city newspapers. Since then news of the prevalence study has appeared on local television newscasts, and in the Wall Street Journal.
    Then after five years of telephone calls and preparation, the call came: The NBC Today Show was ready to cover celiac disease! Over the next several months, we worked with the producer to arrange meeting times and to suggest individuals who could make the segment as informative as possible. The Today Show producer and crew spent a full day filming and interviewing at the CCR. Four days, and four cities (Boston, Baltimore, Alexandria, and Washington, DC) later, all taping was finished and the editing began.
    Two weeks later, word came that the celiac segment would air on Friday, August 15th. The producer was careful to mention that the segment would air unless there was a major news story occurring on that day. We pondered what kind of story that might be, and as luck would have it, we received a call at 4 PM on August 14: "Have you seen the news, theres a black out in New York". Jokingly, we replied: "Cant you come up with something better than that?" Quickly typing on the internet to get into CNN we found that major story, which threatened to bump celiac disease off of the show.
    Behind the Scenes - by Andrea Levario, American Celiac Task Force
    It was a normal July Tuesday morning, sitting staring at a computer screen, sipping coffee—until I answered a call from Meredith Klein, a producer for NBCs Today Show. The call was a first in a series, thanks to all of the hard work by Pam King at the University of Marylands Center for Celiac Research. Knowing Dr. Fasano would address all of the medical details, Pam sought to ensure that the issue of food labels was also covered—thus, being the co-chair of the American Celiac Task Force I was being quizzed about labeling legislation, my sons diagnosis, and what time a crew could arrive to tape on Friday.
    Just before lunch on August 1st, the two-man crew, and Meredith, the producer, arrived. A brief walk through of our house was done to determine where, and how to film—then action! To put my son Pablo at ease the crew let him show off his electric train set. Next, it was back to the kitchen and the gluten-free M&M cookies. Pablo measured ingredients while I read off the recipe. Once finished my husband Dimitrios, the other celiac, moved into the kitchen to whip up some gluten-free pizza. The crew was drooling, honestly. It looked nice outside, so Meredith decided to ask Dimitrios a few questions. All done, we slip the crew some cookies for the road. They spent four hours at our home, and then went for a lunch break. It was then time for us to head to co-chair Allison Herwitts house for the next part of the taping.
    At 3:30 pm, the crew arrived at Allisons house in downtown Washington, D.C. and took some time to walk-through the house to determine its lighting. Tall ceilings, beautiful wall paintings, and a large antique chest mean extra setup time for the crew. "Can this door be moved, how about the chest?" The furniture is rearranged to fit the equipment. They promised to put everything back in place later.
    We sat briefly in the kitchen while the crew taped our strategy session. Next up was Allison and her husband Jim, who staged dinner preparations. While the grill heated up, Meredith had us sit for our interview. She was off-camera without a microphone. She asked us a question, and we were to repeat it as part of the answer. It seems simple enough, until you feel that you are asking her questions to make sure the answer is what we want on TV. In contrast to Shelley Case, who was required to answer "live" on camera, we had the opportunity to say, "I need to do that one again." An hour later, the asparagus and sausages were finished cooking, and dinner was served. The addition of wine and Chebe Bread made it a perfect gluten-free meal—and day.
    The Seven Day Roller Coaster Ride - by Shelley Case, Dietitian and Author
    I was thoroughly enjoying some rest and relaxation with my husband and two daughters at our cottage at the lake after a very hectic speaking schedule, and the completion of the third edition of my book and numerous family commitments. This peace and tranquility came to an immediate halt upon receiving a call Tuesday, August 12th at 10 AM from my publisher who said that a Meredith Klein from NBC in New York was trying to reach me. I returned her call and was informed that the NBC Today Show had filmed a segment with Dr. Fasano and representatives from the Celiac Task Force. NBC decided this five minute and 45 second taped segment needed to be followed by a live interview about the gluten-free diet, and were looking for someone with media experience who could discuss the diet in three minutes or less! She said Dr. Fasanos group recommended me and could I come to New York for the interview. After a pause of shock, I said yes. Silently thinking she would say this would take place in a few weeks or months, my mouth dropped when she said it was this Friday, August 15th. I told her I would need to discuss this with my husband, Blair. He was very supportive and said that I definitely needed to go to New York, and that we would somehow work out the logistics. I called Meredith back at noon and said yes. From then on life went into "warp speed"!
    Numerous calls and emails with Meredith about the interview and travel arrangements took place, as well as an emergency call to my hair stylist (every woman knows this is critical). Also, I felt Blair should join me on this exciting venture to New York City so we called Air Canada to see if he could get a flight using his air mile points on short notice. Amazingly he could but was only able to fly with me from Regina to Toronto and would have to go to Montreal and then to New York. I was to arrive in New York via Toronto at 2:30 PM and he would arrive at 4:30 PM. We decided to stay over Friday and Saturday at our expense to enjoy the sights of New York City and fly home Sunday evening. Again, he was not able to fly with me on the same flights, but at least we would be together in New York.
    Wednesday was a blur. More calls with Meredith, making childcare arrangements, washing clothes, packing, a haircut and so much more to do before we left on Thursday at 7:15 AM Andrea Levario called and told me that they had waited a long time for this story and were counting on me to do a good job. "No pressure here" I exclaimed. My husband had secretly called the local media about the NBC interview. The next thing I knew I was giving a radio and newspaper interview that afternoon about the trip and celiac disease. Word also got out on the internet, and I received many calls and emails from dietitians and the celiac community throughout North America wishing me good luck.
    Feeling tired and somewhat overwhelmed, I called some friends from our church asking them to pray for travel safety, peace of mind and clarity of thought during the interview, and that Blair and I would somehow be able to fly together all the way to New York and back.
    Rising early Thursday morning, we headed to the airport and were delighted to discover they found a seat for Blair on the flight from Toronto to New York! Feeling very grateful, we were on our way to the Big Apple. Upon arrival, I received two calls on my cell phone. One from Meredith making sure I arrived safely and with instructions to head to the NBC studio for the 4:30 PM dress rehearsal, and another from CBC (Canadian Broadcasting Company) requesting a radio interview on Friday after the Today Show.
    We arrived at our beautiful hotel on Central Park South, unpacked and were just about to leave the room when, shortly after 4:00 PM, the power went out. An announcement came on the emergency PA system that told us to remain calm and stay in our room. I told my husband that we should ignore the warning, walk down the 14 flights of stairs, and leave the hotel for NBC. Walking 10 blocks, through the packed streets of people streaming out of office and apartment buildings and traffic jams, we arrived at NBC where we met Meredith, the art directors and crewmembers. Light still came in through the windows of the studio, so we were able to organize all the foods into a display and discuss the format of the interview. Meredith told us to be back Friday morning at 8 a.m. for the 9:10 AM live interview with Katie Couric. They all thought that the power would be back on soon and told us not to worry.
    We headed back to the hotel, walked up the 14 flights of stairs to our room and changed into cooler clothing, as it was 95F and humid. Another miracle—our door locks had an emergency battery back up system and the card key locks worked, unlike many other hotels with only power key locks, which meant that guests in such hotels were unable to get into their rooms and had to sleep in the lobby—or in the street! As we only had a light salad lunch at noon, we went searching for food and drink, and soon discovered how big a challenge finding it would be. Other than a few bars selling their remaining cold beers, restaurants and shops were closed. We finally found a deli that was letting in a few people at a time to purchase items—cash only. Fortunately my wise husband carried cash in addition to plastic. Using flashlights and candles, we sought some safe foods—plain nuts, sunflower seeds, potato chips, dried cereal and bottled water. We crossed the street and sat on a rock in Central Park and enjoyed our "gourmet meal," and watched many bewildered people roaming the streets of New York. We tried phoning home to tell everyone we were fine but our cell phones did not work.
    At dusk we returned to the hotel and had to show our ID at the front door and again at the stairwell in order to get in. The hotels emergency preparation plan was in full swing and they issued each guest with a "glow stick" to get through the night. That little light was a precious gift in a very dark room with the pitch-black skyline out the window. The fear of not knowing what was going on around us, of whether or not we would soon have power, and whether I would be doing the biggest interview of my life the next morning created a lot of anxiety to say the least. My husband said we should plan for the best, set our travel alarm and go to sleep. He was soon in slumber land while I tossed and turned, mentally rehearsing the major points I needed to convey in less than three minutes! Still awake at 4:30 AM the lights and air conditioning suddenly came on. Totally exhausted from all the preparation over the last 3 days and no sleep Thursday night, I wondered how I could possibly think and speak clearly. Blair assured me that it would be fine and to get some sleep. Now was not the time to sleep! I jumped out of bed at 5:30 AM and into the shower and prepared to get myself together.
    We walked to NBC not knowing that Meredith had left a message on my cell phone (which was not working due to the blackout) saying there was a limo at the front door waiting for us. We arrived at the stage door and no one seemed to know what was happening with the guests. After some sweet-talking, the guard let us in and we saw the indoor studio was dark—not a good sign. We went outside and there was Katie and the rest of the Today Show hosts on the air and all they were covering was the blackout. I told Blair that I was glad that they decided not to do the celiac segment this morning because all the people on the east coast would not be able to watch it. After the show was done I had the opportunity to meet Katie and give her my gift from Canada. We got a picture together and she said she really hoped NBC would reschedule the interview because Meredith had worked so long and hard to produce the story.
    Returning to the hotel very disappointed and not knowing whether it would be rescheduled, we again went searching for food. After wandering around for 4 hours we finally found a restaurant that was open and seemed like a safe place to eat. The owner of the family restaurant of over 50 years told us she packed her freezer with ice and sealed the door before leaving the night before. We enjoyed our first real meal in NY other than the snack foods that we ate in Central Park the night before.
    During the day when cell phone coverage began working again, several radio stations and Canadian TV called wanting to know what was happening in New York. I did live interviews "on the street" giving first hand reports of the events, and also some information about celiac disease. I also received an anxious voice message from Pam King wondering if I made it to New York and what happened with the celiac segment.
    Later in the day we went back to the studio and found the art director who was able to check on his computer about Mondays show. Totally amazed, we learned NBC was rescheduling the celiac segment for Monday morning with Matt Lauer (All the other guests from Friday morning including the country band Brooks and Dunn were not rebooked). I immediately called Pam King with our good news. She was elated and relieved to know the celiac story was going ahead and posted the details to the Celiac List Serve. The next call was to Cynthia Kupper from GIG who posted the info on the Dietitian List Serve.
    Now that we knew it was a go for Monday morning, Blair and I finally had a chance to relax. Over the next 48 hours we managed to see four Broadway shows and enjoy the sights of New York.
    Meredith kept in contact with us over the weekend and told us a limo would be waiting again at the hotel to take us to the studio Monday morning! Sunday night we set our travel alarm, but also placed the official hotel wake up call, now that the phone was working. I did manage to sleep a few hours but still kept rehearsing in my mind the big interview. Upon arriving at the studio we were greeted by Meredith in the green room and went over the details of the interview. Then it was off to wardrobe where they pressed my jacket, then over to make-up where they touched up my lipstick and hair. Meredith and I went into the studio and reviewed the food layout. She also reminded me that Matt might not stick to the questions in the script. I had one minute to talk to Matt before we went to the taped segment, which I listened to very carefully, as I had not seen it before. After the segment Matt transitioned into the live interview and the first question he asked was not in the script! Fortunately I was able to answer that question, and then we moved on to the other questions that were in the script. Three minutes flew by and when it was over I felt the weight of the whole world off of my shoulders. Matt, Meredith and I had a short visit outside the studio and Blair took some pictures. Check out my website at www.glutenfreediet.ca and click on "in the media" to see the New York and NBC photos. I thanked Meredith for all her hard work on producing the celiac story, and for bringing me to New York, and I presented her with a gift from Saskatchewan.
    Blair and I returned to the hotel in our limo and then did some quick shopping for our kids. Our last meal was at a restaurant called "Shellys of New York," then it was back to the airport where we managed to get a flight with seats together—all the way home!
    As I reflect back on those seven days, it truly was an emotional and physical roller coaster ride that we will never forget. In spite of the ups and downs, we were truly blessed and we have so much to be thankful for—including the angels that watched over us!
    If you have not seem the Today Show segment on celiac disease, please visit our website at www.celiaccenter.org and enjoy.
    Shelley Case, B.Sc., RD, is a consulting dietitian, member of the Medical Advisory Boards of the Celiac Disease Foundation, Gluten Intolerance Group and Canadian Celiac Association and co-author of the celiac section in the Manual of Clinical Dietetics by the American Dietetic Association and Dietitians of Canada. She is also the author of the best selling book Gluten-Free Diet: A Comprehensive Resource Guide.

    Dr. Ron Hoggan, Ed.D.
    Celiac.com 07/30/2009 - Here is Dr. Ron Hoggan's response to Slate's unfortunate article "Throwing Out the Wheat" which was written by Daniel Engber:
    Dear Mr. Engber,
    You represented Dr. Fasano as saying:
    “For every patient whose intestinal biopsy turns up positive, he says, nine or 10 more test clean but commit to going gluten-free all the same.”
    This ratio is well established in the medical and scientific literature. The rate of gluten sensitivity, as measured by IgA and IgG antibodies against gliadin, (a protein family that is a sub-group of gluten) constitutes about 10% to 12% of the general population.  That is about ten times the rate of celiac disease found in the general population.
    These anti-gliadin antibodies (AGA) clearly demonstrate that gliadin proteins or derivative peptides are reaching the bloodstream and sensitizing the immune system to this foreign (non-self) protein.  Many of these gluten sensitive individuals experience all of the same signs and symptoms as celiac patients.
    Similarly, you state: “Since there's no way to "prove" a case of gluten-intolerance in the lab...”
    This is grossly inaccurate. Although many practitioners will state that AGA are non-specific, I doubt that any of them would argue against the statement that the presence of AGA clearly indicates that gliadin or its fractions have managed to get into the bloodstream. When they say AGA are non-specific, they simply mean that these antibodies are not associated with any specific disease. They seem to be found in a wide range of autoimmune diseases, cancers, and behavioral/psychiatric disorders.
    You also say: “If you're paying more attention to what you eat, there's a good chance your symptoms will lessen. That's not because gluten or red meat or another food is damaging your small intestine; it's because eating less makes it easier for your gut to recover.”
    This assertion is based on a flawed assumption. Gluten-free foods are much more calorie-dense than those made with gluten. Thus, a common mistake made by those beginning a gluten-free diet is to eat about the same quantities they are used to eating. For instance, if one is in the habit of taking two sandwiches in their lunch, they are likely to pack two gluten free sandwiches. Since the gluten-free bread is much more nutrient dense. Increased nutrient densities apply to pasta, baked goods, and almost all gluten-free substitutes. Thus, the switch to eating a gluten-free diet usually leads to eating less, not more, as you claim in the above statement.
    Later you state: “Chances are you'll have reduced your total intake of carbs, and thus the amount of α-amylase in your gut.”  For the reasons stated above, this is also inaccurate.
    You go on to say: “In other words, the mere fact of being on a gluten-free diet could make you more sensitive to grains and cereals—which would only reinforce your conviction that you're gluten-intolerant.”
    I am not aware of any data indicating a reduction of alpha almylase in the context of a gluten free diet. I would be amazed if you can find any such data. It reflects an assumption about the production and function of amylase that appears indefensible to me.
    The low carb craze has followed a very different path to the media, and began with a fellow named Banting in the 1800s whose doctors suggested a low carb diet to him as a means of losing weight. It worked, and he published a pamphlet about it. It saw a resurgence in the form of a ketogenic diet in the 1920s, at Johns Hopkins, as a treatment for epilepsy. Subsequent development of anti-seizure medications during the 1930s left the treatment without any patients, so it was abandoned until 1997 with the airing of First Do No Harm, a movie about one child’s plight and his parents’ struggle to find a treatment for his life threatening seizures.
    Meanwhile, research suggested that the growth of insulin sensitive tumors might be stalled by a ketogenic diet, and various case reports and subsequent clinical trials both support that perspective and indicate that most folks won’t maintain such a boring diet.
    The gluten-free diet was suggested by a concerned mom in 1932 and it was fully 18 years before Dr. Willem Karel Dickie’s doctoral thesis would be accepted and the world would begin to treat celiac disease with a gluten free diet.
    I won’t bore you with the details of this evolution but there are many twists and turns to the story of gaining acceptance of a gluten-free diet for the effective treatment of celiac disease.
    Both of these developments occurred quite separately. The two things they have in common are:
       1. They both gained popular notice and support through the Internet, and;
       2. They both defied conventional medical wisdom when they were first considered.
    Your graph simply identifies the impact that the Internet has had on democratizing health care.
    Your ill-informed attack on a gluten free diet is regrettable because it suggests it is a fad diet rather than a therapeutic one. At best, that will make it more difficult for people to get cooperation when trying to look after their own health by avoiding gluten. At worst, it will dissuade people from sticking to their diets if they believe your false assertion that gluten sensitivity cannot be identified in a lab. It can be, and is, on a very regular basis. 
    Your information on celiac disease was mostly well researched and solid, but you clearly did not put any thought or effort into finding out about gluten sensitivity (often called gluten intolerance). I wish you would correct some of this misinformation, as it is really misleading and potentially harmful.

    Daniel Engber responded to the above email insisting that “it's impossible to prove gluten intolerance in the lab.” And that “Many of the strongest advocates for those with this condition describe it as one that can only be diagnosed by process of elimination.  Or, to be more specific, by an elimination/reintroduction test.”
    He also challenged me asking if
    “All those who have AGA are gluten-intolerant?”

    Then he said that he just doesn’t believe it. 

    Here is my reply:
    July  31, 2009
    Hi Daniel,
    Thanks for your response.
    I don't know who these "strongest advocates" are, but your information about elimination/reintroduction testing being the only way gluten sensitivity is absolutely inaccurate. Check with any reputable blood testing lab that does IgA and/or IgG anti-gliadin antibody testing. They will set you right on this score.
    The presence of AGA in the bloodstream is clear, incontrovertible evidence that the body is mounting an immune response against gluten. This antibody reflects a delayed-type food sensitivity that is sometimes erroneously called an allergy.  This is gluten sensitivity. It may be transient, chronic, or permanent, but there can be no doubt that it reflects the condition that is referred to as gluten intolerance. Not everyone who is gluten sensitive will show these antibodies but, yes, everyone who shows these antibodies is gluten sensitive. It is a basic principle of immunology that elevated selective antibodies reflect prior or current exposure of these antigens to the bloodstream.
    You must have spoken with Alessio Fasano to get that quote. Just ask him about AGA testing. He will tell you the same thing I'm telling you. I have discussed these and related matters with him at some length.
    I think you are mistaken in your claim that you linked to anything that Joe Murray said. I'll be very surprised if he has said anywhere that a gluten-free diet leads to eating less (although he has repeatedly said it can cause weight loss in the context of celiac disease). Could you tell me where this link appears?
    Nonetheless, even if the volume of food consumed is less (more on that in a moment) the increased caloric density would very likely be offset by the significant increase in caloric density of gluten-free foods. While Dr. Murray has treated and spoken with many more celiac than I have, I'd be willing to wager that I have observed many more of them while eating. :-)
     
    Apparently I misunderstood your thesis. I took you to say that public awareness of low-carb/Atkin's dieting and gluten sensitivity followed a largely parallel path because they are both pop culture trends that reflect a kind of hysteria about nutrition that is not based on science. Thus, I offered some data showing that the rise in public awareness of these two nutritional perspectives are based on scientific insights and the rapid increase of public awareness of these issues in 2004 and 2006-2008 was probably the result of improved access to information on the Internet in combination with scientific discoveries during those periods. I should have detailed the discovery and development of serological tests for celiac disease and gluten sensitivity as well as the research that began to reverse the vilification of saturated fats at about the same time.
    (snip)
    The vast majority of those eating a gluten-free are eating a very high carb diet. On this issue your article is quite misled and misleading. Please take the time to respond again, as I am most interested in that link to Joe Murray's comments. I also urge you to look at the significance and nature of AGA serum antibodies. Gluten sensitivity is readily demonstrated by these simple blood tests.
    Best Wishes,    
    Ron
     

    Monday, August 03, 2009 4:50 PM
    Dan replied admitting that he had not, after all, linked to an article by Joe Murray. The link he apparently intended to put in was the following: http://www.montanaceliacsociety.com/physiciansmanual.htm
    I responded with the following message:
    Mon 8/3/2009 9:02 PM
         
    Hi Dan,
    I gave you the wrong url. Please try this one:
    https://www.celiac.com/gluten-free/index.php?showtopic=60511
    I'm wondering how you can continue to assert "it's impossible to prove gluten intolerance in the lab" when I have given you ample information to the contrary as well as directing you to blood testing labs (Great Smokies, Immuo, Imco Diagnostics, etc. etc.) that will verify my assertion. There is also a wealth of information in the peer reviewed medical literature supporting what I'm saying. I'd be happy to provide a list of relevant research reports if you are interested.  
    You don't mean to suggest that this quote from Joe Murray somehow justifies your above assertion do you? Just pick up a telephone and give him a call. I'm very confident that he will not support your notion that gluten sensitivity cannot be identified in the lab. Do remember that Dr. Murray is a sub-specialist in celiac disease. He may not be a big fan of assertions of non-celiac gluten sensitivity, but he won't deny that the AGA blood tests establish immune sensitization and hence, gluten sensitivity. Rodney Ford and Marios Hadjivassiliou are a couple of other world renowned researchers who are reporting AGA as a significant marker of serious disease in the absence of celiac disease.
    Your assertion that "it's impossible to prove gluten intolerance in the lab" was the lynchpin of your entire article. Without it, you may have to acknowledge that you have just discredited a group of people who, on the basis of solid science, are trying to improve their health. Yet you have set back their relationships with skeptical family members and friends based on your inadequate research.
    I really do think that you owe these people a retraction or at least a statement that mitigates some of the damage your article is doing. 
    Sincerely,
    Ron

    Tuesday, August 04, 2009 3:14 AM
    Dan responded saying that  he thought we were having a semantic argument.  It became clear to me that he was confusing gluten sensitivity with gluten sensitive enteropathy – which is another name for celiac disease. He thought I was talking about latent  celiac disease.

    He insisted again that gluten intolerance is not defined by any standard such as celiac disease is. He went on to say: 
    “If you want to define "gluten intolerance" and/or "gluten sensitivity" so it applies to some subgroup of those who suffer from symptoms related to gluten, that's fine with me.  I'm using the phrase "gluten intolerance" to describe all those who experience relief from the gluten-free diet without having been diagnosed with celiac.”
    I responded with the following:
    From: Ron Hoggan, Ed. D.
    Tue 8/4/2009 11:01 AM
    To: Daniel Engber
    Subject: RE: Throwing Out the Wheat
    Hi Dan,
    It sounds like you may be confusing gluten sensitive enteropathy with gluten sensitivity. The former is a descriptive name for celiac disease, while the latter indicates an immune system sensitized to gliadin.
    Selective antibodies are produced in response to foreign proteins or peptides that have breached a barrier (skin or mucosal) and are now present in the bloodstream or imbedded in self tissues. The immune system reacts as if these foreign proteins were bacterial invaders. (In fact, they are cytotoxic and neurotoxic but that is not at issue here (1, 2). If there was only one event during which gliadin proteins or peptides reached the circulation, as might be the case during a bout of flu, for instance, AGA levels usually diminish quite quickly. Thus, when a person shows elevated levels of AGA, the condition is usually chronic. It indicates that they are leaking gliadin proteins and/or peptides into the bloodstream. Celiac disease only afflicts between 10% and 15% of these people with elevated AGA. Serological tests for celiac disease identify endomysium antibodies (EMA) and tissue transglutaminase (tTG). There is no debate about the foregoing. It is common knowledge and is accepted by the vast majority of researchers and practitioners working in this area.
    The controversy comes in when we ask what elevated AGAs mean. Many claim that it is a non-specific finding. That is, AGAs are not diagnostic for celiac disease or any other currently recognized disease. They are much more common among those with autoimmune diseases, AIDS, and several other groups, but they do not provide any clues that will help diagnose a particular illness. AGAs are also found in some apparently healthy individuals. The only condition for which they fairly specific is what is often called a "leaky gut". However, most practitioners do not recognize increased intestinal permeability as a disease entity. There is no debate regarding the connection between elevated AGAs and leakage of gliadin into the body. In the past, the debate has been about whether AGAs are diagnostic for any disease and whether a leaky gut is an issue of any real concern.
    However, in the late 90s, researchers at U. Maryland, working to develop a cholera vaccine, found a protein messenger called zonulin. As its presence increases in the intestinal lumen, it relaxes the tight junctions between gut epithelial cells (3). Zonulin is overproduced by some individuals in response to gluten ingestion. It turns out that those with celiac disease, type 1 diabetes, and a variety of autoimmune diseases are particularly inclined to produce excessive quantities of zonulin in response to gluten ingestion (4).      
    Similarly, Marios Hadjivassiliou and his neurological research group at the Royal Hallamshire Hospital in Sheffield have found that AGA are elevated in more than half of all patients with neurological disease of unknown origin and only about a third of those have celiac disease. The remaining two thirds are simply gluten sensitive, as identified by AGA (5). 
    Variation in zonulin production, from one individual to another, is likely the factor that determines gluten sensitivity.
    Gluten sensitivity does not identify celiac disease, latent celiac disease, or any other enteropathy that I'm familiar with. It identifies an immune system sensitized to gluten. Avoidance of gluten in such cases can help to avoid developing additional autoimmunity, just as it sometimes does in celiac disease, but current evidence suggests that it will usually not reverse it once that autoimmunity has begun.   
    The use of Rodney Ford's term "gluten syndrome"(2) might well have saved us considerable cyber ink, as we might have been able to begin by disagreeing about the value of a gluten free diet across the gluten syndrom spectrum, rather than taking several emails to determine that you were equating gluten sensitivity with celiac disease.
    Best Wishes,
    Ron
    Sources:
    Paganuzzi AS, Zucco F, Cardelli M, de Angelis I, Mattei R, Pino A, Rocca E, Zampaglioni F.Cytotoxic effects of wheat gliadin-derived peptides.Toxicology. 1985 Dec;37(3-4):225-32. Ford RP.The gluten syndrome: a neurological disease. Med Hypotheses. 2009 Sep;73(3):438-40. Epub 2009 Apr 29. Drago S, El Asmar R, Di Pierro M, Grazia Clemente M, Tripathi A, Sapone A, Thakar M, Iacono G, Carroccio A, D'Agate C, Not T, Zampini L, Catassi C, Fasano A.    Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines.Scand J Gastroenterol. 2006 Apr;41(4):408-19. Visser J, Rozing J, Sapone A, Lammers K, Fasano A.  Tight junctions, intestinal permeability, and autoimmunity: celiac disease and type 1 diabetes paradigms. Ann N Y Acad Sci. 2009 May;1165:195-205. Hadjivassiliou M, Gibson A, Davies-Jones GA, Lobo AJ, Stephenson TJ, Milford-Ward A.  Does cryptic gluten sensitivity play a part in neurological illness?  Lancet. 1996 Feb 10;347(8998):369-71. Clemente MG, De Virgiliis S, Kang JS, Macatagney R, Musu MP, Di Pierro MR, Drago S, Congia M, Fasano A. Early effects of gliadin on enterocyte intracellular signalling involved in intestinal barrier function.Gut. 2003 Feb;52(2):218-23.  
    Note:
    I should have added that since Dan was using the phrase gluten intolerance “to describe all those who experience relief from the gluten-free diet without having been diagnosed with celiac,”  he has defeated his own argument. If a person has symptoms and they get relief from a gluten free diet, they would have to be pretty self destructive, foolish, or self-indulgent to go back to eating gluten.

    In a private email I received from another person, he said: “After reading his original article I had the distinct feeling that a girlfriend of his (or friend/relative) had gone on a gluten-free diet and had recently dumped him--maybe because he wasn't so supportive of this change...but I don't have any proof... ”

    I am most inclined to agree with this poster’s suspicions.

    Finally, I forwarded a copy of the letter titled: “Is gliadin really safe for non-coeliac individuals? Production of interleukin 15 in biopsy culture from non-coeliac individuals challenged with gliadin peptides” by D Bernardo1, J A Garrote2, L Fernández-Salazar3, S Riestra4, E Arranz5 from  Gut 2007;56:889-890; doi:10.1136/gut.2006

    These investigators report that “gluten elicits its harmful effect” on all the individuals they studied, not just those with celiac disease. I believe that Jefferson Adams has written a detailed account of this research that appears elsewhere on celiac.com. 

    Although Mr. Engber declined to give me permission to publicly post his emails, and hence, his side of this discussion, I have invited Dan to respond to the above on celiac.com, as I would like to give him every opportunity to either provide some evidence to support his unfortunate claims about non-celiac gluten sensitivity, or to retract his damaging comments in the original article he penned. Although I have been a little rough on him, I do hope he will present his side of this debate, as it is of great importance to many individuals who must negotiate with friends and relatives to safeguard their health.

    These people would not dream of casually scattering rat poison on food to be served to a loved one. However, they seem to feel imposed upon by those who are gluten sensitive, because they do not want gluten scattered on their food. This attitude is just as inappropriate and sometimes, just as dangerous as scattering rat poison on food. 

    Sincerely,
    Ron Hoggan
     
     
     
     

    Jefferson Adams
    Celiac.com 11/04/2011 - For many folks, fall means changing leaves, crisp weather, football, and beer. Or just crisp weather and beer. Fortunately, for those with gluten sensitivities, the explosion of diagnoses for celiac disease and gluten-intolerance has given rise to an explosion of gluten-free products, including a number of gluten-free beers.
    "People are becoming more knowledgeable of the symptoms in which gluten can cause on one's health," said New Planet Beer Marketing Director Danielle Quatrochi, "so people are being diagnosed sooner and more often than before. There's also been a lot of press around the benefits of a gluten-free diet, opening the door for companies to add gluten-free options to their product mix."
    Gluten-free beers have often lacked depth compared to their wheat and barley-infused cousins, and sorghum, a key grain in many gluten-free beer recipes, imparts a distinctly tart flavor. Some gluten-free brewers try to offset the tartness of the millets by using various malts. Others use corn, rice and sugars in place of sorghum.
    Writer Harold Swaney, together with is wife, Erin, and good friend, Kit Hansen, recently set out to do some taste assessments of gluten-free beers. He gathered all the gluten-free beers from all the breweries he could find. In total, they tasted twelve beers by seven brewers.
    The trio tasted Toleration Ale, Redbridge Gluten Free Sorghum Beer, New Planet's Off the Grid Pale Ale, 3R Raspberry Ale, and Tread Lightly Ale, St Peter's Sorghum Beer, Bard's Sorghum Malt Beer, New Grist Beer, and Green's Gluten Free Dubbel Dark Ale, Tripel Blonde Ale, and Amber Ale.
    First up was Redbridge, by Anheuser-Busch. Redbridge is a gluten-free version of a basic American-style lager, made from sorghum, hops, gluten-free yeast. Swaney writes that Redbridge "a clean beer with solid body and nice, subtle finish; the lack of a real sorghum bitter finish." The trio gave Redbridge a thumbs up.
    Next came New Grist, Lakewood Brewery's offering of sorghum, hops, rice and gluten-free yeast grown on molasses. All three tasters were unimpressed. Swaney wrote that New Grist has a "very light body and is eminently forgettable," with one taster comparing it to a "very light, carbonated sake."
    After New Grist came Bards Sorghum Malt Beer, which is brewed from sorghum, yeast and hops.
    Swaney writes that Bards is "strong up front, with notes of caramel and fruit. But, unlike most gluten-free beers that have a distinctly bitter finish, Bards has really no finish. Overall with a solid malt backbone and a nice body." He calls Bards a "respectable gluten-free beer."
    Next came three beers brewed by Green's. All three use millet, buckwheat, rice, sorghum, hops and yeast.
    Of Green's Dubbel Dark Ale, Swaney writes that it has "a slight sorghum finish, but it is sweet up front and passes nicely for a Belgian-style dubbel." Of the Tripel Blonde Ale has notes "fruit up front and…the characteristic mouthfeel of a true tripel."  Swaney reserves his highest accolades for Green's Amber Ale, a medium-bodied ale with "notes of caramel," very little sorghum finish, that he calls "the most balanced of the three."
    The group next sampled Toleration from Nick Stafford's Hambleton Ales in England, which is crafted from Challenger, Liberty and Cascade hops, top-fermenting yeast and specially prepared sugars. Swaney wrote that Toleration "didn't taste much like beer. More like a slightly hoppy barleywine. It had an aroma of dates and figs and was very sweet, but it had almost no carbonation."  His wife, Erin, "compared it to a port."
    Next up was New Planet's Off the Grid Pale Ale, 3R Raspberry Ale, and Tread Lightly Ale. All three are made with sorghum, hops and yeast. The Pale Ale adds brown rice extract and molasses, 3R Raspberry Ale adds corn extract, natural Oregon raspberry puree, and orange peel, while Tread Lightly Ale adds corn extract, and orange peel.
    Among the New Planet offerings, Swaney had the highest regard for Off the Grid Pale Ale. He commended its "malty backbone and hoppy finish." saying that it was "hard to tell it was a gluten-free beer." Swaney says his friend, Kit, who had not tasted a real beer for four years, was "blown away by how much it reminded him of a true pale ale."
    Swaney characterizes Tread Lightly Ale as "a very light beer with a distinct sorghum finish," while the 3R Raspberry Ale is a very carbonated, light ale that evokes a raspberry cider.
    St. Peters, which is made with Sorghum, hops, water. Swaney notes that folks who like European lagers will like this beer. "It starts very bitter, with a distinct grassy aroma," he says, noting that St. Peter's is "definitely a beer that paired well with food."
    Read Harold Swaney's full article at Herald.net.


    Jefferson Adams
    Celiac.com 03/07/2014 - Our latest gluten-free celebrity news comes with word from eon line.com that actress Jennifer Esposito has sparked a bit of a dustup with Rachael Ray over an episode of Ray's 3 in the Bag that aired earlier this month on Food Network, in which Ray shared some favorite gluten-free recipes.
    Actress-turned-activist Jennifer Esposito called Ray out for failing to make any mention of celiac disease, and dubbed Ray's efforts a "wasted opportunity," for failing to mention celiac disease, gluten sensitivity or cross-contamination, adding: "Why be responsible?"
    Esposito also tweeted, "That would mean @rachaelray would have to understand what she is actually speaking about."
    Esposito also tweeted a link to a post in Gluten Dude's blog which slammed Ray.
    VIDEO: Get Jennifer Esposito's gluten-free pizza recipe!
    The former Blue Bloods star ended by tweeting: It's a shame that their r so many suffering at the hands of ignorance such as this."
    Esposito claims her doctor-advised 2012 medical leave from the show for celiac disease led to her suspension from the CBS series.
    Source:
    eonline

  • 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