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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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    GLUTEN-FREE DIET FUELING TENNIS STARS


    Jefferson Adams

    Celiac.com 06/29/2011 - Serbian tennis star Novak Djokovic credits an unbeaten string of victories on the court to his special, gluten-free diet.


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    Meanwhile, Sabine Lisicki recently attributed her collapse on the threshold of a major upset over third seed Vera Zvonareva in the second round of the French Open to a need for her body to adjust to her new gluten-free diet; which Lisicki adopted after discovering she is intolerant to gluten, a protein in cereal grains.

    After physically crumbling within sight of victory, a sobbing Lisicki was carried from the court on a stretcher. The 21-year-old later explained on her website (www.sabinelisicki.com) that her collapse occurred because her body simply let her down. She said that "[d]octors recently discovered that I am intolerant to gluten -- meaning I can't eat e.g. pasta, one of my biggest energy sources."

    "My body needs to adjust to the big change and needs some time. It is good that we found out and it will only make life better in the long run, she added."

    Pasta and bread are still staple foods for many top athletes, as they are important sources of energy. Athletes on gluten-free diets need to find new energy sources.

    Djokovic has enjoyed a 39-match winning streak after changing his diet in late 2010, after tests by his nutritionist showed him to be gluten intolerant.

    Like Lisicki, Djokovic's body cannot process the carbohydrates he traditionally used to fuel his body, and he was forced to find alternative foods to provide the energy and stamina needed to prevail in long matches. For Djokovic, the change has paid off handsomely.

    "I have lost some weight but it's only helped me because my movement is much sharper now and I feel great physically," said an energized Djokovic, who has beaten Rafael Nadal in four finals this year.


    Image Caption: Novak Djokovic serves. Photo: CC-y.caradec
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    Guest Tennis Tiger

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    Many people have trouble processing gluten and it can be a huge problem without them even realizing. I'm sure there are many more athletes that aren't performing as well as they could, because they aren't aware of their gluten allergies.

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    Guest Jenny

    Posted

    What is wrong with the good old potato as an alternative carb for the gluten intolerant?

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  • Related Articles

    Jefferson Adams
    Celiac.com 05/06/2009 - Like so many people with celiac disease, Elisabeth Hasselbeck of ABC's The View has a story to tell. Like so many people with celiac disease, that story involves a long, slow, painful journey from suffering to understanding, to self-empowerment and recovery. In between were periods of confusion, doubt, isolation and malaise. Hasselbeck describes that journey in her new book: The gluten-free Diet: A Gluten-Free Survival Guide.
    Hasselbeck's odyssey began during her sophomore year of college, when she fell ill after returning from a three-week-long trip to Belize. She was diagnosed with a severe bacterial intestinal infection which, her doctor said, was a result of her travels in Central America. The illness put in the school infirmary for nearly a week, with an immensely distended belly and a 103+ fever. Once the initial infection subsided, she was naturally relieved, and thought the worst was over. Little did she know that a long road lay ahead.
    As an athlete, Hasselbeck was eager to get back into shape after she was discharged. Her body had other ideas. During this period, she says she felt absolutely ravenous, yet the only dining hall foods that seemed appealing were soft-serve vanilla frozen yogurt and Rice Krispies. Food had lost its appeal.
    Hasselbeck grew up in an Italian-American neighborhood in Providence, RI, in a family that prized all things bread and pasta, so she wasn't about to give up the appetite and food battle without a fight.
    However, no matter what she ate nothing satisfied her hunger—and everything seemed to upset her stomach. After nearly every meal, she had the classic bloating, and sharp, gassy pains in her gut that are all too familar to most celiacs. Cramps, indigestion and diarrhea were familiar companions; sometimes all at once. Often, she would become too tired to move.
    It was about this time that she became a contestant on Survivor: The Australian Outback. While enduring the trials of surviving in the outback, Hasselbeck was deprived of her normal, gluten-rich American diet, and forced to subsist on things she would never willingly eat at home. Yet, her symptoms were gone, and she had never felt better. Once she returned to the U.S., she narrowed the scope of her quest. She eliminated nearly everything from her diet and introduced items one at a time.
    After nearly forty days basically starving herself, she sought solace in her pre-Australia diet, with dire consequences. After the joy of knowing a healthy, happy gut for the first time in years, she suddenly found herself feeling worse than ever, and spending days in her room, bedridden, save for urgent trips to the bathroom.
    She saw a doctor and received a diagnosis of "irritable bowel syndrome." Suspicious of what she saw as an acknowledgement of symptoms masquerading as a diagnosis, she began to look for connections on her own.
    Fortunately for Hasselbeck, she began to make a connection between the illness she had suffered for so long and the food she was eating. She noticed that when ate starchy foods, her symptoms returned with a vengeance.
    An Internet search told her that she might be suffering an adverse reaction to wheat. She quickly moved to eliminate wheat from her diet. Her experience, as so many with celiac disease know all too well, was an educational one, filled with occasional episodes that left her feeling inexplicably ill.
    Unable to figure out exactly what was making her sick, she undertook more research and stumbled upon some information about gluten intolerance and celiac disease.
    In 2002, after five years of suffering, Hasselbeck diagnosed diagnosed herself with celiac disease, an autoimmune condition triggered by gluten, the protein found in wheat, rye and barley.
    Celiac disease can cause acute damage to the small intestine and the digestive system, and, left untreated, it can leave sufferers at risk for certain types of cancer and other associated conditions. The only known treatment is a lifelong diet free from wheat rye and barley gluten. Once she realized what had been tormenting her for so many long, she set about eliminating all wheat, barley, oats, and rye from her diet.
    Still, even after she made her diagnosis, she faced a long line of skeptical doctors. In fact, it was eight years after her symptoms first began until she found a doctor who was willing to listen, and who had answers.
    Her move  to New York City put her into contact with Dr. Peter Green, the director of the Celiac Disease Center at Columbia University, who confirmed what she'd suspected for years: Elisabeth Hasselbeck has celiac disease. After waiting for years for a sensible explanation to her symptoms, Dr. Green was the first doctor to look for the cause, not simply to treat the symptoms. Despite the same mistakes and accidents that most of us celiacs have also experienced, her perseverance paid off in the end and she remains gluten-free to this day.
    You can watch Elisabeth Hasselbeck daily on ABC.com's The View. Hasselbeck's book is now available at Celiac.com.
    Source: ABC News


    Gryphon Myers
    Celiac.com 11/15/2012 - While nobody can argue with the fact that the gluten-free diet is healthier for the gluten intolerant, some people claim that it has health benefits for everyone. There's no conclusive evidence to suggest that it does, but it's also probably not as 'dangerous' as some skeptics might have you think.

    As the gluten-free diet grows in popularity, more and more celebrities are coming out to promote its health benefits. Some, like a Jennifer Esposito and Miley Cyrus, suffer from celiac disease or non-celiac gluten intolerance. Others, like Kim Kardashian and Lady Gaga, don't have any kind of wheat intolerance, but still tout the diet's health benefits (often weight loss).
    The problem is that while Kim Kardashian, et al. may be finding success with the diet, there is little scientific evidence to support any health benefits for cutting gluten if you aren't sensitive to it. Everyone should consider the role wheat plays in their diet, but it is a bit premature to be declaring the gluten-free diet a cure-all.
    Lately, a growing number of dietitians seem to have noticed this trend, and are advising people to refrain from going off gluten unnecessarily. Dr. Stefanno Guandalini, medical director at the University of Chicago Celiac Disease Center says that “for everyone else, embracing this diet makes no sense” while dietitian Susan Watson advises “So what if so-and-so has found all these health benefits – their health concerns are not necessarily the same as the individual that's reading it or seeing it on TV.” In a segment on ABC Nightline, Dr. Peter Green of Columbia University's Celiac Disease Center warned that switching to a gluten-free diet could cause vitamin B and/or calcium deficiencies.
    The main argument against a gluten-free diet (and in some instances, a valid one) is that gluten-free foods often contain carbohydrate-rich wheat flour alternatives like rice flour or potato starch. Even Dr. William Davis, author of Wheat Belly: Lost the Wheat, Lose the Weight and Find Your Path Back to Health acknowledges that gluten-free alternatives aren't always healthier, reasoning that they can “send your blood sugar and insulin sky-high, even more so than wheat.”
    However, it is fallacious to conclude that this means the gluten tolerant would gain no health benefits from switching to a gluten-free diet. Yes, junk food should be consumed sparingly, but there is just as much (if not more) wheat-based junk food around, and many people already base their diets around it. Dietitians who are skeptical of the gluten-free diet seem to be giving advice on the 'if it isn't broken, don't fix it' model of thinking, but the average American's diet is broken, as evidenced by our sky-high obesity rates. Dr. Green is correct: people should be worried about vitamin deficiencies, but a wheat- and sugar-centric diet is likely littered with them.
    Dietitians should be advising people to more closely monitor their diets, whether they are gluten intolerant or not, and consider whether some staples in their diet could be replaced with more nutritious alternatives. Wheat is delicious (which is why we eat so much of it), but nutritionally, it pales in comparison to alternatives like buckwheat, quinoa, breadfruit, amaranth and millet.
    At the very least, whole wheat is vastly more nutritious than refined wheat. As Susan Watson points out: “if you avoided white bread and white rice, and switched it with whole-grain bread and whole-grain rice, you're getting a way better health benefit than cutting out all wheat.” Dr. Davis disagrees with that last clause though, and advises against consuming any form of wheat. He cites its high glycemic index, as well as the way it is broken down, which yields a morphine-like substance that, according to him, makes people crave more wheat.
    The bottom line is that dietitians are correct: people should not switch over to a gluten-free diet blindly and assume it will make them healthier. They should, however, consider whether wheat is really necessary as the main staple of their diet when there are many healthy alternatives.
    Sources:
    http://www.forbes.com/sites/daviddisalvo/2012/10/02/does-gluten-deserve-to-be-on-the-public-health-enemies-list/2/ http://www.eatingwell.com/nutrition_health/gluten_free_diet/should_you_go_gluten_free_if_you_dont_have_celiac_disease?utm_source=HuffingtonPost_Michelle_Hasselbeck_050312 http://www.cbc.ca/news/health/story/2012/10/05/f-anti-wheat-diet.html http://www.cbsnews.com/8301-504763_162-57381966-10391704/gluten-free-diets-not-always-necessary-study-suggests/ http://celiacdisease.about.com/b/2010/11/05/is-cutting-gluten-from-your-diet-dangerous-if-you-dont-have-celiac.htm

    Jefferson Adams
    Celiac.com 04/05/2013 - One in three adults want to avoid or cut down on gluten in their diets, says a survey from the consumer research firm, NPD Group. NDP began asking consumers about gluten-free issues in 2009, and the responses for their January 2013 survey show the highest level of interest in gluten-free diets so far.
    NDP's chief industry analyst, Harry Balzer, said in a recent press release that avoiding gluten is the "health issue of the day," and compared the current efforts to avoid or reduce dietary gluten to efforts a generation ago to avoid fat, cholesterol, sugar and sodium.
    Specifically, Balzer said: a "generation ago, health was about avoiding fat, cholesterol, sugar and sodium in our diet. While those desires still exist for many, they no longer are growing concerns…Today, increasingly more of us want to avoid gluten in our diet and right now it is nearly 30 percent of the adult population...and it’s growing."
    Gluten-free foods are now a $4.2 billion a year industry, and interest has extended to the restaurant industry as well.
    NPD found that 200 million restaurant visits in the past year included a gluten-free order. “The number of U.S. adults who say they are cutting down on or avoiding gluten is too large for restaurant operators to ignore,” said Bonnie Riggs, a restaurant industry analyst for NDP, in the same release.
    Currently, some three million Americans have been diagnosed with celiac disease, which is now is four times more common than it was 50 years ago.
    While the rise in diagnosis and awareness of gluten-intolerance and celiac disease continues to fuel popularity of gluten-free diets, the supposed health benefits of eliminating gluten are also a factor.
    It is certainly true that some of this gluten-free diet trend has been triggered by pop culture and media celebrities, many of whom are not eating gluten-free out of medical necessity.
    Still, it's likely that the gluten-free trend will continue into the foreseeable future, at least. 
    Source:
    http://www.huffingtonpost.com/2013/03/06/gluten-free-diet_n_2818954.html

    Jefferson Adams
    Celiac.com 07/04/2014 - Celiac disease can be a factor in many cases of unexplained infertility in women. The recent case in Orlando, Florida of a woman named Vicky Crust, serves to drive home that fact, and to illustrate the potential benefits of a gluten-free diet in such cases.
    Crust suffered for years from abdominal pain, constipation, weight loss and a skin rash that overtook her nose, mouth and legs. Now, in spite of all these symptoms, Crust married, and began trying to start a family with her husband. She conceived twice, but was unable to carry full term. She couldn’t figure it out, and neither could doctors. Doctor after doctor failed to diagnose her celiac disease, and her symptoms grew worse as she progressed into her twenties.
    In 2010, Crust was diagnosed with celiac disease and her doctors at the Mayo Clinic believed that because she was otherwise healthy, she could have a successful pregnancy if she adopted a gluten-free lifestyle. Now, to be fair to Crust’s earlier doctors, celiac disease can be hard to spot. "Not everybody has symptoms. Not everybody may have the rash, the diarrhea, just overall weakness and other manifestations of celiac disease," says Dr. Christine Greves, an OB-GYN at Winnie Palmer in Orlando.
    After her diagnosis, Crust embraced a gluten-free diet, and that paid off nicely for her. Her rash healed, her stomach pains disappeared, and, most delightfully of all, she became pregnant. "My life is great now. I couldn't conceive before and now I am six months pregnant," she said. Obviously, celiac disease will not be a factor in every case of unexplained fertility, and a great deal more work needs to be done.
    However, Crust’s story is by no means rare, and is perhaps emblematic of the effects of celiac disease and the importance of getting a proper diagnosis, and adopting a gluten-free diet once diagnosed.
    Do you know anyone with a similar story?
    This story was first reported by WESH in Orlando, Florida.

  • 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