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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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    HOW BIG IS THE GLUTEN-FREE MARKET, REALLY?


    Jefferson Adams

    Celiac.com 04/02/2014 - We hear lots of talk about the burgeoning market for gluten-free foods, but there is also plenty of confusion over what we are talking about when we talk about the gluten-free food market.


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    Photo--Laad Bazaar: CC--SissssouSo, what do we mean when we talk about the 'gluten-free food market?'

    Actually, the definition can vary depending on who's answering the question.

    Major research firms are important players in calculating market information and selling those calculations to commercially interested players, so their definition of the gluten-free market carries a good deal of weight in the business sector.

    However, a number of major research firms each calculate the size of the market a bit differently.

    The Mintel company, for example, employs the broadest definition, including any item with a gluten-free label, including products that might be naturally-gluten-free.

    Calculated that way, Mintel puts the market for gluten-free goods at $10.5 billion in 2013, and predicts it will rise 48% to $15.6 billion by 2016.

    Packaged Facts, meanwhile puts the market value at $4.2 billion for 2012.

    Euromonitor, finally, puts the gluten-free category at $486.5 million for 2013, comprising $281.5 million from bakery; $45.6 million from pasta; and $159.4 million from ready meals. Euromonitor also projects growth of 38.5% from 2013-18.

    For its purposes, Euromonitor confines its gluten-free definition to products formulated to replace wheat flour. Its definition specifically omits products that are are naturally gluten-free or products with minor formulation changes such as Chex cereals or Rice Krispies.

    One thing these companies have in common, is that their estimates all predict robust double-digit market gluten-free growth through the next few years.

    Source:



    Image Caption: Photo--Laad Bazaar: CC--Sissssou
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    admin
    Frederik Willem Janssen is head of the Chemistry Department, Food Inspection Service in Zutphen, and a subsidiary of the Inspector of Health Protection (similar to the FDA in America). Their lab has a special interest in.... modified gluten, edible packaging materials (which may contain gluten), and detection of hidden gluten in foods, including the development of improved detection methods. He is also a member of the Medical/Scientific Advisory Committee of the Dutch Celiac Society.
    Distillation quite effectively removes the gluten and it is very unlikely that splashes of fermented (we call it "moutwijn", i.e. malt wine, can’t remember the correct English word for it) will be carried over to the final distillate. If they are present they must have been added afterwards. A couple of years ago we analyzed some distilled liquor for presence of gluten proteins but we couldn’t detect any in this set (about 40 different types). The beer test, which consisted of a set of 50 different brands, showed that most brands (35) did contain immunoreactive protein in amounts between 1 and 200 mg/liter. Only 15 contained less than 1 mg/liter. There was a strong correlation between the gluten content and whether wheat had been used as an ingredient!
    I found a report in a periodical by the Flemish Celiac Society of an investigation that was published in 1992 about immunological determination of gluten in beer and some distilled liquor. This confirmed our findings that the gluten content of beer is quite variable (the authors found levels from zero to 400 mg /liter gluten).
    They did find gluten in distilled liquor! The levels varied from zero to 200-mg gluten/liter. The highest amount was found in a "Creme de Framboise" (200 mg/liter) but second was a French brandy VSOP with a score of 180 m g/liter. A Dutch gin was negative, which might be an indication that gluten in these type of liquor is not a carry over to the distillate! My guess is that this gluten is derived from the caramel coloring, though there is no proof about this yet. I always advise sensitive patients to abstain from brown colored liquor!
    I would like to stress that the determination of gluten in these types of products is very unreliable and we have to count with false positive as well as false negative values. The gluten proteins could have been broken down to small (but still toxic) peptides and in that case a sandwich-type ELISA might produce false negative results because in that case you always need to two epitopes (binding sites for the antiserum) on one molecule to get a positive reaction. A competitive type assay would be the choice for this type of product, but we haven’t tried this type of analysis yet. We did use it on a soy sauce, which was prepared with wheat gluten and didn’t find any gliadin, which might be an indication that gluten had been broken down to very small peptides with less than one binding site.
    Best wishes,
    Frederik Willem Janssen, Zutpen, The Netherlands. 
     

    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


    Jefferson Adams
    Celiac.com 09/11/2009 - When is a beer not a beer? When it's gluten-free. Until now.
    Beer perpetually hovers near the top of most celiac lists of things they'd love to have if they could. Until recently, the regulation of labels for beer, wine and spirits fell to a little known government agency called the Alcohol and Tobacco Tax and Trade Bureau.
    Because their regulations relied on the Federal Alcohol Administration Act of 1935, which defined beer as a beverage brewed from malted barley and other grains, gluten-free beers did not meet the strict definition, and could not therefore be labeled as 'gluten-free beer,' as no such standard existed.
    That situation has changed, and the Food and Drug Administration is now charged with the regulation of beer labels. Because of this, gluten-free beer can now be labeled 'gluten-free beer' instead of 'sorghum beer' or 'beer made without wheat or barley', or some such silliness.
    That's good news for the nation's estimated two million sufferers of celiac disease, and the many, many more who are gluten intolerant. For these folks, consuming any kind of product containing wheat, rye or barley can cause chronic diarrhea, arthritis, bone loss and a raft of other symptoms.
    In people with celiac disease, the immune system reacts to gluten, a protein found in wheat, rye and barley, which causes inflammation in their gut and interfers with the absorption of nutrients.
    All traditional beers are brewed with malted barley and contain gluten. However, specialty micro brewers began making beer from malted sorghum, an African grain, and sometimes rice. Anheuser-Busch followed later with its own sorghum beer. Beers brewed with sorghum and rice are gluten free, which is great for celiacs, but was not in line with the Federal Alcohol Administration Act of 1935, which defines beer as a beverage brewed from malted barley and other grains.
    So even though it looked, smelled and tasted like beer, the amber, foamy and distinctly beer-like beverage did not count as beer under the rules. Which is why last July 7, 2008, the FDA and TTB agreed that FDA would take over regulation.
    The FDAs Guidance for Industry covers all non-barley beers. So, in a great development for all of the celiac and gluten-intolerant folks out there, these beers can now officially be labeled gluten-free once they've been tested and confirmed by FDA.
    The guidelines give brewers of gluten-free beers until Jan. 1, 2012, to begin adding nutrition labels to their beverages, including a declaration of major food allergens, wheat.
    Up until now, people with celiac disease and gluten intolerance could not be sure that their gluten-free beer was actually safe and gluten-free. Now FDA regulations have established a standard.
    According to Elaine Monarch, executive director of the Celiac Disease Foundation, accurate labels will provide a measure of assurance for celiacs, and possibly make it easier for European gluten-free beverages to enter the market.
    Gluten-free beer is a small, but steadily growing sector of the beer market, with a present market share of under 0.1%, according to Paul Gatza of the Brewers Association in Boulder, Colorado. Still, growth for some brands runs upward of 35% per year. The biggest gluten-free beer players are Anheuser-Busch, which makes Red Bridge, Lakefront Brewery's New Grist, and Bard's Tail.
     


    Jefferson Adams
    Celiac.com 12/14/2012 - In the latest celebrity gluten-free news, actress and comedian Fran Drescher has joined stars like Lady Gaga and Miley Cyrus, and athletes like Novak Djokovic and Andy Murray, in adopting a gluten-free diet.
    Moreover, Drescher is going one step further and making her gluten-free diet a vegan one. However, it's not a desire to shed pounds that led Drescher to join the nearly 3 million people with celiac disease, and numerous others, in making her diet gluten-free. Rather, she was looking for a way to deal with exhaustion. When a doctor suggested prescription medications, Drescher decided that overhauling her diet sounded like a better place to start. So, she resolved to cut gluten, alcohol and animal products from her life. She has since lost 15 pounds, and her results have included more energy, and, she claims, better looking skin.
    Talking with host Wendy Williams on Thursday, Drescher said that changes were not easy to make.
    "I wasn’t able to knock off that kind of weight in years. I just decided that I wasn’t feeling well… and I went to a bunch of doctors, and everybody had different prescriptions for all my symptoms" said Drescher, "and I just decided, ‘No more, I’m gonna do alternative. I’m gonna to switch up my act, eat differently, clean up my act.’ And so I cut out alcohol… so that went, and I became gluten-free and vegan."
    Stay tuned to see how this and other celebrity gluten-free diets turn out…
    Read more and see the video at Examiner.com.
     

  • Recent Articles

    Connie Sarros
    Celiac.com 04/21/2018 - Dear Friends and Readers,
    I have been writing articles for Scott Adams since the 2002 Summer Issue of the Scott-Free Press. The Scott-Free Press evolved into the Journal of Gluten Sensitivity. I felt honored when Scott asked me ten years ago to contribute to his quarterly journal and it's been a privilege to write articles for his publication ever since.
    Due to personal health reasons and restrictions, I find that I need to retire. My husband and I can no longer travel the country speaking at conferences and to support groups (which we dearly loved to do) nor can I commit to writing more books, articles, or menus. Consequently, I will no longer be contributing articles to the Journal of Gluten Sensitivity. 
    My following books will still be available at Amazon.com:
    Gluten-free Cooking for Dummies Student's Vegetarian Cookbook for Dummies Wheat-free Gluten-free Dessert Cookbook Wheat-free Gluten-free Reduced Calorie Cookbook Wheat-free Gluten-free Cookbook for Kids and Busy Adults (revised version) My first book was published in 1996. My journey since then has been incredible. I have met so many in the celiac community and I feel blessed to be able to call you friends. Many of you have told me that I helped to change your life – let me assure you that your kind words, your phone calls, your thoughtful notes, and your feedback throughout the years have had a vital impact on my life, too. Thank you for all of your support through these years.

    Jefferson Adams
    Celiac.com 04/20/2018 - A digital media company and a label data company are teaming up to help major manufacturers target, reach and convert their desired shoppers based on dietary needs, such as gluten-free diet. The deal could bring synergy in emerging markets such as the gluten-free and allergen-free markets, which represent major growth sectors in the global food industry. 
    Under the deal, personalized digital media company Catalina will be joining forces with Label Insight. Catalina uses consumer purchases data to target shoppers on a personal base, while Label Insight works with major companies like Kellogg, Betty Crocker, and Pepsi to provide insight on food label data to government, retailers, manufacturers and app developers.
    "Brands with very specific product benefits, gluten-free for example, require precise targeting to efficiently reach and convert their desired shoppers,” says Todd Morris, President of Catalina's Go-to-Market organization, adding that “Catalina offers the only purchase-based targeting solution with this capability.” 
    Label Insight’s clients include food and beverage giants such as Unilever, Ben & Jerry's, Lipton and Hellman’s. Label Insight technology has helped the Food and Drug Administration (FDA) build the sector’s very first scientifically accurate database of food ingredients, health attributes and claims.
    Morris says the joint partnership will allow Catalina to “enhance our dataset and further increase our ability to target shoppers who are currently buying - or have shown intent to buy - in these emerging categories,” including gluten-free, allergen-free, and other free-from foods.
    The deal will likely make for easier, more precise targeting of goods to consumers, and thus provide benefits for manufacturers and retailers looking to better serve their retail food customers, especially in specialty areas like gluten-free and allergen-free foods.
    Source:
    fdfworld.com

    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