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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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    WHAT IF FAD GLUTEN-FREE DIETS AREN'T SO FAD AFTER ALL?


    Jefferson Adams


    • Are fad gluten-free dieters getting more benefits than originally suspected?


    Celiac.com 02/15/2017 - There's been a lot of talk in the media and among researchers about the large numbers of people who adopt a gluten-free diet without a celiac disease diagnosis. Many of these dieters are regarded with a bit of suspicion. The question areises as to whether gluten was causing them any problems that could be improved by a gluten-free diet. Most have been regarded as simple fad dieters.


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    Well, what if the gluten-free fad isn't such a fad after all? What if many of those without celiac disease who eat gluten-free are actually gaining some heretofore undiscovered benefits?

    That's the intriguing possibility raised by the latest study from the Mayo Clinic's Dr. Joseph Murray, and his colleagues at the forefront of research in celiac disease and gluten intolerance. Dr. Murray's colleagues and coauthors include Rok Seon Choung, MD, PhD, Aynur Unalp-Arida, MD, PhD, Constance E. Ruhl, MD, PhD, Tricia L. Brantner, BS, and James E. Everhart, MD.

    Today, according to the team's research, published this month in the journal Mayo Clinic Proceedings, some 3.1 million Americans currently avoid gluten without a celiac diagnosis for celiac disease. That number tripled between 2009 and 2014, while the number of cases of celiac disease stayed flat.

    When we designed this study 10 years ago, we didn't think to ask why people avoid gluten, because no one avoided gluten without a celiac diagnosis, said Murray. So, could these folks be avoiding gluten for legitimate health reasons? Very possibly, says Murray. There's definitely growing evidence that severe non-celiac gluten sensitivities exist.

    Patients with these sensitivities frequently experience intestinal problems, as well as fatigue, stomachaches and a sense of mental fogginess. And while researchers don't understand the underlying mechanism, clinical studies have shown that a gluten-free diet does relieve symptoms in many gluten-sensitive non-celiac patients. It's possible that gluten may play some role in inflammation, though this is unproven. It's also possible that non-celiacs who cut gluten from their diet might also cut out other irritants and allergens.

    The researchers call for further investigation of long-term health consequences of a gluten-free diet in people without celiac disease.

    How about you? Do you or someone you know not have celiac disease, but avoid gluten?

    Source:


    Image Caption: Photo: CC--mattwi1s0n
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    TEST Driven partly by a perception among consumers that gluten-free foods are healthier than their non-gluten-free counterparts, the global gluten-free packaged food market is projected to grow at a compound annual growth rate of approximately 6% between 2015 and 2019, according to a recent market report from Technavio....

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    Guest Mary Thorpe

    Posted

    I am one of those not diagnosed with celiac disease but have been gluten free for 19 years, since before it became popular. After a double round of antibiotics following a root canal, I developed diarrhea. When it didn't stop after going off the antibiotics, after a month I sought help from my GP. She was no help. I started experimenting with my diet. Finally I heard that wheat affected some people which I never would have thought. I went off, and bingo, the diarrhea stopped (by this time it was black), a rash that was climbing up my legs vanished and after a couple of months I realized I hadn't had a migraine, something that had plagued me once or twice a month for 30 years. I have a list of things that no longer happen, like canker sores, heart arrhythmias, esophageal spasms, twitching eye muscles, muscle spasms in my back, bronchitis after a cold. That´s what I remember off the top of my head. When I get gluten accidentally I get a migraine in a day or two and often get physically ill if something is going around. Otherwise, I don't get sick. I take no prescription drugs, only vitamins. So, I am one of those that Dr. Murray is talking about, though maybe I had undiagnosed celiac disease. I'll never know because I'm not tempted to go on gluten to get tested properly though I do miss chewy bread. As the article implies, we don´t need it. It's poor man's food. We eat like kings without it.

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    I avoid gluten because I was having digestive issues which subsided when I went gluten free. I have no need to get tested when the proof is in avoiding gluten. If I eat gluten I immediately have a reaction. Avoid gluten and I am fine. Celiac or not doesn't matter to me. I just avoid it altogether and I feel much better. Dairy products I avoid also due to mucus production.

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    Guest Gillian

    Posted

    I have Hashimotos hypothyroid (age 68) whilst suffering with intestinal problems I surfed the net for remedies, I found that a gluten-free diet was recomended for Hashi sufferers so decided to try it for a few days.....after 3 days my intestinal problems subsided, my lifelong migraines disappeared and I felt better than I had for months so I continued the diet. One year on I accidently ate something with gluten and had an occurence of Dermatitis Hepetiformis, after this my endocrinologist assumes I am celiac. I do not wish to have a bi-opsy and so am not officially Celiac but after almost 5 years on a gluten-free diet I have never felt better!

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  • Related Articles

    Jefferson Adams
    Celiac.com 04/14/2016 - Driven partly by a perception among consumers that gluten-free foods are healthier than their non-gluten-free counterparts, the global gluten-free packaged food market is projected to grow at a compound annual growth rate of approximately 6% between 2015 and 2019, according to a recent market report from Technavio.
    In addition to health and wellness, Technavio identifies demand from millennials and increased marketing activities as prime emerging trends driving the gluten-free market. Once seen as medical products for gluten intolerant people gluten-free products have evolved into "a lifestyle choice across all customer segments," says Brijesh Kumar Choubey, a lead food industry analyst at Technavio.
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    Just five to ten years ago, buyers of gluten-free foods were likely to be older. Today, younger consumers, specifically 32% of millennials, and 38% of Generation Z, said they would pay higher prices for gluten-free products.
    Bakery products, cookies and snacks are the top gluten-free foods among this consumer group, said Technavio.
    Driven by growing demand, and by new product development, the bakery segment leads the gluten-free packaged food market with 64% market share in 2014. Technavio predicts the segment will outpace the rest of the market through the end of 2019, growing at a rate of about 7%.
    Increased marketing activities from big and small manufacturers alike is the last key driver Technavio cites as a driver for gluten-free packaged food demand.
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    Source:
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    Jefferson Adams
    Celiac.com 08/11/2016 - In many ways, millennials are the special diet generation. To drive that point home, a new survey shows that a full one in five 18-34 year olds now have a food intolerance. That means 20% of millennials must either avoid certain foods, and/or eat special dietary foods to be healthy.
    So, while one in three consumers are actively avoiding gluten right now, that number rises to 40% with millennials.
    With the gluten-free market now worth GBP 210m, the Swedish bakers are calling upon chefs, caterers and operators to take a second look at their offerings. Andrew Ely, managing director at gluten-free cake maker Almondy, says that an in-house company survey confirms that more and more consumers are avoiding gluten, with three quarters of people having bought a gluten-free product in the last year.
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    Jefferson Adams
    Celiac.com 10/07/2016 - Sales of gluten-free products continue to rise, with global the market expected to approach $5 billion by 2021, up from $2.84 billion in 2014, according to a new report from Transparency Market Research.
    Analysts are projecting annual revenue growth of about 7.7% across the sector from 2015 to 2021. They also project that, by 2021, North America will become the fastest growing gluten-free market, though Europe still currently dominates with a 52.5% share. Rising consumer belief in the potential health benefits of gluten-free products is a main factor driving growth in the gluten-free market. That, together with more cases of celiac disease and/or gluten sensitivity, increased use of gluten-free products as a weight management tool. Also a major factor is the high demand for gluten-free bakery products, the largest category in the gluten-free market.
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    The move by manufacturers toward more gluten-free products is probably a wise one. Even though nearly half of consumers claim gluten-free food is a fad, nearly one-in-four consumers said they consumed gluten-free products last year, and the demand for gluten-free products shows no sign of slowing down.

    Jefferson Adams
    Celiac.com 01/27/2017 - US retail sales of gluten-free products rose 11% in 2015, and are predicted to rise a more modest 6% to $1.66bn in 2016, according to a new report from Packaged Facts, which predicts that as the market matures, growth rates are "expected to slow considerably."
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    Unlike some other market research reports, which include everything with a gluten-free label in their market definitions, even those product that typically contain no gluten, Packaged Facts does not. The Packaged Facts reports are notable because they focus more closely on traditionally grain-based product categories: Salty Snacks, Crackers, Fresh Bread, Pasta, Cold (ready-to-eat) Cereal, Baking Mixes, Cookies, Flour, and Frozen Bread/Dough.
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    The latest report notes that, while the market is maturing, it is still quite fragmented. Packaged Facts notes that only Hain Celestial and Pinnacle Foods have market shares exceeding 10%.
    Read more about the Packaged Facts report.

  • 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. 
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    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. 
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    Jefferson Adams
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    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.
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    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