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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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    WHY IS SUBWAY CANADA'S GLUTEN-FREE BREAD ONLY AVAILABLE FOR A LIMITED TIME?


    Jefferson Adams


    • Subway announces gluten-free buns at all stores in Canada. But only for a limited time? Is the company trolling us?


    Celiac.com 12/15/2017 - Is this some kind of cruel trick? As Subway makes a major announcement touting a gluten-free bread option in its restaurants across Canada, it offers a small disclaimer that the gluten's only going away for a limited time.


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    For a limited time? What? Subway is the first fast food restaurant to carry gluten-free bread throughout Canada, but it will only do so "for a limited time?" You got that right. In plain text, clear as day, the Subway press release says that the company will offer its gluten-free option across Canada "for a limited time." Does that mean it will be permanent in some places and not in others? Does it mean they will bring the entire promotion to an end at some point?

    What does this mean for customers? What does it mean for people with celiac disease and gluten intolerance?

    In the short term, I guess it means get you're Canadian, and gluten-free, and looking for a gluten-free sub, Subway has you covered. For how long exactly? Stay tuned.

    Read more at: Restobiz.ca


    Image Caption: Photo: CC--Mike Mozart
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    Guest Michelle

    Posted

    Does it matter that Subway has gluten free buns? Their food is in NO WAY safe for celiacs. crumbs get into all of the food containers, because they cut buns right beside them, and they use the same gloves to touch all the food. If you eat there (even if it's just a salad) you are at high risk of gluten contamination.

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    Guest Scott Adams

    Posted

    Does it matter that Subway has gluten free buns? Their food is in NO WAY safe for celiacs. crumbs get into all of the food containers, because they cut buns right beside them, and they use the same gloves to touch all the food. If you eat there (even if it's just a salad) you are at high risk of gluten contamination.

    I've eaten at Subway in Oregon and had zero issues. If you tell them to be extra careful because you are celiac, they are trained to respond and do that. Of course everyone must make their own choices and assess their own risks.

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    Subway may be using it as a test item to see what kind of sales it generates before making it a permanent item. I personally would be a bit hesitant to order at Subway, I would definitely check if they were trained on cross contamination first.

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    Even the US chains don't all offer the gluten-free rolls. We have quite a few franchises in my area and NONE of them offer them. I went in and asked about them at one store last week and was told I was the 3rd or 4th person to do so in the last couple of weeks. It is so easy for them to do since they can be kept frozen until needed. They did tell me they were going to talk to management about it took my name and number to contact me. I have heard nothing yet.

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    Guest Ella Jeans

    Posted

    I totally agree Michelle. I've eaten there a few times and been glutened every time. Even though they changed their gloves and wiped the cutting board and knife, all the food closest to them has bread crumbs on it. I wrote a letter to Subway Canada but have yet to hear back from them.

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    Guest Scott Adams

    Posted

    I totally agree Michelle. I've eaten there a few times and been glutened every time. Even though they changed their gloves and wiped the cutting board and knife, all the food closest to them has bread crumbs on it. I wrote a letter to Subway Canada but have yet to hear back from them.

    If you ask they will pull separate ingredients out of the refrigerator that are stored separately. The roll is wrapped separately too, and they made mine on the sandwich paper, not the counter. They seemed to know what they were doing when I told them I had celiac disease. I've never had an issue in the Oregon stores.

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    Guest Ella Jeans

    Posted

    If you ask they will pull separate ingredients out of the refrigerator that are stored separately. The roll is wrapped separately too, and they made mine on the sandwich paper, not the counter. They seemed to know what they were doing when I told them I had celiac disease. I've never had an issue in the Oregon stores.

    Scott.... it's different in the US than it is here in Canada. There aren't that many with celiac disease or intolerance per capita here so it's not as easy to find truly trained personnel or major food chains that are able to be totally gluten free. They tend to be gluten friendly and you eat at your own risk.

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    Guest Scott Adams

    Posted

    Scott.... it's different in the US than it is here in Canada. There aren't that many with celiac disease or intolerance per capita here so it's not as easy to find truly trained personnel or major food chains that are able to be totally gluten free. They tend to be gluten friendly and you eat at your own risk.

    Of course, cross contamination can occur, but it is my understanding that Subway IS training their workers to avoid this, especially for those of have celiac disease.

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    I would not trust a "gluten-free" bread from any chain, it is just too easy for someone to be careless and touch regular bread and the gluten-free food without realizing it. I have watched Subway sandwiches being made, and I won't even order "salad style" because I see what they do - they use the same pair of gloves to prepare the entire sandwich, so if the guy ahead of me has hot peppers, regular bread, etc. then with each ingredient they add to his order, they are contaminating every bin with the previous items. I have multiple food issues, so no thanks, I'll pack and eat my own.

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    Guest Johanne

    Posted

    Restaurants want to capitalize on the gluten-free opportunity, but fail to do it properly, their way of dealing with it is to put a disclaimer about cross-contamination. If they truly cared they would setup a designated area and have individual packages for the other gluten-free products. I see it on not as a cash grab! If they were seriously committed to serving the growing celiac community they invest to doing it correctly!

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    Guest Jefferson

    Posted

    I would not trust a "gluten-free" bread from any chain, it is just too easy for someone to be careless and touch regular bread and the gluten-free food without realizing it. I have watched Subway sandwiches being made, and I won't even order "salad style" because I see what they do - they use the same pair of gloves to prepare the entire sandwich, so if the guy ahead of me has hot peppers, regular bread, etc. then with each ingredient they add to his order, they are contaminating every bin with the previous items. I have multiple food issues, so no thanks, I'll pack and eat my own.

    Did you read the Press Release? Here's an excerpt: "The gluten-free bread from Subway is produced and packaged in a gluten-free facility. Subway Canada also carries a variety of proteins, toppings and sauce options that do not contain gluten. ‘Sandwich Artists' take steps when preparing orders to minimize possible cross-contamination." Can they guarantee it? No. But they do seem to be taking their responsibility seriously.

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    Jefferson Adams
    Celiac.com 09/08/2011 - What started in January as a quiet and limited campaign by Subway to test gluten-free rolls and brownies in the Dallas market, then spread to a few Portland outlets, has rapidly grown into a plan to include more than 500 stores.
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    Source:

    http://www.qsrweb.com/article/183399/Subway-expands-gluten-free-test

    admin
    Celiac.com 08/14/2015 – Recently I took a last minute, end of Summer road trip with my family and on one of our pit stops I was delighted to discover the often rumored, highly elusive and possibly "Holy Grail" of gluten-free food: Subway's gluten-free sub rolls! Yes, I am here to tell you that they do indeed exist, even though I almost couldn't believe it even when I saw them—but there they were...a whole stack of six inch long gluten-free Subway rolls—sitting right in front of me in tidy, individually wrapped cellophane packages.
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    Source:
    cnbc.com

    admin
    WHAT IS CELIAC DISEASE?
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    NO SYMPTOMS
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    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