• Join our community!

    Do you have questions about celiac disease or the gluten-free diet?

  • Ads by Google:
     




    Get email alerts Subscribe to Celiac.com's FREE weekly eNewsletter

    Ads by Google:



       Get email alertsSubscribe to Celiac.com's FREE weekly eNewsletter

  • Member Statistics

    72,029
    Total Members
    3,093
    Most Online
    Sharon Rye
    Newest Member
    Sharon Rye
    Joined
  • Announcements

    • admin

      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
  • 0

    FDA CLARIFIES GLUTEN-FREE RULES FOR RESTAURANTS


    Jefferson Adams

    Celiac.com 01/03/2014 - The United State Food and Drug Administration (FDA) has clarified what their recent gluten-free rule means for restaurants. When the FDA announced its gluten-free labeling standard in August, the agency said that, for restaurants, “any use of an FDA-defined food labeling claim (such as “fat free” or “low cholesterol”) on restaurant menus should be consistent with the respective regulatory definitions.


    Ads by Google:




    ARTICLE CONTINUES BELOW ADS
    Ads by Google:



    Amici's Gluten-Free MenuThe agency noted this same approach would now be followed with respect to “gluten-free” claims made in restaurants and other retail food service establishments.

    The FDA's updated Question & Answer, #9 under ‘Labeling’, now reads:

    FDA recognizes that compliance with the gluten-free rule in processed foods and food served in restaurants is important for the health of people with celiac disease.

    In August 2013, FDA issued final rule that established a federal definition of the term ‘”gluten-free” for food manufacturers that voluntarily label FDA-regulated foods as “gluten-free.”

    This definition is intended to provide a reliable way for people with celiac disease to avoid gluten, and we expect that restaurants’ use of “gluten-free” labeling will be consistent with the federal definition.

    The deadline for compliance with the rule is not until August 2014, although we have encouraged the food industry to bring its labeling into compliance with the new definition as soon as possible.

    Given the public health significance of “gluten-free” labeling, we encourage the restaurant industry to move quickly to ensure that its use of “gluten-free” labeling is consistent with the federal definition and look forward to working with the industry to support their education and outreach to restaurants.

    In addition, state and local governments play an important role in oversight of restaurants. We expect to work with our state and local government partners with respect to gluten-free labeling in restaurants. We will consider enforcement action as needed, alone or with other agencies, to protect consumers.

    For more information:


    0


    User Feedback

    Recommended Comments

    What is important here is more an education of food preparers. They may have an understanding of foods that are listed or considered gluten free and feel that is the end of the story. However, as we all know so well, unless the AREA prepared or cooked in/on is also gluten free - free from cross contamination - then gluten intolerant patrons will undoubtedly still get sick. This component seems unlikely to be easily resolved as so many lower level preparers are totally unfamiliar with what celiac - or even - gluten is....

    Share this comment


    Link to comment
    Share on other sites
    Guest Lula D. Whitield

    Posted

    I felt the article was excellent. I am patiently waiting for all restaurants to start severing gluten free food. Some do now but their choices are very limited.

    Share this comment


    Link to comment
    Share on other sites
    Guest Tracy Grabowski

    Posted

    Education is the key to getting these establishments on board with appropriate gluten free labeling. These establishments could also serve to profit from being recognized as a "safe" place to eat for gluten-free consumers.

     

    Unfortunately, I don't believe that most restaurants and bakeries understand the importance of the integrity they must have from storage to preparation and all the way through serving the meal or product when they say something is "gluten free."

     

    I have personally seen bakeries label something gluten free. And, the item is sitting right next to "traditional" bakery. Cross-contamination issues are hugely important to recognize as well.

    Share this comment


    Link to comment
    Share on other sites

    I really enjoy the latest up to date information that you put out here for the celiac world. Thanks!

    Share this comment


    Link to comment
    Share on other sites
    Guest Gayle a Weber

    Posted

    Cross contamination is a huge deal in restaurants. I should not have to ask that my food be cooked separately if I say first that I'm extremely sensitive to gluten but apparently, I do.

    Share this comment


    Link to comment
    Share on other sites
    Guest P. Austin

    Posted

    I just got off the phone from talking with the FDA regarding their gluten-free regulations for restaurants. They told me, point blank, that although there is a write up about the FDA expecting restaurants to follow suite with the labeling and packaging regulations, that they do NOT regulate restaurants and that the FDA gluten-free regulations are not mandatory for restaurants. All restaurant regulations are entirely up to individual states.

    Share this comment


    Link to comment
    Share on other sites


    Your content will need to be approved by a moderator

    Guest
    You are commenting as a guest. If you have an account, please sign in.
    Add a comment...

    ×   Pasted as rich text.   Paste as plain text instead

      Only 75 emoticons maximum are allowed.

    ×   Your link has been automatically embedded.   Display as a link instead

    ×   Your previous content has been restored.   Clear editor

    ×   You cannot paste images directly. Upload or insert images from URL.


  • Popular Contributors

  • Ads by Google:

  • Who's Online   11 Members, 0 Anonymous, 502 Guests (See full list)

  • Related Articles

    admin
    The following was a post from Merete Askim regarding the avoidance of the contamination of foods during the manufacturing process. If you have any questions regarding it, direct them to him at: Merete.Askim@INF.HIST.NO.
    My name is Merete Askim, and I am a College Lecturer at the Department of Food Science, Soer-Tronedelag College, Trondheim, Norway. In my teaching in nutrition and food chemistry, I am very interested in food allergy and intolerance. My students get jobs as food technologists, so it is important for them to be aware of food allergy and intolerance.
    I have invented a new concept which I call ALLERGY-HYGIENICS.
    This combines both the aspects of avoiding contamination by:
    Harmful Bacteria Ingredients Not Meant to be Part of the Food in Question A traditional concept in industrial food production is called HACCP (Hazard Analysis Critical Points), which is concerned primarily with bacterial contamination. My new concept ALLERGY-HYGIENIC improves upon HACCP, by adding the concept of consideration of allergic and intolerant ingredients, either directly through insufficient consideration of the impact of an ingredient on the population, or inadvertently through contamination by ingredients not meant to be part of the food in question.
    We teach the students to start the analysis of food production with the least complex product, and end with the most complex, to have knowledge of every ingredient, down to the smallest, including the food-additives.
    For example, some firms use vacuum tubes to deliver ingredients from storage facilities to their production machinery. If a gluten free product is being made, and the tube used to deliver rice flour was previously used to deliver wheat flour, there is likely cross-contamination which cannot be removed by simply cleaning the final production machinery. The tube itself would have to be cleaned out, or the facility would have to be designed so that gluten free flours are never transported in tubes which at other times contain gluten.
    Another example is when a dairy produces both "strawberry-yogurt" and "raspberry -yogurt" on the same day, the ALLERGY-HYGIENIC concept is to avoid any strawberry contamination in the raspberry product, or vice versa.
    Our goal is that all products will eventually have ALLERGY-HYGIENIC qualities!
    But we know this takes time and can be expensive in some occasions. It is a new concept in the traditional way of hygienic thinking. Even with ALLERGY-HYGIENICS, we can not guarantee no contamination, but we are attentive, and take our precautions.
    At our Department of Food Science, Trondheim, Norway, want this new concept ALLERGY-HYGIENIC to catch-on all over the world, and become common knowledge. So please tell others, and if you dont mind, remember that it was created here.
    When you are in contact with the food-industry, you might ask them:
    Is your production in accordance with ALLERGY-HYGIENIC principles? Have you taken ALLERGY-HYGIENIC considerations in your production? If you find this concept useful, please let me know by private email. I would also be interested in your experiences as Celiacs with locating cross-contamination in foods. By cataloging your real-life experiences in the field, I can help my students and their companies determine likely problematic areas in food production.
    Merete Askim: Tel (work): 47 73 91 96 25
    N-7004 Trondheim, Norway

    admin

    Celiac.com 12/19/2003 - In a press release dated November 24, 2003, FDA Commissioner, Mark B. McClellan, M.D., Ph.D., applauded the Senate Health, Education, Labor and Pensions Committee reporting out several health-related bills. Among the bills unanimously approved by the Committee was S. 741, a bill that includes the proposed Food Allergen Labeling and Consumer Protection Act of 2003. Action by the Committee took place on November 21. I wish to thank the Committee Chairman Senator Judd Gregg, Ranking Member Senator Edward Kennedy and the rest of the Committee members for taking these actions, Dr. McClellan said, and I look forward to continuing to work with the members of both houses of Congress toward the enactment of these bills.
    The Food Allergen Labeling and Consumer Protection Act will provide improved food labeling to better inform consumers who suffer from food allergies.
    Having the endorsement of the FDA will be key as we look ahead to floor action by the full Senate in early 2004.
    Andrea Levario
    Co-Chair, American Celiac Task Force

    admin
    Celiac.com 01/31/2006 – On Tuesday, January 10, 2006, federal authorities raided French Meadow Bakery in Minneapolis, MN, and seized more that 30,000 loaves of spelt and kamut bread and accused the company of mislabeling it as "wheat-free". According to U.S. Attorney Thomas Heffelfinger spelt and kamut share common proteins with wheat that can be just as dangerous to those who are allergic to wheat. French Meadow Bakery considers both grains to be safe alternatives to wheat, and claims that it has only received a single complaint of an allergic reaction during its 16 years in business. According to the U.S. Food and Drug Administration the bakery was given plenty of forewarning, as it was told last April that it needed to change its labels and not use "wheat-free" on any products that contain spelt or kamut—but the bakery failed to comply. Wheat is considered one of the top 10 allergens, and allergies to it can be life threatening—especially to allergic children. According to the new Food Allergen Labeling and Consumer Protection Act, foods that contain spelt or kamut cannot carry "wheat-free" or "wheat-alternative" labels. Heffelfinger believes that mislabeling it will create a serious health risk for a significant portion of the population.
    French Meadow Bakery has agreed to change its labels and has submitted the revised ones to the Food and Drug Administration for approval, however, on its Web site they have the following statements:
      "In the meantime the packaging changes have become a challenge for us and several other companies as to whether spelt is wheat or is not...We feel it is more important to look at the nutritional and digestive properties since it (spelt) is not a hybrid of what we call wheat today...We are not alone in this, after reviewing our fellow bakers Web sites, (Rudis Bakery and Food for Life) we learned that they too call Spelt a wheat alternative...Our intention has not and is not to risk the health of our valued customers...As an example of this, we state on our White Spelt and Cinnamon Raisin Spelt products a warning: CELIACS NOTE: SPELT CONTAINS GLUTEN."   Celiac.com has also just learned that Purity Foods, a major spelt producer, has applied for an exemption from the Food Allergen Labeling and Consumer Protection Act and in it claim that spelt is not wheat, and that some people who are allergic to wheat can tolerate spelt. However, according to Donald D. Kasarda, Former Research Chemist for the United States Department of Agriculture:
      The scientific name for bread wheat is Triticum aestivum var. Aestivum—the first part of the name defines the genus (Triticum) and the second part, the species (aestivum). Species falling in the genus Triticum are almost certain to be harmful to celiac patients...Some Triticum species of current concern include Triticum aestivum var. spelta (common names include spelt or spelta), Triticum turgidum var. polonicum (common names include Polish wheat, and, recently, Kamut), and Triticum monococcum var. monococcum (common names include einkorn and small spelt). I recommend that celiac patients avoid grain from these species. Also, given their very close relationship to bread and durum wheats, I think it is unlikely that these grains would be safe for those with classical allergic responses to wheat. The companys bread will remain frozen until the case is settled, and Heffelfinger has indicated that none of the products already on food store shelves across the country will be recalled because the bread would likely exhaust its shelf life by the time a recall could be issued. Celiac.com, however, believes that this issue is settled—spelt and kamut are forms of wheat and those with celiac disease and/or wheat allergy should completely avoid them—there are just too many alternative grains out there to take such health risks. We can only hope that Purity Foods application for exemption will be met with strong, scientifically-supported opposition.

    Jefferson Adams
    Celiac.com 07/20/2012 - Many of the millions of Americans who suffer from celiac disease and gluten-intolerance are eagerly awaiting the FDA's forthcoming standards for gluten-free product labeling. Until then, different agencies may apply differing standards, often with confusing results.
    The recent dust-up between Widmer Bros. brewing of Oregon, one of many breweries crafting gluten-free beers, and the Treasury Alcohol and Tobacco Tax and Trade Bureau ("TTB") over the ingredients in Widmer's gluten-free brew, provides a good illustration of the confusion that can arise when different sets of standards and rules govern what can and cannot be called 'gluten-free.'
    Widmer Bros. is a division of Craft Brew Alliance (CBA), the nation’s ninth’s largest brewing company, and recently unveiled two new gluten-free beers, Omission Gluten Free Lager and Omission Gluten Free Pale Ale. Unlike most gluten-free beers, which are brewed from sorghum and usually taste very different than traditional beers, Omission is made using traditional ingredients, including barley--which contains gluten.
    Widmer then uses enzymes to reduce the gluten in both beers to a level that is well below the 20 parts per million (ppm) gluten threshold set by the World Health Organization for gluten-free products; the very standard likely to be followed soon by the FDA. Professional testing show gluten levels for Omission beers at just 5-6 ppm. Meanwhile, those familiar with the final products say they taste very much like traditional beers.
    However, it is not the gluten levels in the beer that seems to be at issue, but the fact that Widmer begins their brewing process with barley and other traditional ingredients. According to the TTB, wine, beer or distilled spirits made from ingredients that contain gluten cannot be labeled as ‘gluten-free.’
    Certainly the commonly accepted European standard of 20 ppm means that the vast majority of products labeled 'gluten-free' still contain measurable levels of gluten, a good deal of those likely above the 5-6 ppm of Widmer's beers.
    For beer drinkers with celiac disease, finding a gluten-free beer that tastes like a traditional beer is like finding the Holy Grail. Given that Omission beers supposedly taste closer to traditional beers than most gluten-free beers currently on the market, and given that they come in well below the standard for products to be labeled gluten-free, there are undoubtedly a number of people with celiac disease and gluten-intolerance that are hoping Widmer will prevail in their battle against the TTB.
    What do you think? Should the gluten-free standard be based on scientifically established gluten levels of the final product, or on the gluten levels in the ingredients originally used to create it? Should Widmer be allowed to label and sell their Omission beers as 'gluten-free?'
    Source:
    KXL.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