Both Haverford College and Bryn Mawr College have created dedicated, exclusively gluten-free dining areas for their students with celiac disease or gluten intolerance, according to a report by Campus Reform.

Bryn Mawr opened their gluten-free dining area in 2013, and Haverford followed in 2014.

The exclusive eating areas are the brainchild of Bernie Chung-Templeton, executive director of dining services at both schools.

Each of the gluten-free dining areas has signage clearly warning students to refrain from bringing in food from outside, including the main school cafeteria.

What do you think? Do students with celiac disease or gluten intolerance deserve dedicated, exclusively gluten-free dining options?

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Celiac.com 06/19/2015 - And the biggest gluten-free diet cheats are? Men.

According to a recent survey commissioned by U.K.-based gluten-free bread company Newburn Bakehouse, gluten-intolerant men feel stigmatized by their dietary restrictions, which leads them to cheat on their diets far more commonly than women. 

The survey showed that 36 percent of U.K. men sensitive to gluten in food regularly cheat, even though cheating can have adverse health consequences.

Moreover, one in five of those surveyed said they believe a gluten-free diet is “not for real men.”

This makes for some fairly large numbers of male gluten-free diet cheats.

Studies by the University of Maryland Center for Celiac Research show that about 6 percent of the U.S. population suffers from some degree of gluten intolerance, while about 1 percent has celiac disease.

How about it? Do you or any males you know have celiac disease or gluten intolerance? Do you or they cheat of a regular basis? Share your thoughts below.

However, a new study reveals that many popular probiotics actually contain traces of gluten, which is worrying for people who may have celiac disease or gluten intolerance.

Researchers at the Celiac Disease Center at Columbia University Medical Center used a detection technique called liquid chromatography-mass spectrometry to analyze 22 popular, high-selling probiotics and measure gluten content. The team found that more than half of them (55%) contained gluten, including products labeled "gluten-free," according to research presented on May 16 at Digestive and Disease Week in Washington DC.

For reasons doubtless including liability, the team did not list the names of the brands or products they tested. It is safe to assume that these would include major, easily accessible brands.

These revelations may be unsurprising, given recent reports about gluten contamination in dietary supplements.

So, if you have celiac disease or gluten intolerance, and take probiotic supplements, be sure to double-check your products; they may contain traces of gluten.

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Not following a gluten-free diet, on the other hand, can result in serious complications associated with malabsorption.

When celiac disease goes untreated, when people who have celiac disease refuse to follow a gluten-free diet, chronic gluten-related inflammation and damage impairs absorption of nutrients, and likely causes malabsorption of oral medications.

Malabsorption resulting from damaged mucosa can lead to:

1. Nutritional deficiencies of the fat-soluble vitamins A, D, E, and K, as well as the B vitamins, thereby diminishing the absorption of iron, calcium, and folic acid. Nutritional deficiencies can lead to:
2. Iron-deficiency anemia refractory to oral iron supplementation, and potentially osteoporosis and osteopenia due to bone loss due to decreased calcium and vitamin D absorption. A combination of nutritional deficiencies and the damaging effects of systemwide chronic inflammation can cause:
3. Reproductive abnormalities, such as delayed puberty, secondary amenorrhea, infertility, or decreased fertility. Adverse immune responses to gluten ingestion can trigger other common manifestations, such as:
4. Dermatitis herpetiformis, a papulovesicular rash. Beyond that, problems can include:
5. Fractures secondary to low bone mineral density. In some cases, untreated celiac disease can lead to intestinal malignancies such as:
6. Intestinal T-cell lymphomas.
7. Small-bowel adenocarcinoma.
8. Esophageal cancer.
9. B- and T-cell non-Hodgkin lymphomas.

Rapid, proper diagnosis and effective treatment of celiac disease are crucial to preventing a cascade of related problems that can further impair diagnosis, and cause irreparable damage to patient health.

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Celiac.com 05/29/2015 - On Thursday, May 7, Dateline featured Tom Brokaw's journey with multiple myeloma, a serious blood malignancy that develops in bone marrow.

Now an author of a recent book on gluten and health is saying that Brokaw's cancer may be linked to adverse gluten reactions.

Numerous cancers, including non-Hodgkin's lymphoma, throat/esophageal, stomach/intestinal/colon, and multiple myeloma are now being connected to gluten consumption, says Anne Sarkisian, author of "Toxic Staple: How Gluten May Be Wrecking Your Health — And What You Can Do About It!!"Â

Scientific research suggests that multiple myeloma may be linked to gluten, says Sarkisian, "and thousands of scientific studies from around the world link gluten to over 300 symptoms, diseases, and associated conditions."Â

"Early detection of celiac disease is vital to reducing complications such as lymphoma and many other cancers and diseases. Does this mean a gluten-free lifestyle is preventative medicine? More alternative medical experts advocate this approach,"Â says Sarkisian.

Could Brokaw's multiple myeloma be related to gluten? Possibly. Sarkisian's claim sounds good, and may be true, but, at the end of the day, there's just no way to know for sure.

It is true that early detection of celiac disease is vital to reducing complications such as lymphoma and many other cancers and diseases, and it is also true, as Sarkisian asserts, that "More alternative medical experts advocate this approach [a gluten-free diet],"Â for many people without celiac disease. 

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If you suffer from any of the 10 Most Common Complaints of Celiac Patients, you might want to consider the possibility of celiac disease.

Most doctors, however eager they may be to render proper treatment, are bound by clinical treatment protocols and guidelines that limit the circumstances under which they can order blood screens for celiac disease.

So, when should doctors test people for celiac disease? According to the American College of Gastroenterology's (ACG) clinical guideline on diagnosis and treatment of celiac disease, people should be tested for celiac disease if they have:

1. Signs and symptoms of malabsorption, including chronic diarrhea with weight loss, steatorrhea, abdominal pain after eating, and bloating.
   Or
2. Laboratory evidence of malabsorption, particularly in people who have a first-degree family member with a confirmed celiac disease diagnosis. This includes associated nutritional deficiencies.
   Or
3. A personal history of an autoimmune disease, or an IgA deficiency.
   Or
4. Biopsy-proven DH, iron-deficiency anemia refractory to oral supplementation, or hypertransaminasemia with no other origins.

It's interesting to me that the above guidelines don't match up very well with the top ten physical complaints of people who have celiac disease. Those complaints are: Osteopenia/Osteoporosis; Anemia; Cryptogenic hypertransaminasemia; Diarrhea; Bloating; Aphthous stomatitis; Alternating bowel habit; Constipation; Gastroesophageal reflux disease and Recurrent miscarriages.

What do you think? Do doctors need to have more freedom to conduct blood screens when considering the possibility of celiac disease?

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Celiac.com 05/22/2015 - The fact that celiac disease is commonly misdiagnosed will come as little surprise to anyone who's ever gone through what can often be a long, circuitous process of getting diagnosed. Celiac symptoms can be vague, and can mirror symptoms of numerous other conditions.

Even though celiac awareness is improving, and blood screens are becoming more common, misdiagnosis remains common for people who are eventually diagnosed with celiac disease.

Can you guess the most common misdiagnoses that doctors make for patients with celiac disease?

The most common misdiagnoses include:

1. Irritable bowel syndrome: People with celiac disease are often told that they have irritable dowel syndrome when they actually have celiac disease. In fact, IBS is the most common misdiagnosis for people with celiac disease.
2. Inflammatory bowel disease: Coming in a close second to IBS, inflammatory bowel disease is another common misdiagnosis for people who actually have celiac disease.
3. Gastro-esophageal reflux disease: People with GERD don't have any higher rates of celiac disease than the rest of the population. However, to be fair, a pretty high percentage of newly diagnosed celiac patients have reflux and/or esophageal dysmotility; which might explain the high prevalence of reflux symptoms in celiac disease patients, and the common misdiagnosis of GERD.
4. Ulcers: Ulcers are often wrongly suspected, well before celiac disease is finally diagnosed.
5. Viral gastroenteritis: Another very common thing doctors suspect long before they suspect celiac disease, is viral gastroenteritis.
6. Chronic fatigue syndrome: Fatigue is a common complaint of many people with celiac disease, so maybe it's understandable why many people with celiac disease find themselves with a misdiagnosis of chronic fatigue, rather than an accurate diagnosis of celiac disease.
7. Allergies: Many people find themselves wrongly diagnosed with environmental allergies long before they are diagnosed with celiac disease.
8. Parasitic infection: Celiac disease symptoms can mirror symptoms of certain gut parasites, which is one reason that many people with celiac disease find themselves being checked for parasites long before they get checked for celiac disease.
9. Gallbladder disease: Celiac disease symptoms can mirror symptoms of gallbladder disease, which is why many people who actually have celiac disease find themselves diagnosed with gallbladder problems.
10. Colitis: Another common culprit for misdiagnosis is colitis, which shares many symptoms with celiac disease.
11. Cystic fibrosis: Many people don't realize that in a number of cases, the symptoms of celiac disease can lead doctors to suspect cystic fibrosis, rather than celiac disease, thus prolonging diagnosis, treatment and recovery.
12. Psychological dysfunction: In many cases, celiac disease symptoms can be so hard to pin down that doctors find themselves wondering if the symptoms aren't really in the patient's head. In their quest for diagnosis, many people with celiac disease have been referred to a psychologist, rather than evaluated for celiac disease.
13. Lactose intolerance: Lactose intolerance is a common misdiagnosis in celiac patients, because the mucosal damage from gluten leaves them unable to digest lactose-containing products.

In addition to being frustrating and painful, misdiagnosis of celiac disease is a big deal because, left unaddressed, the damage done by the disease continues unabated, and can snowball into further health and wellness problems.

Have you, or anyone you know, suffered through misdiagnosis before being diagnosed with celiac disease? Share your story in our comments section.

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Here are five important things to remember about celiac disease:

1. Tiny Amounts of Gluten Trigger Big Reactions
   For people with celiac disease, exposure to as little as 30 to 50 mg of gluten (about 1/50th the size of a slice of bread) on any given day can trigger damage to the mucosal lining of the small intestine.
2. Nutritional Deficiencies are Common
   Many people with celiac disease, even those who avoid gluten, suffer from nutritional deficiencies. Doctors recommend that people with celiac disease be monitored regularly for nutritional deficiencies, especially vitamins A, D, E, and B12, carotene, copper, iron, folic acid, magnesium, selenium, and zinc. Doctors recommend vitamin and mineral supplementation, as needed.
3. Bone Loss and Weakness are Common
   People with celiac disease should receive regular screening for osteopenia or osteoporosis. If needed, they should receive calcium supplements to ensure that they are getting the recommended dietary allowance for calcium.
4. Nutritional and Drug Malabsorption are Common
   Gluten reactions cause inflammation in the small-intestine and, over time, damage that decreases absorption of common dietary nutrients, and likely promotes malabsorption of oral drugs or medicines, as well. That’s why it’s important for people with celiac disease to be monitored for proper drug and nutritional levels, and to receive supplements as needed.
5. Celiac Disease Can Impair the Effectiveness of Certain Drugs
   Based on their molecular properties, drugs currently under investigation for their absorption characteristics in gluten sensitivity include acetaminophen, aspirin, indomethacin, levothyroxine, prednisolone, propranolol, and certain antibiotics. Please check with your doctor before taking any of these drugs.

Celiac.com 05/14/2015 - A few years ago I ceased writing about the SCD (Specific Carbohydrate Diet) here on celiac.com because I feared I might be an impostor.  I was never formally diagnosed as celiac by way of a biopsy, and despite bloating, night rashes, brain fog, unpredictable bowel habits and headaches the main cause was identified as IBS (Irritable Bowel Syndrome). Still, the old shoe fit, because every time I tried to behave like a non-celiac, I got ill, very ill.

Finally in 2010 during a routinely scheduled colonoscopy, a large polyp was discovered that could only be effectively removed via a surgical resection. The intestine is like a long garden hose and I only have half the previous length left.  Recovery was slow and difficult and I had barely been able to eat anything in hospital, so once home, I started the SCD all over again with the three day strict introductory regimen and had to reintroduce previously tolerated foods very gradually.

When I was completely recovered, I decided that after so many years of restriction and without a formal diagnosis it was easy to use the excuse that it was in my head more than in my tummy.  But you can't defy reality and the result was, and is, a re-commitment—a spiritual and digestive reawakening—combined with awareness of what today's expanded food culture is doing to us health-wise (more like unwise!).

Some interesting things have been happening in the greater world of food and nutrition.  More and more reliable sources realize that the evolution of food products and eating habits over the past five decades is making too many people obese and/or ill.  I also discovered I have a food addiction and consequently am rededicated to being even more creative and imaginative about satisfying meal preparation. Good to know that pop culture is in my corner. 

Hello and "Bravo" to TV reality shows about cooking and home renovation. With no house to flip, no kitchen island to install, I am doing my fixer upper and making SCD cooking more enjoyable than ever with newer concoctions than I created before the surgery.  So, I'm back, avoiding food boredom and self pity, being good to myself and good for myself, and happy to encourage others to deal with their gastric issues. Now we are the envy if the food world. The ultimate irony of having been made to feel different is that gluten-Free has become almost a fad—often adopted by people who don't need to be gluten-free (present company definitely excluded)!

BTW: I am now 84.

Because chronic gluten-related inflammation and damage impairs absorption of nutrients, and likely causes malabsorption of oral medications, it is extremely important for people with celiac disease to review the nutrition labels of all foods and beverages, as well as the package inserts (PI) for information about gluten content.

Most oral medications depend on absorption through the small intestine via passive diffusion. GI-tract damage may shift this diffusion process into systemic circulation, which can result in increased or decreased absorption, depending on the drug molecules.

Since drug molecules have varying and unique chemical properties, it is hard to determine the exact means of drug absorption in celiac patients, and also hard to determine the impact of celiac disease on drug absorption.

Based on their molecular properties, researchers suspect the absorption of a number of drugs is impaired by gluten sensitivity.

These drugs include: acetaminophen, aspirin, indomethacin, levothyroxine, prednisolone, propranolol, and certain antibiotics.

For these reasons, it is important for doctors to monitor serum drug levels for medications with narrow therapeutic indexes in people with celiac disease. If you have celiac disease, please let your doctor know before you take these drugs.

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The study was conducted by a team of researchers headed by I. Aziz of the Department of Gastroenterology in Royal Hallamshire Hospital at Sheffield Teaching Hospitals in Sheffield, UK. The team also included M.A. Karajeh, J. Zilkha, E. Tubman, C. Fowles, and D.S. Sanders.

The team set out to measure any changes in awareness of gluten-related disorders among the general public, and among chefs. To do so, they compared results from face-to-face questionnaires on celiac disease and gluten sensitivity on the general public and chefs based in Sheffield, UK. The survey was conducted in 2003, and repeated in 2013. They compared the results from the 265 chefs in 2013 against results from the 322 chefs in 2003.

Whereas in 2003 the public were significantly more aware of gluten-related disorders than chefs, by 2013, rates of awareness in the groups were about equal. The 2003 group was 85% male, with a mean age 37.6 years old. The second group was younger at 27.1 years, on average, and more evenly mixed, with 38% women.

Overall, the results showed a significant increase in chefs' awareness of gluten-related disorders from the years 2003 to 2013. Awareness of celiac disease had risen from a dismal 17.1% in 2003 to a respectable 78.1% in 2013 (adjusted odds ratio (AOR) of 12.5; 95% CI 7.9-19.6). For Gluten Sensitivity, awareness had climbed from a mere 9.3% in 2003 to 87.5% in 2013 (AOR 65.7; 95% CI 35.4-122; P<0.001).

The survey also showed that 44% of the public and 40% of chefs (P=0.28) properly recognized the official gluten-free symbol.

There has been a marked increase in both the public's and chefs' awareness of gluten-related disorders. Hopefully, this awareness will translate into better, safer gluten free offerings for people with celiac disease and gluten-sensitivity.

Find further reading, including hard numbers from the survey, in the European Journal of Gastroenterology and Hepatology.

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Celiac.com 05/06/2015 - Gluten is a common ingredient in many commercial food products. Less commonly known, however, is that many manufacturers use gluten as an inert ingredient in such products as medications, supplements, and vitamins. For people with celiac disease, exposure to as little as 30 to 50 mg of gluten per day can damage the mucosa of the small intestine. So, it is important to know the gluten content of prescription and nonprescription medications, even though a lack of labeling laws can make it challenging to find products that are gluten-free.

Given the lack of resources to verify the gluten content of prescription and non-prescription medications, it is best to check with the manufacturer. Your pharmacist can help make the process a bit simpler than doing it yourself. There are three things you and/or your pharmacist can do to determine the gluten status of any prescription drug. First is the use of a package insert (PI). You or your pharmacist can use the PI to review drug formulations, and find contact information for pharmaceutical manufacturers.

Gluten is used in numerous medications, supplements, and vitamins, often as an inert ingredient known as an excipient. For prescription medications, the PI should include a detailed listing of excipients; however, if this information is not readily available, the FDA provides drug labeling information for prescription and some OTC medications at DailyMed (dailymed.nlm.nih.gov). 

For non-prescription products, there often is nothing in the PI regarding gluten content, which means you will likely need to check with the manufacturer to be sure.

Second, you or your pharmacist can visit company websites to help determine whether a medication potentially contains gluten.

Third, you can find manufacturer contact information on the product or its packaging, by conducting an Internet search using the manufacturer's name, or by accessing online drug-information resources such as Clinical Pharmacology, Facts & Comparisons, and Martindale. When requesting information from a manufacturer, it is helpful to provide the lot number.

Recent research by Mangione and colleagues showed that information about the gluten content of non-prescription products is usually available and easy to access through the manufacturer.

Fourth, there are some third-party websites, such as Open Original Shared Link, which is maintained by a clinical pharmacist, contains a detailed chart listing selected brand and generic medications that are gluten-free, as well as those free of lactose or soy. However, this is not a comprehensive or definitive list of products, as ingredients and formulations can change from lot to lot in the manufacturing process.

Lastly, Open Original Shared Link, the Celiac Disease Foundation offers a variety of resources and provides information on the treatment of celiac disease, tips on living gluten-free, and support-group contact information.

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