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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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Hi to any & all who read my post, and an advanced thank you to those who reply,

 

     My post may be kind of robust & lengthily, but please read until the end if you are able. To give a sort of "back story" here, I'll explain my situation in a nutshell. In November of 2014 I was diagnosed with a gluten intolerance by my allergist after recurrent, severe mouth ulcers and a bodily rash. I had a blood allergy panel, but NOT a Celiac specific panel, which ruled out other food allergies completely - corn, pea, chickpea, chicken, tomato, egg, milk, etc. My allergist suggested a gluten-free diet, which I adopted & have been adhering to since then. Recently, I've been acutely sick since August of 2016, so we're talking a year plus now. My symptoms began with a burning abdominal sensation, pain after eating, premature and uncomfortable full feeling, bloating, etc. My internist referred me to my current GI doctor where I was diagnosed with GERD (chronic acid reflux) , and prescribed Omeprazole, which I still take daily. My next appointment in February had me still feeling awful & my GI doctor decided to perform an upper endoscopy, which I did in March. He was looking for ulcers, evidence of bleeding or infectious disease, and Celiac. Mind you, I had informed him that I've been eating strictly gluten free for almost three years now. He claimed this really didn't matter? This has left me wondering. Anyway, the results came up empty, but I was found to have evidence of gastritis. Then came the rest of my symptoms - frequent diarrhea, bloody diarrhea, extremely greasy stools, stools that float, mucus in stools, unable to "wait" to use the bathroom (I.e. Urgency), alternations of diarrhea and constipation, weight loss, low grade fever, EXTREME fatigue, poor concentration, memory loss, cognitive decline, and my mouth sores have reared their ugly head once again. After I first went gluten-free, the ulcers probably cleared up for a good year at least, which was heaven on earth for me. Now, they're back with a ruthless vengeance. As we speak, I've barely recovered from one for a day or so, and I'm down with two more. You can't even make this stuff up. After I addressed these new symptoms with my GI, he was concerned I may have had Crohn's Disease or Colitis, so he performed a colonoscopy, which ruled out both conditions through gross observation & biopsy samples. Since colonoscopies can only read so much of your colon & terminal small intestine, I then had a  PillCam to see the rest. The only results he could suggest was that I have a "slow bowel transit," so I was diagnosed with Irritable Bowel Syndrome. The umbrella term for all intestinal and abdominal suffering with no definitive cause. 

 

    Summary of my bible here is that I'm still suffering greatly. The intestinal issues are really giving me poor quality of life, and these pervasive mouth ulcers are more than I can bare anymore with the pain, inability to eat, weight loss, etc. it's all a sick and harrowing cycle that I am caught in the middle of. In saying this, I'm almost curious that I could have Celiac disease that was horribly missed. If I had already been gluten free & a biopsy was taken it would appear as though I'm a healthy individual, no? I was informed you had to be eating a strict gluten FILLED diet prior to ANY testing. ALL of my testing was performed after I already went gluten free, which could have altered results horribly.

 

I'm almost crazy enough to think that if this is the case, I'm going to eat gluten just so I can be re-tested because I can't go on like this anymore. 

 

Can anyone please clarify and/or suggest something?

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I am so sorry you have been suffering so much for so long. Yes you do need to eating gluten for celiac related testing. There is a lot we have to do to be safe. While gluten free have you been using things like a seperate toaster, dedicated condiments, butters,jams etc? have you been baking with wheat flour for others? What is your diet typically like? I ask because your doctor is woefully ignorant of the diagnosis process for celiac so he may also not have told you what you need to do to be safe.  The Newbie 101 thread at the top of the Coping section has a lot of info.

I hope you get some answers soon.

One more thing. Are you being woken up at night with D? That is a good sign that you don't have IBS. IBS D hits when folks are awake.

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2 minutes ago, ravenwoodglass said:

I am so sorry you have been suffering so much for so long. Yes you do need to eating gluten for celiac related testing. There is a lot we have to do to be safe. While gluten free have you been using things like a seperate toaster, dedicated condiments, butters,jams etc? have you been baking with wheat flour for others? What is your diet typically like? I ask because your doctor is woefully ignorant of the diagnosis process for celiac so he may also not have told you what you need to do to be safe.  The Newbie 101 thread at the top of the Coping section has a lot of info.

I hope you get some answers soon.

One more thing. Are you being woken up at night with D? That is a good sign that you don't have IBS. IBS D hits when folks are awake.

No, my kitchen is NOT Celiac safe/friendly. Although I do maintain a gluten free diet and use only gluten free products in my cooking/backing, there is high risk for cross contamination with toaster use, other appliances, butters, sauces, etc. Same goes for the rarer occasion that I'll dine out - I eat gluten free & only from a gluten free menu, but I don't only eat at places with Celiac friendly kitchens/prep space.

 

From what I can remember, I'd like to say I have been woken up with issues just a few times though, and not anything significant. I won't dispute the probability I have IBS, however, I think there is more going on, too.  

 

Thank you for your kind words & well wishes.

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I am so sorry that you are sick.  I think you have to decide if you want to get back on a gluten free diet and get tested or remain gluten free and seriously eat as if you had celiac disease or NCGI.  That means following celiac cross contamination protocol.  Like not sharing toasters (unless you use toaster bags), condiments  (unless squeeze bottles), etc.  NO dining out until you are seeing significant improvement.   Each time you dine out it is like playing Russian Roulette.  Go when you have mastered the diet and can afford to take a hit.  

Here is the deal.  Celiacs all react differently.  If they get "glutened" it can generate symptoms swiftly or it can take a while for those antibodies to ramp up and you will not feel the effects for a day or so.  It can take weeks, months or years for antibodies to stop attacking your body.  A few gluten exposures, antibodies ramp up, you feel awful, start to recover and then you take another hit from gluten.  It can be a vicious cycle.  Many celiacs take a long time to recover, but the learning curve to the diet is steep.  I think you realize that now.  I won't get into developing other concurrent AI issues after repeated glutenings.  

Your doctor does not sound celiac-savvy.  Not that all GIs need to be experts, but they should keep up on research and follow protocol as recommended by the GI Association.  Consider a new GI.

Can you do this diet without a diagnosis?  Yes.  While I was formally diagnosed four years ago, my hubby went gluten free 16 years ago per the poor advice of two medical doctors.  He refuses to do a challenge now because we know that gluten makes him sick.  So, he is just as careful as I am.  

Consider getting another family member tested who may have celiac symptoms.  This is a genetic related disease.  

The pill camera can catch celiac disease, but not always because villi are microscopic.  I imagine it mostly catches severe damage that affects the actual structure of the small intestine.   At least you might have ruled out Crohn's.  The GI might have missed areas if damaged.  The small intestine is a very long tube and if stretched out larger than a tennis court!  Get all copies of your test results from your doctor.  You need to keep advocating and having those records in your possession is priceless. 

Take care.  

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3 hours ago, caitlynmariah said:

Hi to any & all who read my post, and an advanced thank you to those who reply,

 

     My post may be kind of robust & lengthily, but please read until the end if you are able. To give a sort of "back story" here, I'll explain my situation in a nutshell. In November of 2014 I was diagnosed with a gluten intolerance by my allergist after recurrent, severe mouth ulcers and a bodily rash. I had a blood allergy panel, but NOT a Celiac specific panel, which ruled out other food allergies completely - corn, pea, chickpea, chicken, tomato, egg, milk, etc. My allergist suggested a gluten-free diet, which I adopted & have been adhering to since then. Recently, I've been acutely sick since August of 2016, so we're talking a year plus now. My symptoms began with a burning abdominal sensation, pain after eating, premature and uncomfortable full feeling, bloating, etc. My internist referred me to my current GI doctor where I was diagnosed with GERD (chronic acid reflux) , and prescribed Omeprazole, which I still take daily. My next appointment in February had me still feeling awful & my GI doctor decided to perform an upper endoscopy, which I did in March. He was looking for ulcers, evidence of bleeding or infectious disease, and Celiac. Mind you, I had informed him that I've been eating strictly gluten free for almost three years now. He claimed this really didn't matter? This has left me wondering. Anyway, the results came up empty, but I was found to have evidence of gastritis. Then came the rest of my symptoms - frequent diarrhea, bloody diarrhea, extremely greasy stools, stools that float, mucus in stools, unable to "wait" to use the bathroom (I.e. Urgency), alternations of diarrhea and constipation, weight loss, low grade fever, EXTREME fatigue, poor concentration, memory loss, cognitive decline, and my mouth sores have reared their ugly head once again. After I first went gluten-free, the ulcers probably cleared up for a good year at least, which was heaven on earth for me. Now, they're back with a ruthless vengeance. As we speak, I've barely recovered from one for a day or so, and I'm down with two more. You can't even make this stuff up. After I addressed these new symptoms with my GI, he was concerned I may have had Crohn's Disease or Colitis, so he performed a colonoscopy, which ruled out both conditions through gross observation & biopsy samples. Since colonoscopies can only read so much of your colon & terminal small intestine, I then had a  PillCam to see the rest. The only results he could suggest was that I have a "slow bowel transit," so I was diagnosed with Irritable Bowel Syndrome. The umbrella term for all intestinal and abdominal suffering with no definitive cause. 

 

    Summary of my bible here is that I'm still suffering greatly. The intestinal issues are really giving me poor quality of life, and these pervasive mouth ulcers are more than I can bare anymore with the pain, inability to eat, weight loss, etc. it's all a sick and harrowing cycle that I am caught in the middle of. In saying this, I'm almost curious that I could have Celiac disease that was horribly missed. If I had already been gluten free & a biopsy was taken it would appear as though I'm a healthy individual, no? I was informed you had to be eating a strict gluten FILLED diet prior to ANY testing. ALL of my testing was performed after I already went gluten free, which could have altered results horribly.

 

I'm almost crazy enough to think that if this is the case, I'm going to eat gluten just so I can be re-tested because I can't go on like this anymore. 

 

Can anyone please clarify and/or suggest something?

 I had a pillcam done two and a half months after I went gluten-free and it only showed gastropathy.  three and a half months before the pillcam and endoscopy showed damage consistent with celiac.  That damage was after a 10 or 11 week gluten challenge.

 prior to that I was gluten-free for a number of month, though probably not  cautious enough. endoscopy during that time showed only inflammation.

 prior to the above, I was gluten-free after some mild positive blood work and went on a six-week gluten Challenge and my biopsy was absolutely perfect. 

 my third endoscopy was initially reAd to show an increase in a certain cell only and then went on, upon further inspection by the specialist, to show damage consistent with celiac.

 it was the continued issues after to endoscopIes  that finally made me resume eating gluten for a longer  time and going to see a Celiac specialist out of state.

 it's been over three months and I'm still having symptoms.

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When the doc did the endoscopy, did he take biopsies? How many? From what locations? Get your records!!!! If he didn't take biopsies for celiac disease then he can NOT say you don't have it. 99% of the time, villi damage can not be SEEN by the GI doc during the endoscopy. And yes, the doc has no clue when saying it doesn't matter that you were gluten free for 3 years!

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The beginning of your story sounds very much like mine. I stopped eating gluten regularly when I adopted a mostly paleo diet years ago (bonus: my lifelong canker sores disappeared!). When I got 23andme testing done and learned I have both high-risk celiac genes, I stopped eating gluten altogether, thinking I couldn't trigger celiac if I didn't have gluten exposure. But, since I didn't have a celiac diagnosis or symptoms, I wasn't careful about cross-contamination. 

Then I got sick. My symptoms were vague: bloating, food sitting like a rock in my stomach after eating, exercise intolerance, weight loss, chest tightness. I had a bunch of tests, tried omeprazole, and eventually had an endoscopy. Because I hadn't eaten gluten in a year, I didn't expect any results suggesting celiac, but sure enough, my biopsies came back as Marsh 1: inconclusive, but all the other reasons to cause this result had already been ruled out or were very unlikely. I then had bloodwork for celiac, which was negative, as expected for anyone on a gluten-free diet. At this point I was sent to a gastroenterologist, who said she could not definitively diagnose me with celiac, and that my options were either to assume I have celiac and live like a celiac, or to do the full 12-week gluten challenge and then repeat all the testing.

i didn't want to take the risk of triggering another autoimmune disease by doing the gluten challenge, so I cleaned up my kitchen, replaced my cutting boards, cast iron pans, and anything plastic or silicone, and confined gluten to one corner of the counter. I started being the annoying person at restaurants and potlucks asking a thousand questions. And my symptoms went away.

i still don't know whether I have celiac. I struggle with the restrictions it places on my life outside of my home (travel, social life). Periodically I wonder whether I shoukd just do the gluten challenge so I know. But I'm afraid of the possible risks.

Your allergist did you a great disservice my telling you to go on a gluten-free diet without testing you for celiac. But that ship has sailed. At this point I would say your choices are the same as mine: either do a complete 12-week gluten challenge and then retest, or decide to live as if you had a firm celiac diagnosis. It can be a tough decision. Good luck and I hope you figure it out and get better very soon!

 

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On 9/22/2017 at 2:56 PM, cyclinglady said:

I am so sorry that you are sick.  I think you have to decide if you want to get back on a gluten free diet and get tested or remain gluten free and seriously eat as if you had celiac disease or NCGI.  That means following celiac cross contamination protocol.  Like not sharing toasters (unless you use toaster bags), condiments  (unless squeeze bottles), etc.  NO dining out until you are seeing significant improvement.   Each time you dine out it is like playing Russian Roulette.  Go when you have mastered the diet and can afford to take a hit.  

Here is the deal.  Celiacs all react differently.  If they get "glutened" it can generate symptoms swiftly or it can take a while for those antibodies to ramp up and you will not feel the effects for a day or so.  It can take weeks, months or years for antibodies to stop attacking your body.  A few gluten exposures, antibodies ramp up, you feel awful, start to recover and then you take another hit from gluten.  It can be a vicious cycle.  Many celiacs take a long time to recover, but the learning curve to the diet is steep.  I think you realize that now.  I won't get into developing other concurrent AI issues after repeated glutenings.  

Your doctor does not sound celiac-savvy.  Not that all GIs need to be experts, but they should keep up on research and follow protocol as recommended by the GI Association.  Consider a new GI.

Can you do this diet without a diagnosis?  Yes.  While I was formally diagnosed four years ago, my hubby went gluten free 16 years ago per the poor advice of two medical doctors.  He refuses to do a challenge now because we know that gluten makes him sick.  So, he is just as careful as I am.  

Consider getting another family member tested who may have celiac symptoms.  This is a genetic related disease.  

The pill camera can catch celiac disease, but not always because villi are microscopic.  I imagine it mostly catches severe damage that affects the actual structure of the small intestine.   At least you might have ruled out Crohn's.  The GI might have missed areas if damaged.  The small intestine is a very long tube and if stretched out larger than a tennis court!  Get all copies of your test results from your doctor.  You need to keep advocating and having those records in your possession is priceless. 

Take care.  

Cyclinglady,

     First of all - thank you SINCERELY for your thorough & kind response. I apologize it's taken me quite some time to generate my own response, however, I've just been busy with work.

 

     As I've mentioned in an above response to another's post, I currently do not maintain a "Celiac" kitchen space. For example, my family shares a toaster, condiments, cutting boards, knives, other appliances, etc - you can assume the rest of the picture. I am also the only person in my household who eats a gluten free diet. Furthermore, on the rare occasion I dine out, which I hate doing because I have IBS & seem to ALWAYSSSS "pay for it" for the next few days afterward, I do occasionally consume foods that would have potential to share a fryer (fries), and be subject to cross contamination. I also do not dine exclusively at strictly gluten free restaurants with certified gluten free cooking preparation methods. Though, if a location offers gluten free "options" I'm not sure how imperative a strictly gluten free restaurant is, though I know Celiac varies in severity & I guess it could be I'm one of those "hyper-sensitive" individuals if I do indeed have the disease.

     Anyway, in regards to the "gluten challenge" to have results appear in testing.. how long does one have to consume gluten products for? I'm in a place now where my insurance is almost fully covered, and I'd seriously consider doing yet another upper endoscopy (I had my first performed in March of this year, which only evidenced Gastritis of the stomach and duodenum) but I want to make sure I'd do this "right" if I so chose to. I'm already going to see a Rheumatologist in a few weeks time (been waiting over three months time) because of concluding issues. I feel that my problems have only grown increasingly worse in the last few months & I worry this "trend" will only continue if I don't pursue an answer.

     Does anyone on this thread maintain experience with reintroducing gluten just to be re-tested for Celiac? I've heard the endoscopy is gold standard, and that blood tests aren't always conclusive, nor are they accurate. Can anyone confirm, please?

 

 

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On 9/22/2017 at 4:11 PM, ironictruth said:

 I had a pillcam done two and a half months after I went gluten-free and it only showed gastropathy.  three and a half months before the pillcam and endoscopy showed damage consistent with celiac.  That damage was after a 10 or 11 week gluten challenge.

 prior to that I was gluten-free for a number of month, though probably not  cautious enough. endoscopy during that time showed only inflammation.

 prior to the above, I was gluten-free after some mild positive blood work and went on a six-week gluten Challenge and my biopsy was absolutely perfect. 

 my third endoscopy was initially reAd to show an increase in a certain cell only and then went on, upon further inspection by the specialist, to show damage consistent with celiac.

 it was the continued issues after to endoscopIes  that finally made me resume eating gluten for a longer  time and going to see a Celiac specialist out of state.

 it's been over three months and I'm still having symptoms.

Pieces of your story sound harrowingly familiar. Please let me extend my heartfelt empathy that you still have symptoms - if anyone knows what that feels like, it's me.

     When you were tested for Celiac, did you have to blatantly ask that your biopsies be sampled and examined for this disease? Prior to my upper endo, my GI doctor speculated I had Celiac that hadn't yet been fully "caught"... I said I've been maintaining a gluten-free diet for almost three years, and he said if I was still having problems it meant my test results would surely reflect that. Well, they didn't. And I'm still having problems.

  I just recently found out, after mulling over my biopsy results for the hundredth time, that it appears as though my (six) biopsies were only tested for H. pylori.. nowhere on the pathology does the word "Celiac" appear. Hmm, strange? I think so.

     Also, strangely enough, my GI doctor showed me gross images of a random patient's pillcam results who indeed had Celiac. The slides showed distinctive villi & my doctor informed me that if I had Celiac, this is exactly what my pillcam recording would find (I had the computer with me that day, and could monitor the gross (literally & figuratively) images as the pill moved through my digestive system.

 

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On 9/22/2017 at 6:49 PM, squirmingitch said:

When the doc did the endoscopy, did he take biopsies? How many? From what locations? Get your records!!!! If he didn't take biopsies for celiac disease then he can NOT say you don't have it. 99% of the time, villi damage can not be SEEN by the GI doc during the endoscopy. And yes, the doc has no clue when saying it doesn't matter that you were gluten free for 3 years!

     The upper endo had him taking six biopsies & my colonscopy was only biopsied three times, and ONLY my colon was biopsied.. NOT my terminal ileum (the portion he could scope, anyway), which I had basically requested because I thought I had Crohn's. He was under the impression I had Colitis, even microscopic, which suggests why he only took samples from my colon. Still royally pissed off at this fact! 

     Luckily, I had both done at different hospitals but that both have patient online portals wherein I can obtain my results. Prior to me having my upper endo procedure, my GI speculated I had Celiac that hadn't yet been "caught", although I told him I had been gluten free for almost 3 years prior to testing. He stated that if I was STILL having symptoms, my test results would absolutely be reflective of this. Well, obviously they weren't. And here I am, still symptomatic. 

     In reading over my results, the pathology states I was only tested for H, pylori & that only evidence of Gastritis was found in my stomach & duodenum. NOWHERE on that pathological report is the word "Celiac" mentioned. Does this suggest I wasn't even tested for it??? I feel like he was "testing" me only through gross observation & with his naked eye!!!!

 

  

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On 9/23/2017 at 8:13 AM, Noobette said:

The beginning of your story sounds very much like mine. I stopped eating gluten regularly when I adopted a mostly paleo diet years ago (bonus: my lifelong canker sores disappeared!). When I got 23andme testing done and learned I have both high-risk celiac genes, I stopped eating gluten altogether, thinking I couldn't trigger celiac if I didn't have gluten exposure. But, since I didn't have a celiac diagnosis or symptoms, I wasn't careful about cross-contamination. 

Then I got sick. My symptoms were vague: bloating, food sitting like a rock in my stomach after eating, exercise intolerance, weight loss, chest tightness. I had a bunch of tests, tried omeprazole, and eventually had an endoscopy. Because I hadn't eaten gluten in a year, I didn't expect any results suggesting celiac, but sure enough, my biopsies came back as Marsh 1: inconclusive, but all the other reasons to cause this result had already been ruled out or were very unlikely. I then had bloodwork for celiac, which was negative, as expected for anyone on a gluten-free diet. At this point I was sent to a gastroenterologist, who said she could not definitively diagnose me with celiac, and that my options were either to assume I have celiac and live like a celiac, or to do the full 12-week gluten challenge and then repeat all the testing.

i didn't want to take the risk of triggering another autoimmune disease by doing the gluten challenge, so I cleaned up my kitchen, replaced my cutting boards, cast iron pans, and anything plastic or silicone, and confined gluten to one corner of the counter. I started being the annoying person at restaurants and potlucks asking a thousand questions. And my symptoms went away.

i still don't know whether I have celiac. I struggle with the restrictions it places on my life outside of my home (travel, social life). Periodically I wonder whether I shoukd just do the gluten challenge so I know. But I'm afraid of the possible risks.

Your allergist did you a great disservice my telling you to go on a gluten-free diet without testing you for celiac. But that ship has sailed. At this point I would say your choices are the same as mine: either do a complete 12-week gluten challenge and then retest, or decide to live as if you had a firm celiac diagnosis. It can be a tough decision. Good luck and I hope you figure it out and get better very soon!

 

Hi & thank you for your reply!

    Ironically, our stories do sound strikingly familiar! I'm sorry you have to ride this struggle bus also - I know how much it can suck!! 

     Unfortunately, I am in the process of heavily considering doing the gluten challenge because I've already sustained further damage from whatever disease or illness it is that I have going on. I'm already scheduled to see a Rheumatologist for a potential autoimmune disease diagnosis.. and I know how AI diseases are highly comorbid. My grandmother has fibromyalgia & it's speculated I do as well, which I know that illness can be highly indicative of Celiac as well. 

   Are there any resources (I.e. Websites) you know of that go into detail in discussing the gluten challenge? It's a really difficult decision with a full-time work schedule, and the fear of being and feeling sick for a long time.

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1 hour ago, caitlynmariah said:

   Are there any resources (I.e. Websites) you know of that go into detail in discussing the gluten challenge? It's a really difficult decision with a full-time work schedule, and the fear of being and feeling sick for a long time.

You are in one of the best places there is to ask any questions you need about a gluten challenge. You might find it helpful to do a new topic to get input from those of us who have gone through it.

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Getting the family ready for school....but here is some information regarding a challenge:

http://www.cureceliacdisease.org/faq/what-is-a-gluten-challenge/

https://www.verywell.com/whats-involved-in-a-gluten-challenge-562708

Some experts recommend a shorter challenge, but I would do the longest to reduce the risk of being mis-diagnosed.  

Edited by cyclinglady
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So....somewhere your pathology slides are in storage. You can seek a second opinion and have the slides sent to be read. Mine were sent from Upstate NY to Boston and back. 

I also said to heck with it and did a gluten challenge. They said 3 months. I was so used to feeling poorly that it really was not any worse for me. 

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    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

    Jefferson Adams
    Celiac.com 04/17/2018 - Could the holy grail of gluten-free food lie in special strains of wheat that lack “bad glutens” that trigger the celiac disease, but include the “good glutens” that make bread and other products chewy, spongey and delicious? Such products would include all of the good things about wheat, but none of the bad things that might trigger celiac disease.
    A team of researchers in Spain is creating strains of wheat that lack the “bad glutens” that trigger the autoimmune disorder celiac disease. The team, based at the Institute for Sustainable Agriculture in Cordoba, Spain, is making use of the new and highly effective CRISPR gene editing to eliminate the majority of the gliadins in wheat.
    Gliadins are the gluten proteins that trigger the majority of symptoms for people with celiac disease.
    As part of their efforts, the team has conducted a small study on 20 people with “gluten sensitivity.” That study showed that test subjects can tolerate bread made with this special wheat, says team member Francisco Barro. However, the team has yet to publish the results.
    Clearly, more comprehensive testing would be needed to determine if such a product is safely tolerated by people with celiac disease. Still, with these efforts, along with efforts to develop vaccines, enzymes, and other treatments making steady progress, we are living in exciting times for people with celiac disease.
    It is entirely conceivable that in the not-so-distant future we will see safe, viable treatments for celiac disease that do not require a strict gluten-free diet.
    Read more at Digitaltrends.com , and at Newscientist.com