Celiac Disease Versus Gluten Intolerance: 6 Things To Know

Millions of people live with celiac disease or gluten intolerance. While both disorders cause a reaction to the protein in this grain crop, symptoms and severity vary.

Why does the difference matter? Knowing which one you have helps you make the right choices to protect your health. Many people also appreciate the peace of mind a definitive diagnosis gives.

You should have the facts if you suspect you have either disorder or love someone who does. Here are six things you should know about celiac disease versus gluten intolerance:

How They Are Diagnosed 

Celiac disease is not a food allergy but an autoimmune condition that causes a full-scale inflammatory response when a person who has it ingests wheat gluten. While typical food allergy testing involves skin pricks to test your reactivity to various substances, diagnosing celiac disease is more invasive.

Doctors begin with a blood test to measure antibodies that indicate an immune response to gluten. Your physician then uses an endoscope to take a small biopsy of small intestinal tissue to examine it for damage to the lining. In some cases, advanced imaging techniques can explore the entirety of the small bowel, enhancing the provider’s view through novel light technology.

The Underlying Causes 

Non-celiac gluten intolerance can baffle doctors. It can produce similar symptoms to celiac disease, absent the autoimmune response. Even traditional allergy testing may not have skin effects, and there is currently no specific test to confirm this diagnosis. Doctors remain unsure of the underlying cause, although some suspect the glyphosate used to spray wheat crops is a potential culprit.

Celiac disease, in comparison, is an autoimmune disease. While science remains unsure exactly what combination of factors triggers overactive immune responses in some, there is a strong family connection suggesting a genetic predisposition.

While both conditions increase systemic inflammation, gluten intolerance doesn’t lead to lasting damage. Celiac disease, however, harms the small intestinal lining with each exposure.

The Range Of Symptoms 

Both people with celiac disease and gluten intolerance experience similar gastrointestinal symptoms after ingesting wheat, including:

• Bloating and discomfort
• Constipation or diarrhea
• Abdominal pain
• Fatigue and brain fog
• Body aches

However, those with celiac disease often experience a wider range of symptoms. They may experience nausea and vomiting and develop anemia or nutritional deficiencies from poor absorption. Additionally, they may have:

• Skin rashes
• Mouth ulcers
• Neurological problems
• Weight loss
• Issues with fertility

The Effects Of Accidental Ingestion

People with celiac disease and gluten intolerance often follow gluten-free diets to control their symptoms. However, the effects may differ if they accidentally ingest the troublesome substance.

A single milligram of wheat gluten is enough to cause reactivity in someone with celiac disease, with symptoms appearing anywhere from a few hours to several days after ingestion. Conversely, someone with gluten intolerance generally has to eat a substantial amount of the offending food before getting sick.

Why does it matter? Someone with a gluten intolerance can probably do fine by picking the croutons off their lunchtime salad if the restaurant accidentally forgets. Someone with celiac disease, however, should insist on fresh greens or risk a reaction.

How Common Each Is

Celiac disease is relatively rare, affecting less than 1% of the total population. The percentage with a wheat allergy is equally low at less than 1%. However, many people experience gluten intolerance with no identifiable underlying condition.

The relative rarity of celiac disease and allergies makes specifying your diagnosis crucial when dining out at restaurants and working with caterers. Folks with either condition may need food prepared in a dedicated gluten-free kitchen to be truly safe and likely eschew buffet-style dining due to the cross-contamination risk. However, those with gluten intolerance are generally fine as long as they avoid the gluten-containing menu offerings.

How To Treat Each Condition

The basic treatment for celiac disease and gluten intolerance is the same: avoid wheat and products made from it. However, even this rule is easier said than followed. Many of the ultra-processed convenience foods people rely on contain it, as does sandwich bread and rolls, baked goods, pasta and crackers.

Fortunately, hope exists, as manufacturers today use more alternative flour in products targeted to the gluten-free crowd. Doing so allows people with celiac disease or gluten intolerance to enjoy favorites like spaghetti off store shelves, although they should read labels carefully. You can also experiment with flours such as the following when baking at home:

• Almond
• Chickpea
• Brown rice
• Coconut
• Cassava
• Amaranth

Scientists are hard at work finding solutions to celiac disease. They include genetically modified crops with reduced gluten content, digestive enzymes and peptidases and inhibiting or blocking certain cells responsible for spurring inflammation.

What To Know About Celiac Disease And Gluten Intolerance

Many people are sensitive to wheat. However, it’s important to know if you have an intolerance or celiac disease. While both produce symptoms, celiac disease can result in lasting small intestinal damage. Understanding the difference between celiac disease and gluten intolerance empowers you to make better choices regarding your health.