Celiac Disease and Gluten Intolerance: What’s the Difference?

(3 min read)

July 17, 2024

Celiac Disease and Gluten Intolerance has become a buzzword in recent years. While many think that they are one and the same and are often used interchangeably. In reality, they are very distinct medical conditions with different underlying mechanisms, symptoms, and treatment requirements. In this post, we'll delve into what is gluten and understand the difference between the various types of gluten sensitivities.

What is Gluten?

Gluten is the collective name given to a complex mixture of related proteins naturally found in grains like wheat, barley and rye. Each of these proteins are different in each of the grains.

Wheat has a combination of gliadin and glutenin, rye has secalin, and barley has hordein. These proteins are what give bread its chewy texture and dough its elasticity. It’s what makes your pizza crust stretchy and your muffins rise! However, for those with celiac disease or gluten sensitivity, gluten can cause digestive issues and other health problems.

Celiac disease and Gluten intolerance are terms often used interchangeably, but they represent distinct conditions with different underlying mechanisms, symptoms, and treatment requirements. Understanding the nuances between these two conditions is essential for proper diagnosis and management.

What is Celiac disease?

Celiac disease is a serious autoimmune disorder where ingestion of gluten leads to damage in the small intestine.

When people with celiac disease eat gluten, their immune system attacks the lining of the small intestine, causing inflammation and damage that can lead to various gastrointestinal and systemic symptoms, nutrient malabsorption, and other health complications.

What is Gluten Intolerance?

Gluten intolerance, also known as non-celiac gluten sensitivity (NCGS), is a condition where individuals experience digestive disorders, fatigue, and headaches when they consume gluten-based products like wheat, barley, and rye. While the symptoms include gut-related disorders, there is no impact on the small intestine.

Decoding the Difference Between Celiac Disease and Gluten Intolerance (NCGS)

Diagnosis and Management

Celiac Disease

Celiac disease diagnosis is more straightforward, involving serological tests for specific antibodies (such as tTG-IgA) and confirming the diagnosis with an intestinal biopsy. A strict, lifelong gluten-free diet is essential for managing celiac disease. Even small amounts of gluten can cause damage to the intestines and lead to serious health complications.

Gluten Intolerance

Diagnosing gluten intolerance involves ruling out celiac disease and wheat allergies. This is typically done through a combination of patient history, symptom assessment, and exclusion diets. There is no definitive test for gluten intolerance, making it a diagnosis of exclusion. Management primarily involves a gluten-free diet, and symptoms generally improve when gluten is eliminated.

In Summary

While both gluten intolerance and celiac disease requires the avoidance of gluten to manage symptoms, the underlying causes, diagnostic procedures, and long-term implications differ significantly. Understanding these differences is crucial for effective diagnosis and treatment, ensuring individuals receive the appropriate care based on their specific conditions.

References

Fasano, A., & Catassi, C. (2012). Celiac disease. New England Journal of Medicine, 367(25), 2419-2426 (Link)

Sapone, A., Bai, J. C., Ciacci, C., Dolinsek, J., Green, P. H., Hadjivassiliou, M., ... & Fasano, A. (2012). Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC medicine, 10, 1-12. (Link)

Catassi, C., Bai, J. C., Bonaz, B., Bouma, G., Calabrò, A., Carroccio, A., ... & Fasano, A. (2013). Non-celiac gluten sensitivity: the new frontier of gluten related disorders. Nutrients, 5(10), 3839-3853. (Link)