Celiac Disease vs. Gluten Sensitivity - Understanding the Difference

Man, this gluten thing has got me like... What?

Is this a trend or something that is rampant in the good old US of A? I have friends that are going gluten-free when they really don’t even know what gluten is, let alone been tested for any kind of sensitivity or disease process.

What is gluten?

So, gluten is by definition is “a substance (protein) present in cereal grains, especially wheat, that is responsible for the elastic texture of dough. A mixture of two proteins, it causes illness in people with celiac disease.” Gluten in latin actually means “glue.”

Celiac disease

In a nutshell, a person with celiac disease can’t eat gluten. Like, not at all. They get various symptoms like diarrhea, malnutrition, vitamin deficiencies, abdominal pain, rashes, joint pain, as well as anemia.

Celiac disease is an autoimmune disorder that attacks the small intestine. It is hereditary and 1 in 10 have a risk of developing celiac disease.

It's under diagnosed here in our country, but in other countries they seem to get it and test often for it. The longer that it takes to diagnose, the higher the risk of other autoimmune disorders and gastrointestinal cancers.

How do you know you have it?

Blood tests can reveal celiac disease antibodies, but for this test to work, you actually have to be eating gluten. Yikes. Once this specific antibody is present, then its on to take a chunk of your small intestine for biopsy and check it out under the microscope.

Once you are diagnosed

No gluten for you! It should be easy - cut out grains and wheat, the end. However, gluten is in lots of other things that the FDA does not label - wine and spirits, eggs and who knew, but meat as well.

Not only do you have to dip, dive, duck, and dodge gluten, but you may consume gluten in products that you thought were gluten-free. It’s a problem.

So what is the difference between celiac disease and gluten Intolerance?

Ok, so the real term is “non-celiac gluten sensitivity.” It just means that no antibodies can be found in blood tests and biopsies of the small intestine do no reveal celiac disease. Patients experience brain fog, abdominal pain, diarrhea and constipation as well as chronic fatigue when they eat things with gluten in them.

Per celiac.org, they cannot confirm that gluten is the culprit, but they suspect it. More tests are needed to find out what is happening molecule wise and what is triggering the response definitively.

Correlation doesn't equal causation. Example - If I eat a whole cake (yum) and I have abdominal pain after, I could say it was the flour I ate that caused me to have abdominal discomfort. Really, I shouldn't have eaten the whole cake.

If in doubt, we should all go gluten-free, right?

Um, that is really a terrible idea. Gluten-free doesn’t mean your being “healthy.” There are many gluten-free products out there that have tons of sugar and fat and are full of refined grains and hardly any fiber.

Just look at some of the cookies that are labeled “gluten-free.” They are full of sugar and are not necessarily a healthier option (scientificamerican.com). I think sometimes people mix up gluten-free with a healthy diet, and just like everything, it can be unhealthy if you do it wrong.

However, there is a bit of a caveat - if you are hell bent on going gluten-free, even if you don’t have a wheat sensitivity and think you are being preventative, then stick to the basics.

Don’t get crap to eat just because it says “gluten-free.” You can replace gluten with fruits and veggies and do awesome.

I am pretty sure anyone who does this and eats less crap will likely lose weight anyway, even if they are eating gluten.

In Conclusion

Celiac disease can shorten your life and if not diagnosed early can cause major problems and co-morbidities at an earlier age. The earlier the diagnosis, the less chance of colon cancer and other autoimmune disorders popping up. Celiac disease is a serious autoimmune disorder and if you suspect you have it, then you need to go to your doctor.

Testing is pretty straightforward in celiac disease versus gluten sensitivity. You can do a blood test that will test for antibodies that may be present and/or get a biopsy of the small intestine.

Once diagnosed, then you just stop having gluten, duh, so easy, right? Well, not so much.

There are many things with gluten in them that you would never suspect. Celiac.org has a whole lot of info for gluten-free diets as well as what foods may have gluten in it that you would have never even suspected.

Non-celiac gluten sensitivity is a whole other ball of wax. You maybe thought of as a hypochondriac if your doctor has tested you and you don't pop positive for celiac disease.

I would highly recommend you go to celiac.org so that you can get a list of physicians who have dealt with non-celiac gluten sensitivities before and who wont laugh you right out of the door.

Either way, if you are having symptoms like the ones mentioned above, you need to see your physician pronto. Maybe you ate too much cake or maybe you really do have celiac disease.