Going gluten-free is the latest health trend. But for millions of Americans with celiac disease or a gluten intolerance, it's not a lifestyle choice - it's mandatory. The words celiac, sensitivity, and intolerance are often used interchangeably among people beginning their exploration of gluten. But using them this way is incorrect.
There's a genuine difference between being sensitive or intolerant of gluten and having celiac disease (CD). Although you both focus on gluten avoidance, one is better understood than the other. In fact, there's a possibility that some people's gluten intolerance may have nothing to do with gluten at all.
Celiac disease, or CD, is an autoimmune disease believed to be genetic. About 33 percent of the general population carries the gene, but it only activates in 1 percent of people (roughly 1 in 100). CD becomes activated over the course of your life. Activation triggers can include stress and trauma, but some research suggests viruses could also play a role. If you have a genetic predisposition, you may experience your first symptoms at any age - even well into adulthood.
When you have CD, your body reacts to your consumption of gluten with inflammation and by attacking the lining of the small intestine (villous atrophy). Villous atrophy can lead to difficulty in absorbing nutrients and contribute to other long-term health issues. There are 200 recognized symptoms of CD, and cases may present vastly differently depending on the patient's health history. Some of the most common symptoms include :
Around 10 percent of people with CD will also experience dermatitis herpetiformis (DH), which is CD that presents a skin rash. These rashes are chronic and leave you feeling uncomfortably itchy. They also develop blisters. However, under 20 percent of people who experience DH will also present the other signs of celiac disease.
How do you know if you have CD? A simple antibody blood test confirms your diagnosis.
Gluten intolerance is also known as gluten sensitivity or non-celiac gluten sensitivity (NCGS), and it affects more people than CD (approximately 6 out of 100 ). Scientists don't yet know much about gluten intolerances. It's not an autoimmune disease, but it's also not an allergy because people with NCGS aren't necessarily allergic to wheat. Unlike CD, there's no evidence that it's genetic either.
Is it possible that you are experiencing NCGS? Maybe, if you recognize these potential symptoms :
Because researchers aren't sure what the mechanism behind a gluten intolerance is, they don't know what parts of the grain cause the symptoms. It's unclear how much gluten can trigger sensitivity or even if gluten itself is the culprit. Celiac disease may mask itself as NCGS. If you present symptoms of NCGS, your doctor will want to rule out CD and allergies first.
If following a gluten-free diet helps you manage your symptoms, it may be the case that you have NCGS. However, there's no other diagnostic tool available for gluten intolerances (there are tests for allergies , which are immune-related).
Both CD and gluten intolerances relate to your body's ability to metabolize gluten successfully. Both also (usually) respond positively to removing all forms of gluten from your diet. However, the difference between the two lies in the mechanism underlying them. Researchers understand what happens to the body when CD becomes activated, but they aren't sure what causes NCGS. In other words, what you might think is a gluten sensitivity could be something else entirely.
In the same vein, the risks associated with both differ. If you have celiac disease and you don't manage it well, you could struggle with malnutrition, extreme weight loss, gastrointestinal cancers, and type 1 diabetes. There are no long-term risks or complications associated with gluten sensitivity or NCGS.
Additionally, the length of time you need to remove gluten from your diet differs. If you have CD that is activated, you won't eat gluten again for the rest of your life (without symptoms and flare-ups). Those who have a gluten sensitivity or intolerance can skip gluten for one to two years to relieve your symptoms. Then, you can begin eating small amounts of gluten again - if you choose.
Does eating cereals, grains, and rice leave you feeling sluggish, constipated or gassy, or bloated? Not everyone feels that way after eating pasta or a slice of bread, and you're right to want to look for answers. The issue may or may not be gluten-related, but it's important to rule out any allergies or diseases first.
You will likely need both a celiac blood test and an allergy test to eliminate autoimmune responses. If one (or both) of those come back positive, then you likely have your answer. The only treatment for these conditions is to avoid gluten and wheat. Ingesting them in any form can cause your symptoms to flare up, which includes intestinal cell damage when you have CD.
The issue with a gluten sensitivity or intolerance is that it may not be gluten itself causing the harm. A gluten-free diet may help manage your symptoms, but it may not tackle them all. If you find that going gluten-free for at least three to six months doesn't provide relief, you may need further investigation. Celiac Disease and Gluten Intolerance Are Not the Same
What's the difference between celiac disease vs. gluten intolerance? CD is a hereditary autoimmune disease. Plus, it comes with a confirmed diagnosis, a list of complications, and a mandate to avoid gluten in your diet for the rest of your life.
Gluten intolerances affect more people (potentially) but are also less well understood. In some cases, what appears to be a sensitivity to gluten can also have nothing to do with gluten at all. Does eating gluten leave you feeling poorly? The first step to wellness is to rule out CD and any allergies. Contact us today to take the first step on your journey to gut health.