Celiac vs. Gluten Intolerance: Is There a Difference Between Celiac Disease and Gluten Intolerance?

According to the Celiac Disease Center at the University of Chicago, celiac disease affects roughly 1 in 133 people in the United States. An inherited autoimmune disorder, this condition affects the digestive process of the small intestine. When a person who has this disease consumes food that contains gluten, the immune system launches an attack against the gluten, mistakenly damaging healthy cells lining the small intestine in the process.

Over time, celiac disease-related autoimmune activity inhibits the small intestine’s ability to absorb nutrients from food which can lead to a wide variety of symptoms including chronic fatigue, brain fog, bone or joint pain, tingling in the hands or feet, and even depression or anxiety. As long as a person with celiac disease continues to consume gluten, damage can and will be done to the digestive system – a lifelong gluten free diet is the only known effective treatment for this condition.

Gluten is just one of the hundreds of proteins found in wheat. A wheat allergy is an immune reaction to any of those proteins. When someone who has a wheat allergy consumes wheat, a certain group of white blood cells called B-cells begins to produce immunoglobulin E (IgE) antibodies which attack the wheat molecules as if they were foreign invaders. While this is happening, other tissues in the body send out chemical messengers that alert the rest of the body to the presence of a threat. The speed with which this reaction occurs can range from a few minutes to a few hours after consumption and may be accompanied by a variety of symptoms including nausea, itching, abdominal pain, swollen lips or tongue, difficulty breathing, and anaphylaxis.

A person who is allergic to wheat must avoid all forms of wheat – this is the only known treatment available for wheat allergies at this time. They may, however, be able to consume gluten from non-wheat sources such as barley or rye. It is entirely possible for someone to have a wheat allergy as well as celiac disease or a gluten sensitivity, so additional testing may be warranted if you’ve been diagnosed with a wheat allergy. Wheat is one of the 8 most common food allergies in the United States and, while children can sometimes grow out of it, wheat allergies that develop in adulthood are typically permanent.

Also known as non-celiac gluten sensitivity, gluten sensitivity is not a condition that is currently well-defined within the medical community. It is neither an autoimmune reaction like celiac disease or an allergic reaction in which the immune system produces antibodies. As such, diagnosis of gluten sensitivity is usually made by ruling out other conditions – there is no test or biomarker that can be used to identify this condition. If celiac disease and wheat allergy have both been ruled out, switching to a gluten free diet may be warranted and, if that results in a reduction of symptoms, a diagnosis of gluten sensitivity can then be confirmed. At this time, a gluten free diet is the only known treatment for gluten sensitivity.

It is fairly common for the term gluten intolerance to be used interchangeably with gluten sensitivity. While neither of these terms are well defined within the medical community, many consider gluten sensitivity to be a milder form of gluten intolerance. For example, someone who experiences mild symptoms triggered by gluten consumption that resolve quickly may be diagnosed with gluten sensitivity. On the other hand, someone who develops serious symptoms that last for a longer period of time would likely be diagnosed with gluten intolerance.

Unlike celiac disease, both gluten sensitivity and gluten intolerance do not cause damage to the lining of the small intestine. The body does, however, identify gluten as a foreign invader which triggers the launch of an immune response. Inflammation is part of that response and can contribute to symptoms such as bloating, diarrhea, and abdominal discomfort but the symptoms and the inflammation typically resolve as soon as the gluten has been eliminated from the body via digestion. Frequent gluten consumption paired with gluten sensitivity or intolerance may contribute to other symptoms such as headaches, lethargy, hyperactivity, muscle weakness, and joint pain.

If you experience negative symptoms after eating gluten-containing foods, it is a pretty safe bet that you have some kind of disease, allergy, or sensitivity to gluten. Unfortunately, identifying the exact condition you have may not be quite so simple. The first step in diagnosing your problem is to have your doctor run a blood test which may be followed by other diagnostic tests. While running these tests, you need to continue consuming gluten-containing foods – it is only after you have a diagnosis that you should switch to a gluten free diet.

A blood test cannot confirm a diagnosis of celiac disease, but it can reveal the presence of immunoglobulin E antibodies which would suggest some kind of autoimmune or allergic reaction to gluten. If your blood test comes back positive for IgE antibodies, your doctor may recommend an endoscopy to check the small intestine for damage – damage to the lining of the small intestine would confirm a diagnosis of celiac disease while a lack of damage would suggest wheat allergy, non-celiac gluten sensitivity, or gluten intolerance. To confirm a wheat allergy, your doctor may want to perform a RAST or skin prick test.

The first step in switching to a gluten free diet is learning to identify foods that contain gluten. The next step is to begin incorporating gluten free foods into your diet. The best way to identify gluten free foods is to simply look for the “gluten free” label on the package, as you’ll see on every single Schär product. Another way to identify gluten-containing foods is to check the allergen warning on the food label – if it lists wheat, there is a good chance that the product also contains gluten. There are, however, gluten-containing ingredients that do not contain wheat, so you’ll have to be very careful when choosing foods that aren’t labeled “gluten free”.

Here are some of the different words that suggest a food contains gluten:

• Wheat (ex: wheat flour)
• Barley
• Rye
• Wheat protein
• Wheat starch
• Bulgur
• Malt
• Couscous
• Farina
• Seitan
• Wheat germ oil
• Wheat germ extract

Other foods and food ingredients that may contain gluten include things like hydrolyzed vegetable proteins, modified food starch, natural or artificial flavors, seasonings, and flavorings. You should also keep in mind that even if a food product doesn’t contain gluten-specific ingredients, it could still be cross-contaminated if it was produced on equipment that is also used to produce gluten-containing foods. This is primarily a concern for people with celiac disease but could also affect people with wheat allergies or severe gluten intolerance. The only way to ensure your food is truly 100% gluten free is to buy from a reputable gluten free company that labels their products “gluten free” and manufactures their products in a strictly gluten free environment.

If you have been diagnosed with celiac disease or a wheat allergy, you need to switch to a gluten free diet immediately for relief. For gluten sensitivity and gluten intolerance, you might still be able to consume regular amounts of gluten as long as your symptoms are mild and manageable, but you may find that it isn’t worth the side effects.

Wherever you land on the spectrum, you’ll be glad to know that there are more gluten free foods out there than ever before. You may not even have to give up your favorite foods – you’ll just have to switch to their gluten free counterparts.