What are the Differences Between Celiac Disease and a Gluten Allergy?

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What is Gluten and Who Should Avoid It?

Celiac disease and non-celiac gluten sensitivity (also referred to as a gluten allergy) are two different conditions that produce very similar symptoms. Both are the result of the body’s reaction to gluten, which is a protein found in wheat, barley, and rye. If you believe your body doesn’t tolerate gluten, understanding if you have one of these conditions can be helpful. Celiac disease is a genetic condition that can result in damage to the intestinal tract. Gluten allergy causes inflammation in the intestines, but it isn’t clear if long-term damage occurs, as researchers are still trying to determine who’s affected by gluten and provide a definitive answer to the question, “What is a gluten allergy?”

Common foods where gluten can be found include:

  • Beer
  • Bread and pastries
  • Cakes, cookies, and brownies
  • Cereal and granola
  • Crackers
  • Croutons
  • Flour tortillas
  • Gravies and sauces (where wheat flour is a common thickening ingredient)
  • Ramen, udon and soba noodles
  • Pancakes, crepes, waffles, and biscuits
  • Pasta

What are the Differences between Celiac Disease and Gluten Allergy?

Celiac disease is a genetic condition that involves a faulty immune system response in which consuming gluten causes your body to attack the lining of your small intestine. This action results in damage called villous atrophy that can lead to malnutrition and osteoporosis. In rare cases, it can also cause cancer. In order for celiac disease to be present, you must have inherited the genetic disposition, be consuming gluten and have “activated” the condition as a result of trauma, stress or some other trigger that produces celiac disease symptoms.

Celiac disease is an autoimmune condition. This means that the gluten itself isn’t causing damage, but rather that it stimulates an inappropriate response from the body’s white blood cells. In this way, celiac disease is similar to type 1 diabetes and autoimmune thyroid disease.

Celiac disease can be diagnosed with a blood test, and in the case of a positive result, a biopsy of tissue from the small intestine. You must be consuming a diet that contains gluten at the time of testing in order to get proper results.

Gluten sensitivity or gluten intolerance is now viewed by the medical community as a stand-alone illness and not a type of celiac disease. However, there’s very little research on the condition and many different opinions about it among healthcare professionals.

There’s some belief that gluten sensitivity involves an immune system reaction. That reaction, which is different than in celiac disease, causes inflammation both in the digestive tract and outside it. It’s unclear whether this reaction causes damage to the body or only symptoms that resolve when the body is free of gluten.

A diagnosis of gluten sensitivity following signs of gluten allergy is achieved by first ruling out celiac disease. If you don’t have that condition, you participate in a “challenge test” in which you first eliminate gluten from your diet to see if the symptoms resolve. Then you challenge your system by reintroducing gluten to see if you begin experiencing the gluten allergy symptoms again.

Currently, there’s no medication or therapy for addressing celiac disease or gluten sensitivity. To prevent your symptoms, you must remove all gluten from your diet. A dietician can help you formulate a food plan that ensures you’re getting proper nutrition and staying free of gluten.

If you suspect you have one of these conditions, make an appointment with a Baptist Health allergist who can help you understand celiac disease vs gluten allergy and the ramifications.

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