The difference between coeliac disease and gluten intolerance

Have you ever had unpleasant symptoms or felt bloated after eating gluten-rich foods such as bread, granola or pasta, and wondered if you have gluten intolerance or perhaps even celiac disease? Although these two conditions have similar symptoms, there are distinct differences in how they work. In recent years, the gluten-free diet has become increasingly popular. However, many people have no clear idea of the difference between celiac disease and gluten intolerance and why some people need to live gluten-free.

Table of Contents

• Have you ever felt unwell or bloated after eating foods like bread, cereal, or pasta
• What is celiac disease?
• What symptoms can occur with celiac disease?
• Is gluten intolerance the same as gluten sensitivity?
• What is non-celiac gluten sensitivity?
• Symptoms of non-celiac gluten sensitivity
• The difference between gluten intolerance and celiac disease
• Can you be gluten intolerant without having celiac disease?
• I have celiac disease – what should I do?

Have you ever felt unwell or bloated after eating foods like bread, cereal, or pasta

One possible explanation could be a reaction to gluten, as seen in conditions like celiac disease or non-celiac gluten sensitivity (often referred to as gluten sensitivity). Both conditions present with similar symptoms but differ in how the body reacts to gluten. In general, both celiac disease and gluten sensitivity fall under the term “gluten intolerance.” While gluten-free diets have become increasingly popular in recent years, many people remain uncertain about the exact difference between these two forms of gluten intolerance and why some people truly need to avoid gluten.

What is celiac disease?

Celiac disease is an autoimmune condition that affects the digestive system. When someone with celiac disease consumes foods containing gluten, an immune response is triggered in the small intestine. Gluten is a protein primarily found in grains such as wheat, rye, and barley. It gives baked goods like bread and cakes their elastic and fluffy texture. In cooking, gluten also helps stabilize dough and give it structure. The immune response triggered by gluten mistakenly targets the body’s own intestinal cells instead of harmful invaders. Over time, this ongoing inflammatory response damages the intestinal villi. As the small intestine becomes damaged, nutrient deficiencies may occur due to poor absorption. Commonly affected nutrients include iron, calcium, vitamin D, folic acid, and vitamin B12.

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What symptoms can occur with celiac disease?

The autoimmune reaction associated with celiac disease damages the small intestine’s ability to absorb and process nutrients from food. This damage can lead to malnutrition and a range of physical symptoms, including brain fog, tingling in the hands or feet, chronic fatigue, bone or joint pain, and mood swings. Other symptoms include:

• Diarrhea

• Weight loss

• Bloating

• Abdominal pain

• Constipation

• Vomiting

Source: NHS, 2022

Is gluten intolerance the same as gluten sensitivity?

The terms “gluten intolerance” and “gluten sensitivity” (also known as non-celiac gluten sensitivity) are often used interchangeably in everyday language, which can lead to confusion. In the medical field, the definitions of these terms are not always clear, further complicating diagnoses. Generally, “gluten intolerance” is used as an umbrella term that includes various reactions to gluten, such as celiac disease and gluten sensitivity. It is important to recognize and correctly diagnose these differences.

What is non-celiac gluten sensitivity?

Non-celiac gluten sensitivity (NCGS) is a form of gluten reaction that does not exhibit the specific characteristics of celiac disease, an autoimmune condition. It is often referred to as gluten sensitivity or non-celiac gluten intolerance. The diagnosis and understanding of NCGS are still being researched within the medical community, especially since there are currently no specific tests to definitively identify this condition, unlike with celiac disease. With non-celiac gluten sensitivity, symptoms such as bloating, nausea, abdominal pain, and diarrhea may occur, without triggering an autoimmune response or causing lasting intestinal damage.

Symptoms of non-celiac gluten sensitivity

Similar to celiac disease, common symptoms of non-celiac gluten sensitivity include:

• Stomach pain

• Gas

• Constipation

• Nausea

• Diarrhea

• Bloating

• Fatigue

Source: Cleveland Clinic, 2021

If you notice any of these symptoms after eating gluten-containing products, you may have non-celiac gluten sensitivity. People with this condition may find relief by using digestive enzymes, reducing the amount of gluten in their diet, or eliminating gluten entirely.

The difference between gluten intolerance and celiac disease

The main difference between gluten intolerance and celiac disease lies in the long-term damage celiac disease can cause to the body. While similar symptoms may occur after eating gluten-containing foods, gluten sensitivity and gluten intolerance do not lead to intestinal damage, unlike celiac disease (Cleveland Clinic, 2022).

Can you be gluten intolerant without having celiac disease?

Yes, many people with celiac-like symptoms test negative for celiac disease. In such cases, a gluten-free diet may still help reduce symptoms and improve well-being. These individuals most likely have non-celiac gluten sensitivity.

I have celiac disease – what should I do?

People with celiac disease must follow a lifelong gluten-free diet. Learning to identify gluten-containing products is the first step in making this lifestyle change. The next step is to gradually introduce gluten-free foods into your diet. The easiest way to check if something is gluten-free is to look for a “gluten-free” label on the packaging. Another way to identify gluten-containing foods is to review the allergen information on the food label. If wheat is mentioned, the product likely contains gluten. However, there are also gluten-containing ingredients that do not include wheat, so be cautious when buying products that are not explicitly labeled as gluten-free.