Celiac Disease Versus Gluten Sensitivity: What’s the Difference?

Why do people follow gluten-free diets? Eating gluten-free (GF) has been a trend for years, yet people still confuse the health causes for the diet: celiac disease versus gluten sensitivity. Does it matter if someone is a celiac, a sensitivity to gluten, or has a wheat allergy?

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Being a celiac myself, I’m am well-versed in stomach bloating, diarrhea, and migraines, thus I support anyone who wants to try gluten-free diets for reasons beyond a diagnosis.

The differences between the ailments are interesting, you can read more about them below. But ultimately, it’s clear that celiacs should eat GF and people with gluten sensitivity symptoms should probably also eat GF. Someone with an allergy to wheat must stay away from foods with wheat (which contains gluten). Then everyone else can mind their own gluten-filled business.

Celiac Disease

Celiac disease is an autoimmune disease that has serious long-term health consequences. Symptoms can include diarrhea, weight loss, abdominal pain, and fatigue. Skin rashes, headaches, mental fogginess, neuropathy, and joint pain may also occur.

The key to celiac symptoms is that there is no key. Symptoms vary depending on a person’s age, gender, and some people may not experience any symptoms at all.

If a person with celiac eats gluten — a combination of proteins found in wheat, barley, and rye — the villi of his or her small intestine degrade. Having degraded intestinal villi isn’t good because our villi, which are tiny, finger-like tentacles, are responsible for absorbing nutrients from food. Thus, without working villi, a celiac cannot absorb nutrients from food and malnourishment can result.

Testing for celiac begins with a blood test called a tTG-IgA test. In order for the test to work, you must already be eating gluten as a regular part of your diet. If your test results show an abnormally high amount of celiac disease antibodies, a small intestine biopsy may be performed. This biopsy can confirm small intestine villi damage consistent with celiac disease.

Eating GF for life is the only way to restore villi function and to prevent the myriad of celiac-associated ailments, not to mention stopping the uncomfortable symptoms.

Celiac Disease Symptoms

Keep in mind symptoms that appear in adults may be different than the symptoms of a celiac child. There are also differences between men and women. General symptoms include:

  • bloating and gas
  • chronic diarrhea
  • constipation
  • pale, stinky stool
  • stomach pain
  • nausea and vomiting

Gluten Sensitivity

On the other hand, gluten sensitivity is not an autoimmune disease and some people who suffer from the symptoms of a glutenous diet do not have the antibodies or intestinal damage that celiacs possess. Yet, people with gluten sensitivity, or non-celiac gluten sensitivity (NCGS), are still unable to tolerate gluten. Symptoms are very similar to those of celiac disease.

Yet, diagnosis is difficult. According to a study published in the Gastrointestinal Endoscopy Clinics, “the majority of symptoms associated with NCGS are subjective, including abdominal pain, headache, ‘brain fog,’ tingling and/or numbness in hands and feet, fatigue, and musculoskeletal pain.” Additionally, rashes, diarrhea and more severe neurological and psychiatric conditions, including schizophrenia, have been reported to be connected to NCGS.

A GF diet is a suggested treatment to alleviate NCGS symptoms, especially as the diet often results in an improvement of the symptoms. But, unlike with celiac, it’s difficult, if not impossible, to discern if gluten is the cause of the symptoms. Even though a gluten-free diet is usually the best solution.

Gluten Sensitivity Symptoms

The most common symptoms of non-celiac gluten sensitivity are:

  • mental fatigue
  • physical fatigue
  • gas, bloating, and abdominal pain
  • headaches

Wheat Allergy

Just as you may be allergic to certain foods like peanuts or shellfish, you can also be allergic to wheat. Wheat allergies typically appear in young children, and they often grow out of it before they are old enough to go off to school. It is estimated that one-third of children with wheat allergies never grow out of it.

If you’re allergic to wheat, eating foods like cookies, pasta, crackers, and bread can make result in uncomfortable symptoms or even life-threatening. There are some rye and barley foods that contain gluten but are still wheat-free. When living with a wheat allergy, it’s important to read the label of food and some beauty products.

Wheat allergies are often mistaken as celiac or gluten sensitivity because the symptoms are similar. However, the biggest difference is wheat consumption can be fatal to a person with a serious wheat allergy. If someone is experiencing symptoms from eating wheat-containing products, they must be diagnosed. Wheat allergies can be diagnosed with a simple skin prick testing.

Wheat Allergy Symptoms

There is an overlap of symptoms of celiac disease, gluten sensitivity, and a wheat allergy. When someone extremely allergic to wheat is exposed, they may experience life-threatening reactions like impaired breathing and the body going into shock.

  • hives
  • nausea
  • headaches
  • sneezeing
  • asthma
  • runny nose
  • impaired breathing

Does it matter if you’re a celiac if you want to eat GF?

Of course not.

Being a celiac, I often hear the sneer, “Oh, you’re a real gluten-free person.” Or “You actually have a reason to be GF.”

My response stays consistent: Why should I care what other people eat? It’s not like other GF people are stealing my food!

I experienced chronic diarrhea, abdominal bloating, mental fogginess, migraines, and chronic anemia (iron deficiency) my whole life. I was finally diagnosed with celiac disease as a sophomore in high school. So having suffered through similar symptoms as someone with NCGS, I am sympathetic to anyone who wants to get rid of these symptoms as well. Having a positive celiac test and being gluten sensitive are equally important reasons to eat GF.

GF diets and foods weren’t nearly as common when I was diagnosed as a teen as they are today, and fortunately, I’ve honed key practices on how to eat GF. Lowering expectations, and executing communication and preparation are the keys to success! Whether you’re a bona fide celiac or not, if eating GF alleviates your symptoms, do it!

Do you follow any gluten-free diets?

About the Author

Clare Gallagher is an ultrarunner for The North Face and travels extensively for races and philanthropic work. She studied coral ecology at Princeton University where she also ran cross country and track. Clare has taught English in Thailand where she started a non-profit environmental stewardship program, she has scribed in emergency rooms across Denver, and she writes regularly for various running blogs.

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