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  • David Greenberg
    David Greenberg

    Celiac Disease vs. Gluten Sensitivity or Gluten Intolerance

    Reviewed and edited by a celiac disease expert.

    Caption: Photo: CC--Andy G

    Celiac.com 11/13/2012 - Going gluten-free seems to be the newest dietary trend that many people are following, even if it is not mandatory for one’s health. This trend was brought on by an increased number of cases of celiac disease, and gluten sensitivity, also referred to as gluten intolerance. Both diagnoses come with the recommendation of avoiding gluten-containing foods (wheat, rye, barley), however both are different in the way the body is affected.

    Photo: CC--Andy GCeliac disease, also known as gluten sensitive enteropathy, is an autoimmune disease that affects the small intestine causing it to become inflamed when gluten is digested. The immune system then generates an abnormal response to gluten and attacks its own intestinal tissue.  This leads to the wasting away of the villi that line the small intestine, malabsorption of nutrients and thus malnutrition. Symptoms may include anemia, osteopenia, lactase deficiency, diarrhea, constipation, delayed growth, and weight loss due to malabsorption of nutrients. Other symptoms that may present are arthritis, dermatitis, infertility, muscle weakness, and constant fatigue. A series of tests and evaluations are performed including an examination of one’s family history as genetic predisposition is common, blood tests, and the final confirmation of an intestinal biopsy. Once confirmed a strict adherence to a gluten free diet is necessary.

    Non-celiac gluten sensitivity is often interchanged with gluten intolerance. There are cases where symptoms are less severe, which may be considered gluten sensitivity, whereas severe cases would be labeled as gluten intolerance due to the intensity and length of time symptoms last. Gluten sensitivity differs from celiac disease in that the body views gluten as an invader causing a direct response in the form of inflammation inside and outside of the digestive tract, and with this disorder one's own tissue (lining of small intestine) is not attacked, as we see with celiac disease. Once gluten is removed from the body, the inflammation goes away unlike the symptoms associated with celiac disease. Symptoms include bloating, abdominal discomfort, and diarrhea due to the inflammation of the digestive tract. Headaches, lethargy, attention-deficit disorder, hyperactivity, muscle weakness/disturbances and joint pain may present as well. Tests performed for a diagnosis of celiac disease are usually done with the findings not showing the indicators necessary, leading to a trial gluten-free diet. With the diet, symptoms will disappear, and a diagnosis of gluten sensitivity will be given.

    Unfortunately celiac disease and gluten sensitivity are becoming increasingly prevalent. Thus it is important to know how each diagnosis affects the body, and the reasons for being put on a gluten free diet. With more research being done, there may soon be more answers as to why more cases continue to emerge.


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    I am new to the reality that I am gluten intolerant. I am also lactose intolerant. After reading this article and keeping off gluten for the weeks ( going paleo) I appreciate finally understanding all that pain and suffering can end with some answers. My next steps are to learn more non-gluten recipes for breads and to get the proper testing by my Dr. And help her to identify the signs in others as I have been complaining for years with no answers .

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    My son has not been growing. He was off the charts big as a toddler. By the 3rd grade he had fallen to the 60th percentile. Now in grade 7 he is in the 25th percentile for height. I am 5'10", my husband is 6'1". He was recently diagnosed with celiac disease. It's no surprise as several family members have it. He also has hypotyroidism so auto immune issues are present. We are eager to put him on a gluten free diet but are frustrated... His Dr. wants us to wait on further testing. Does if really matter if it's an intolerance or an allergy? The earliest appointment offered was September, 5 months away! Why wait if the outcome is going to be placing him on a gluten free diet anyway?

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    Thank you for this site. Since I am relatively new at this, help is needed. There are so many good articles and recipes that choosing what to peruse first is a little bit difficult, but doable.

    This site has been a tremendous help in the initial stages of living gluten free. I still refer to it frequently to get ideas and answers. Best wishes with your quest to be truly gluten free and healthy!

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    I have tried gluten free in an effort to figure out what foods trigger my horrific migraines. One thing I have noticed - there is an additive in 99.9% of the wheat on the market - it's called thiamine mononitrate - and it is what puts the "enriched" in "enriched wheat flour." So I tried finding just plain, non-enriched flour (you can get it at Sprout's - Bob's Red Mill Flour, unenriched type). So this is tricky - I'm still not 100% sure I don't have a low-level gluten sensitivity (as in, I can tolerate it up to a point) or a total intolerance to chemicals (and there are a lot of them out there). I have become a hard-core label reader, not because I'm a health nut, but because I hate migraine headaches. It is really difficult to pinpoint one factor when we are all eating so many chemicals at the same time - who knows how those things affect us. Chances are, if you can't pronounce it, it didn't grow in nature. Thanks for the article.

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    This article and site are helping a lot. I read another article on Pintrest of all places about the symptoms of gluten sensitivity and a couple light bulbs went off in me head. I am glad this site is here because it is allowing me to get information about stuff a lot of doctors overlook.

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    I love coming to this site and reading all the articles and comments. I have had celiac for about 4 years now and still continue to learn more everyday. I keep an open mind and think about how I change recipes to accommodate my gluten free way of life and am grateful for all the options I still have. Sites likes this one have so much to offer.

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    I just want to share with everyone that I purchased the America's Test Kitchens How Can This Be Gluten Free cookbook and the results of everything I have made have been PERFECT!! Perfect texture, muffins and breads rise beautifully. Much better outcome than anything using Bob's all purpose gluten-free Flour or even Pamela's Artisan Blend GL Flour. Best $20 I've spent and I'm baking and cooking again!

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    Great explanation, thank you! I do want to mention that my daughter tested NEGATIVE for celiac, but has many of the symptoms of the auto-immune response. I truly believe that even if one tests negative for celiac, you may still have wasting away of the villi. My daughter's symptoms confirm this, in my opinion. Also, DOES ANYONE KNOW OF A DOCTOR IN NEW MEXICO WHO ACTUALLY BELIEVES THAT CELIAC AND GLUTEN INTOLERANCE EXISTS?? At this time we have no support of any western medicine doctors. I'm even willing to take her to Phoenix or Denver if I can find someone who can help. I haven't been able to find a functional medicine doctor here either. Thanks for the feedback.

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    My son has not been growing. He was off the charts big as a toddler. By the 3rd grade he had fallen to the 60th percentile. Now in grade 7 he is in the 25th percentile for height. I am 5'10", my husband is 6'1". He was recently diagnosed with celiac disease. It's no surprise as several family members have it. He also has hypotyroidism so auto immune issues are present. We are eager to put him on a gluten free diet but are frustrated... His Dr. wants us to wait on further testing. Does if really matter if it's an intolerance or an allergy? The earliest appointment offered was September, 5 months away! Why wait if the outcome is going to be placing him on a gluten free diet anyway?

    If he's going to be tested for celiac disease he needs to be currently consuming gluten.

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    Great explanation, thank you! I do want to mention that my daughter tested NEGATIVE for celiac, but has many of the symptoms of the auto-immune response. I truly believe that even if one tests negative for celiac, you may still have wasting away of the villi. My daughter's symptoms confirm this, in my opinion. Also, DOES ANYONE KNOW OF A DOCTOR IN NEW MEXICO WHO ACTUALLY BELIEVES THAT CELIAC AND GLUTEN INTOLERANCE EXISTS?? At this time we have no support of any western medicine doctors. I'm even willing to take her to Phoenix or Denver if I can find someone who can help. I haven't been able to find a functional medicine doctor here either. Thanks for the feedback.

    I would suggest that you do not waist time on doctors. Just go now on a strict gluten free diet including corn and oats along with the standards of wheat, rye and barley. In a month or less you should feel noticeably better. If so, continue the gluten free diet forever and kiss the doctors goodbye.

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    Just starting to read all the info on 'gluten intolerance' which I THINK I may have... I'm going to try to eliminate the cereal I have every morning! Do the 'digestive enzymes' help when trying to figure it all out?

    They did not help me to digest gluten at all. Going gluten free was surprisingly easy for me! AND SO HELPFUL!

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  • About Me

    David Greenberg graduated from NYU with a degree in economics. He has since joined the Good Greens team and become passionate about healthy living and healthy eating. Good Greens is a gluten-free and vegan protein bar company. David partners with other health writers and professionals to share healthy insight around the web. His web site is: http://www.goodgreens.com/.

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