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  • Dr. Ron Hoggan, Ed.D.
    Dr. Ron Hoggan, Ed.D.

    Celiac Disease—Gluten Sensitivity: What's the Difference? By Ron Hoggan

    Reviewed and edited by a celiac disease expert.

    This article appeared in the Spring 2005 edition of Celiac.coms Scott-Free Newsletter.

    Celiac.com 04/10/2005 - Celiac disease is, by definition, a condition in which the intestinal wall is damaged as a result of eating gluten. It is a chronic illness in which the symptoms wax and wane1 for reasons that are not yet understood. Celiac disease is the result of genetic and environmental factors. We now know two HLA markers (DQ2 and DQ8) for the predisposition for celiac disease2. One environmental factor is, of course, the consumption of gluten, but there may be other environmental contributors. Recent research reveals that about 1% of the population suffers from this condition3 although most remain undiagnosed.

    On the other hand, gluten sensitivity is characterized by antigliadin antibodies. This condition afflicts at least 12% of the general population4 and is found in patients with a wide variety of autoimmune diseases. In some studies of neurological diseases of unknown origin, a majority of patients show signs of gluten sensitivity4. These patients are mounting an immune response to the most common food in the western diet, yet many practitioners consider gluten sensitivity to be a non-specific finding, frequently counseling patients to ignore these test results. This is particularly unfortunate since a strict gluten-free diet has repeatedly proven helpful to patients who are fortunate enough to consult a practitioner who is versed in gluten sensitivity and its connection with autoimmunity.

    Untreated celiac disease carries an added risk for a wide variety of additional autoimmune diseases. The most likely cause of this predisposition to additional autoimmune disease is a condition sometimes referred to as leaky gut syndrome. We know that gluten causes intestinal damage. We also know that this damage allows large undigested and partly digested proteins to leak into the bloodstream through the damaged intestinal wall. This leakage results in immune system production of antibodies to attack these foreign proteins as if they were invading microbes. The result is the production of a huge variety of selective antibodies, and each type recognizes a particular short chain of amino acids located somewhere in the proteins structure. Unfortunately, our own tissues can contain very similar or identical sequences of amino acids. Hence, by a process called molecular mimicry, we are producing antibodies that attack both the foreign food proteins that are leaked into our blood through the damaged intestinal wall, and similar amino acid sequences in our own tissues, often resulting in an autoimmune disease5.

    The supposedly non-specific antigliadin antibodies in gluten sensitivity provide two important pieces of information: 1) That the intestinal wall has been damaged and is permitting leakage of food proteins into the bloodstream, and; 2) That the dynamic contributing to increased autoimmunity in celiac disease may well be an important contributing factor in gluten sensitivity5. The currently common view that celiac disease is a serious illness, while disregarding gluten sensitivity, is dangerous to gluten sensitive patients.

    This bias is also a divisive element in the gluten-sensitive/celiac community. Whether a person has "biopsy proven" damage to the intestinal wall, if this person gets sick from eating gluten, or mounts an immune response to gluten, we are all in the same leaky boat (please pardon the pun). We need to work together to get a better understanding of gluten sensitivity in all its forms (including celiac disease). As a community, we need to discourage any kind of dismissal of illnesses that are partly or wholly mediated by gluten.

    If we can stand together in our quest for widespread recognition of the damaging impact of gluten consumption, we can all enjoy a healthier life. Our descendants will also inherit a more gluten-savvy world.

    Ron Hoggan is an author, teacher and diagnosed celiac who lives in Canada. His book "Dangerous Grains" can be ordered at Celiac.com. Rons Web page is: www.DangerousGrains.com

    Sources:

    • Cooke W, Holmes G. Coeliac Disease. Churchill Livingstone, New York, N.Y. 1984.
    • Fasano A. Celiac disease--how to handle a clinical chameleon.
      N Engl J Med. 2003 Jun 19;348(25):2568-70.
    • Fasano A, Berti I, Gerarduzzi T, Not T, Colletti RB, Drago S, Elitsur Y, Green PH, Guandalini S, Hill ID, Pietzak M, Ventura A, Thorpe M, Kryszak D, Fornaroli F, Wasserman SS, Murray JA, Horvath K. Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. Arch Intern Med. 2003 Feb 10;163(3):286-92.
    • Hadjivassiliou M, Grunewald RA, Davies-Jones GA. Gluten sensitivity as a neurological illness. J Neurol Neurosurg Psychiatry. 2002 May;72(5):560-3.
    • Braly J, Hoggan R.. Dangerous Grains, Penguin-Putnam-Avery, New York, N.Y., 2002.

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    I read the article because I had an EGD last week and the gut shows no evidence of celiac disease yet when I knowingly or otherwise consume even small amounts of wheat, I am uncomfortable within 20 minutes so must be gluten sensitive. I have a daughter who was diagnosed as allergic to wheat as an infant.

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    Many times gluten sensitivity is so low that we accept a state of being that we believe is normal when , in fact, our health is compromised. I underwent a cleansing diet that eliminated gluten and was amazed at how well I felt after 10 days on the diet.

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    Very good article! I have spent the last 5 years suffering from this condition and have been told by many doctors its just ulcerative colitis from stress or the usual acid burns from indigestion and the good old IBS I have rehab myself to a better lifestyle vegetarian that works extremely well lettuce meats protein shakes eggs D3 vitamins, avoiding all that is wheat based. I no longer have my skin falling off my face from heavy fat clustering pimples nor am I anemic nor am I suffering major weight loss from eating wheat once oh and the unbearable crippling cramps in my abdominal area. this is a serious condition and I wish there was an easier way to enjoy life and eat whatever but hey life is full of challenges.

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    I was recently diagnosed with celiac by a rheumatologist. My doctor prescribed antidepressants basically out of frustrastion as he continually told me there was nothing wrong. I am now learning about this disease. Your information has been crucial in both educating and helping me to heal. Thank You!

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    Thank you so much for this informative article. I have been suffering from leaky gut symptoms and mood ailments for quite some time. I have recently started my journey with a gluten-free diet, and have been amazed with the results. Yes, it is challenging to stay committed, but I know I don't ever want to feel mentally and physically drained again merely because of what I'm eating. It's reassuring that there is proven hope!

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  • About Me

    As co-author of "Dangerous Grains" and "Cereal Killers", the study of the impact of gluten continues to be a driving passion in my life. I am fascinated by the way that gluten induces illness and impedes learning while it alters mood, behavior, and a host of other facets of our existence. Sure, the impact of gluten on health is an important issue, but that is only the most obvious area of impact. Mood disturbances, learning disabilities, and the loss of quality of life due to psychiatric and neurological illness are even more tragic than the plethora of physical ailments that are caused or worsened by gluten. The further I go down this rabbit hole, the more I realize that grains are a good food for ruminants - not people. I am a retired school teacher. Over the last decade, I have done some college and university level teaching, but the bulk of my teaching career was spent working with high school students. My Web page is: www.DangerousGrains.com

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