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[PixieDixie]

I have a couple of questions. What si the difference between NCGS and Celiac?

I have had a rash that typical rash meds could not get rid of and recently realized gluten is likely as going gluten free has relieved the itchiness and the rash is starting to dissipate and is less, not gone, but maybe headed that way. The oldest parts of the rash that are gone left my skin a darker color. Are rashes associated with NCGS. 
I’m fairly certain gluten is the culprit for this. Is the rash a distinguishable feature of celiac?

[trents]

Welcome to the forum, @PixieDixie!

1. Celiac disease is an autoimmune disorder. The body mistakenly identifies gluten as a threat and sends attacker cells to the lining of the small bowel when gluten is ingested, causing inflammation which, over time, begins to damage the "villous lining" of the small bowel. The villous lining of the small bowel is made up of millions millions of tiny finger-like projections which make up a huge nutrient absorbing surface to absorb the vitamins and minerals found in the food we eat. With the increasing damage caused by this ongoing inflammation, these millions and millions of tiny finger-like projections get worn down to nubbins and the absorbing efficiency of the villous lining becomes less and less. Over a significant period of time, this can lead to medical problems that are tied to nutrient deficiencies. NCGS (or "gluten sensitivity") does not produce an autoimmune reaction and so does not damage the villous lining of the small bowel. The exact immune system engagement represented by NCGS is poorly understood at this point in time. Some experts feel that NCGS can be a precursor to the development of celiac disease and it is 10x more common than celiac disease. The GI distress symptoms of NCGS are similar to that of celiac disease, however, and there is not testing available yet for NCGS. There is testing available for celiac disease, on the other hand, and it is often necessary to get formal testing done for celiac disease to either confirm it or rule it out in order to arrive at an official diagnosis of NCGS.

2. Celiac disease testing is invalidated once a person has embarked on a gluten free diet. One must have been eating significant quantities of gluten (equivalent of 4-6 slices of wheat bread daily) for weeks or months leading up to the day of testing in order for the testing to yield reliable results.

3. The rash associated with celiac disease is known as dermatitis herpetiformis. Celiac disease is the only known cause for dermatitis herpetiformis and if you can get a dermatologist to diagnose the rash as dermatitis herpetiformis then you can be assured you have celiac disease. The rash is characterized by having pustules in the bumps. dermatitis herpetiformis must be biopsied during an active breakout and this can make it difficult to get diagnosed sense it is usually difficult to get a dermatology appointment on short notice. And it is also true that not all dermatologists know how to properly biopsy for dermatitis herpetiformis. One mistake they often make is taking the sample from the bump whereas it needs to be taken from an area next to a bump. Most people with dermatitis herpetiformis also have GI involvement but they may not discern it due to lack of symptoms. They are what we call "silent celiacs" and this is much more common than you might think. A small percentage of those with dermatitis herpetiformis have only an epidermal expression of celiac disease and have no GI involvement.

[Scott Adams]

If you have DH you will likely also want to avoid iodine, which is common in seafoods and dairy products, as it can exacerbate symptoms in some people. This article may also be helpful as it offers various ways to relieve the itch:

 

[PixieDixie]

Yeah, hard for me to not eat salmon though it does cause varying degrees of irritation to the rash. Alright, guess I’m gonna have to be careful with iodine. Thanks for the article.

[Scott Adams]

No everyone with DH has issues with iodine, but some do, so it's good to be aware of this just in case you fall into that group.