The Difference Between Celiac Disease and Gluten Intolerance
Gluten Sensitivity and Gluten Intolerance are two terms that can be, and often are, used interchangeably. These terms describe any health problem where the underlying cause is gluten. That’s right, these terms cover the spectrum from light gluten intolerance/sensitivity to Dermatitis Herpetiformis (skin manifestation of Celiac) to Celiac Disease. Celiac Disease is the most severe form or gluten intolerance/gluten sensitivity. So, every person living with Celiac Disease, is gluten intolerant/gluten sensitive. However, to clarify, you can be gluten intolerant/ gluten sensitive and not have Celiac.
(Non-Celiac) Gluten Intolerance or Gluten Sensitivity: According to Wall Street Journal Article, “Dr. Peter Green, director of the Celiac Disease Center says that research into gluten sensitivity today is roughly where celiac disease was 30 years ago.” The bottom line is that we are still learning what non-celiac gluten intolerance/ gluten sensitivity really is. According to a recent BMC Medicine on Celiac and Gluten Intolerance/Gluten Sensitivity: “Gluten-sensitive individuals (GS) cannot tolerate gluten and may develop gastrointestinal symptoms similar to those in Celiac Disease, but the overall clinical picture is generally less severe and gluten sensitivity was not accompanied by:
- The presence of tissue transglutaminase autoantibodies (these auto-antibodies cause auto-immune diseases) -OR-
- Autoimmune comorbidities (Comorbidity is the presence of another diseases in addition to a primary disease, AKA Celiac plus another auto-immune disease).”
Here’s another excerpt from the Wall Street Journal: “In the new study, researchers compared blood samples and intestinal biopsies from 42 subjects with confirmed celiac disease, 26 with suspected gluten sensitivity and 39 healthy controls. Those with gluten sensitivity didn’t have the flattened villi, or the “leaky” intestinal walls seen in the subjects with celiac disease. Their immune reactions were different, too. In the gluten-sensitive group, the response came from innate immunity, a primitive system with which the body sets up barriers to repel invaders. The subjects with celiac disease rallied adaptive immunity, a more sophisticated system that develops specific cells to fight foreign bodies. Dr. Fasano hopes to eventually discover a biomarker specifically for gluten sensitivity.” Mrs. Kupper, executive director of Gluten Intolerance Group of North America, concluded the article with, “for now, a gluten-free diet is the only treatment recommended for gluten sensitivity, though some may be able to tolerate small amounts. There’s a lot more that needs to be done for people with gluten sensitivity,” she says. “But at least we now recognize that it’s real and that these people aren’t crazy.”
Celiac Disease (the word “Celiac” is from the Greek word “abdominal”) is the most severe form of gluten intolerance/gluten sensitivity. Celiac disease is an auto-immune disorder (the immune system attacks itself) that damages the lining of the small intestine (the villi) and compromises the absorption of nutrients. Celiac Disase is a permanent intolerance to gluten (which means 100% no tolerance policy when it comes to gluten- do not consume it for ANY reason). The villi absorb our nutrients, so when these are destroyed, the body experiences malabsorption of minerals and vitamins such as Vit A, B12, B6, K, Calcium, Magnesium and the list goes on.
The Wall Street Journal put together a diagram that I thought was really helpful…
Dermatitis Herpetiformis (according to the Columbia Disease Center in NY) is the skin manifestation of Celiac Disease. It is characterized by an extremely itchy, watery blister or rash that is found on the limbs, trunk, face and scalp. The blisters are often mirrored on both sides of the body or face and reoccur in the same areas. The eruptions are often mistaken for and treated as other skin conditions including psoriasis, infected mosquito bites, contact dermatitis, allergies or “non-specific dermatitis.”
It’s important to note that non-celiac gluten intolerance, gluten sensitivity and Celiac Disease are NOT allergies. A Gluten Allergy (according to Health Now website): One develops allergic symptoms due to the immune system “labeling” something as a toxin or foreign invader. This reaction is created by a specific immunoglobulin (a protein designed to fight toxic or foreign substances) named immunoglobulin E or IgE for short. This is different than an:
Auto-immune reaction: which means the body attacks its own cells. The immune system mistakes some part of the body as a pathogen (infectious agent) and attacks it’s own healthy tissue.
What does all of this mean? It means that many of us avoid gluten for many different reasons, but the culprit is what ties us together: Gluten
Okay, I hope I didn’t butcher that, lol. please keep in mind that we are constantly learning more about all of these conditions that are triggered by gluten. And as our numbers grow, so will our voice and the knowledge of these conditions. To those who don’t have Celiac, but have “non-celiac related gluten intolerance/gluten sensitivity”, I say to you, you are important, your condition is real. Don’t let anyone let you feel less of a person because you don’t have Celiac, be thankful you don’t have Celiac. Celiac Disease is often take more seriously because the ramifications of this disease are serious. I got my bone scan results today and I’m on the border line between osteoporosis and osteopenia. I won’t lie, I know it’s going to be fine, but I cried. It’s hard to feel so young and yet know that my insides are feeling so old. I cried for the years that I unknowingly didn’t know I was damaging my body so severely, I cried for the loss of years I had while seeking a diagnosis. I’m a pretty positive chick, so every once in while, I give myself permission to let it out, to mourn…so that I can move on to the joy in my life and to the work at hand. So… I cried…. because some days I’m acutely aware that this disease encompasses so much more than a gluten free diet…
So to those who have Celiac, keep pressing!!! Hang in there and keep rocking and rolling until you are as healthy as possible! And to those with gluten sensitivity, I applaud you for your courage to live a gluten free life even though non-celiac-gluten-intolerance/sensitivity is not as well known as Celiac Disease. But it will be one day, it will!!! We all deserve to feel the best we can no matter the reason for our challenges. So to all my Celiac, gluten intolerant, gluten sensitive, gluten allergic, and dermatitis herpetiformis friends: hang in there, treat yourselves well and stick to your gluten free guns.