Gluten-related disorders are becoming increasingly common, with more people reporting adverse reactions to gluten-containing foods. While the spectrum of gluten reactivity ranges from mild to severe, the two main conditions are gluten intolerance (also called non-coeliac gluten sensitivity) and coeliac disease. Understanding the distinctions between these two conditions can help people better manage their health.
With gluten-free diets becoming more popular, it’s important to understand what prompts someone to actually require 100% gluten elimination from their diet for medical reasons versus simply wanting to go gluten-free. This article will examine the key differences between gluten intolerance and coeliac disease, from causes to symptoms and treatment, to help provide clarity between the two gluten-related conditions.
What is Gluten?
Gluten is a protein found in grains like wheat, barley and rye. It acts as a glue that holds food together and helps bread to rise. Gluten makes dough more elastic, helping it keep its shape. It also gives a chewy texture to products like bread and pasta.
Gluten Intolerance
Gluten intolerance is a condition where gluten causes unpleasant digestive symptoms. These can include abdominal pain, bloating, gas, diarrhea and constipation. Joint pain, headaches, fatigue and skin issues like rashes may also occur.
The exact cause of gluten intolerance is unknown. It does not involve damage to the small intestine like coeliac disease. However, it appears to be an immune reaction to gluten in genetically predisposed individuals. Avoiding gluten products usually improves the symptoms.
Coeliac Disease
Coeliac disease is an autoimmune disorder. The immune system mistakes gluten as a threat and produces antibodies to fight it. This causes damage to the lining of the small intestine, preventing it from properly absorbing nutrients from food.
In coeliac disease, the villi of the small intestine become inflamed and flattened. Villi are tiny, finger-like projections that absorb nutrients. When they are damaged, nutrient absorption is impaired. This can lead to symptoms like diarrhea, abdominal pain, bloating, weight loss, fatigue and even behavioural issues in children.
Coeliac disease is a serious genetic autoimmune disease that runs in families. Eating a strict gluten-free diet for life is essential to managing coeliac disease. Working with a Gluten-free coach or a coeliac coach like Ali Walsh can make the transition to a GF lifestyle easier.
Key Differences
While gluten intolerance and coeliac disease share some similar symptoms, there are distinct differences:
- Gluten intolerance does not always involve the immune system, while coeliac disease is an autoimmune disorder.
- Coeliac disease causes damage to the small intestinal lining, while gluten intolerance does not.
- Gluten intolerance symptoms may be more variable, while coeliac disease symptoms are specifically gastrointestinal.
- Coeliac disease is lifelong and genetic, while gluten intolerance can be temporary.
- A gluten-free diet is optional for gluten intolerance but required for coeliac patients.
The Bottom Line
Gluten intolerance and coeliac disease both involve adverse reactions to gluten and can share symptoms like abdominal discomfort, bloating and fatigue. However, coeliac disease is an autoimmune condition that damages the small intestine and requires a strict gluten-free diet. Gluten intolerance does not damage the intestines and may not require fully eliminating gluten. Consulting with a doctor can help determine the cause of gluten-related symptoms.