What is it?
Individuals who experience distress when eating gluten-containing products and show improvement when following a gluten-free diet may have gluten sensitivity (GS), instead of celiac disease (CD). These individuals are unable to tolerate gluten and develop an adverse reaction when eating gluten. GS has not been well researched, but there is a significant amount of clinical evidence supporting the existence of this condition. In early 2012 GS was classified by an international group of recognized celiac experts as a distinct condition. It is estimated to affect up to ten times more people than CD.
Symptoms seen in gluten sensitivity may resemble those that are associated with celiac disease. In GS there is no indication that gluten causes the same type of damage to the intestine as it does in CD.
There are no agreed upon medical tests that can be performed to confirm GS. However, having an antibody reaction to gluten or gliadin is highly suspicious. To diagnose GS, both celiac disease and wheat allergy should be ruled out. Antibody testing and small intestine biopsy would rule out CD. Immune-allergy tests to wheat would also be negative. Finally an elimination diet is most often used to evaluate whether health improves with the elimination or reduction of gluten from the diet.
Although there are currently no scientific studies that support specific treatment of GS, large numbers of people have discovered that avoiding gluten dramatically changes their health. The recommended course of action is to follow a gluten-free diet. It may or may not be possible for some individuals with gluten sensitivity to tolerate a low-gluten diet instead of a gluten-free diet. Consult an expert in GS for dietary guidelines.
What is it?
Celiac disease is a specific digestive disease that results in damage to the small intestine. The disease is genetically inherited and chronic. When individuals with celiac disease consume gluten, their bodies have an immune response. As a result, the villi of the small intestine become damaged, which causes nutrients to pass through the digestive system without being absorbed. This may lead to gastrointestinal distress and eventually, malnutrition. Malabsorption of nutrients has many serious side effects. There are several forms of celiac disease including classical (gastrointestinal), non-classical (extra-intestinal), and silent or sub-clinical.
Symptoms of celiac disease vary by individual and may include diarrhea, gas, bloating, vomiting, constipation, constipation alternating with diarrhea, nausea, skin irritation, malabsorption, weight loss, anemia, chronic fatigue, weakness, muscle cramps, neurological complaints (including seizures), joint pain, migraine headaches, concentration and memory problems, autoimmune disorders and many other health problems. Malabsorption caused by celiac disease can have serious effects on many organs and body systems.
The diagnostic criteria for celiac disease are very clear and specific. Initial screening is done by blood tests including tTG-IgA/IgG, EMA-IgA/IgG, and DGP. If these tests are positive, a small intestine biopsy may be done. A positive small intestine biopsy, followed by return of health after adhering to a gluten-free diet will confirm a diagnosis of celiac disease.
The only treatment for celiac disease is lifelong elimination of gluten from the diet. Consult a physician for diagnosis and a dietitian for treatment guidelines.
Frequently Asked Questions
Will gluten damage my intestines?
If you have an intestinal biopsy or celiac blood testing which shows that you do not have celiac disease then you will not have villous atrophy. This does not guarantee that you are not experiencing some other type of intestinal damage, but this area is poorly understood.
If I have gluten sensitivity (GS) now, will I develop celiac disease later?
There is no research that shows whether or not individuals with GS will develop celiac disease. Continue to be checked by your doctor regularly if you continue to eat gluten.
Why does a gluten-free diet work for some persons with autism, multiple sclerosis or chronic fatigue, even when they do not have celiac disease?
It is possible that they have GS. This may be one reason why eliminating gluten from their diets results in improvement of some symptoms.
My doctor says that I have some elevated blood tests but do not have celiac disease. What do I have?
You may have a form of GS. Avoiding gluten may help you to feel better. Talk to your doctor or consider a trial elimination of gluten to determine whether or not gluten is negatively affecting you.
I avoid wheat, but I am still having symptoms. What is wrong with me?
A wheat allergy is different from gluten sensitivity. If your symptoms are due to celiac disease or gluten sensitivity, you need to avoid all gluten-containing foods: wheat, rye and barley, as well as any hybrids or products derived from these grains.