Celiac Disease and Gluten Sensitivity

1 Big Thing: Celiac Disease is an autoimmune disorder where gluten damages the small intestine, while Gluten Sensitivity causes discomfort without intestinal damage.

Why it Matters: Understanding the differences between these conditions is important for appropriate dietary choices, symptom management, and long-term health.

Between the Lines: While both involve reactions to gluten, their underlying causes, symptoms, and management strategies differ significantly.

Go Deeper

Celiac disease and gluten sensitivity are often mentioned in the same breath, but they are distinct conditions with different implications for health and diet. Here's a closer look:

Celiac Disease: An Autoimmune Condition

• Celiac disease is an autoimmune disorder where the ingestion of gluten leads to damage in the small intestine.
• It's estimated to affect 1 in 100 people worldwide.
• When people with celiac disease eat gluten, their body mounts an immune response that attacks the small intestine, leading to damage to the villi, small finger-like projections that line the intestine and promote nutrient absorption.
• Symptoms can range from digestive problems (such as diarrhea, bloating, and gas) to more serious complications like osteoporosis, infertility, nerve damage, and seizures.
• A strict, lifelong gluten-free diet is essential for managing this condition.

Gluten Sensitivity: A Milder Reaction

• Gluten sensitivity, or non-celiac gluten sensitivity (NCGS), is a condition wherein individuals experience symptoms similar to those of celiac disease, but without the associated intestinal damage.
• Symptoms of gluten sensitivity can include abdominal pain, bloating, diarrhea, constipation, headaches, and fatigue.
• The pathogenesis of NCGS is not completely understood, and there is no definitive test for diagnosing it.
• Management typically involves a trial of a gluten-free diet to see if symptoms improve.

Diagnosis and Treatment

• Diagnosis of celiac disease involves serologic (blood) tests and endoscopy with biopsy of the small intestine.
• For gluten sensitivity, diagnosis is more challenging due to the lack of specific biomarkers and is often reached by ruling out celiac disease and wheat allergy.
• Treatment for both conditions revolves around dietary changes, primarily the avoidance of gluten-containing foods.
• In celiac disease, adherence to a gluten-free diet can heal intestine damage and prevent further complications.

Living with Gluten-Related Disorders

• Living with either condition requires significant lifestyle adjustments, particularly in diet.
• Many foods contain gluten, including obvious sources like bread and pasta, and less obvious ones like soy sauce and certain processed foods.
• For those with celiac disease, even small amounts of gluten can cause damage, making cross-contamination a concern.
• A dietitian can help in identifying safe foods and ensuring nutritional needs are met.

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Please note: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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