There has been a lot of controversial data in the last few years in and around gluten. Common questions asked are ,is gluten bad for me? Why should I go gluten free? Do I have gluten intolerance? This article will help you understand the difference between celiac disease and non-celiac gluten sensitivity.
What is Celiac disease?
Celiac disease is an auto-immune disorder that affects the small intestine and eventually the entire digestive process. When a person suffering from Celiac disease consumes foods containing gluten or sometimes even traces of gluten, their immune system starts attacking the gluten molecules. This fault in the immune system starts damaging the healthy cells that line the small intestine. Prolonged exposure to these gluten molecules inhibits the intestines’ ability to absorb nutrients, which can be tricky and can often lead to symptoms such as fatigue, bloating, joint pain, depression, etc. In such situations, it is best to completely avoid gluten and hinder the autoimmune response to ensure optimal nutrient absorption.
What is Gluten sensitivity:
Gluten sensitivity, also known as non-celiac gluten sensitivity (NCGS), is not a well-defined condition. The diagnosis is made by ruling out other conditions, and unfortunately, there is no test or biomarker that can be used for diagnosis. Non-celiac gluten sensitivity, unlike celiac disease, does not involve an autoimmune reaction and therefore there is no antibody production involved. There is no damage to the small intestine lining and the symptoms are similar to IBS, like bloating, abdominal pain, acid reflux, constipation and diarrhea. Refer to the picture below for better understanding.
There can also be non-intestinal symptoms like fatigue, foggy mind, numbness, joint pain, but it is important to understand that these can be subjective. The clinical symptoms of NCGS overlap with celiac disease making it difficult to distinguish between the two.
This brings us to another question – How do we determine if someone has Celiac disease or gluten sensitivity?
A study conducted by Dr. Fasano suggests a diagnostic algorithm that can help us identify the disease, which is depicted in the diagram below.
Stay Tuned For The Following Article Where We Guide You Through The Transition Of Gluten-free Eating!
By:
Written by Disti Vira, Dietetic Student
Reviewed by Manmeet Behl, RD,NM
Updated: Dec 4, 2020
References
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- Al-Toma A, Volta U, Auricchio R, Castillejo G, Sanders D, Cellier C, Mulder CJ, Lundin KAE. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United European Gastroenterol J. 2019. Doi: 10.1177/2050640619844125.
- Uhde, et al., (2016). Intestinal cell damage and systemic immune activation in individuals reporting sensitivity to wheat in the absence of coeliac disease. BMJ Journals, 65(12), 1930-1937. doi:10.1136/gutjnl-2016-311964 (http://gut.bmj.com/content/early/2016/07/21/gutjnl-2016-311964.full)
- Harvard Medical school. (2014, December). Celiac disease. Harvard Health publishing. https://www.celiac.ca/gluten-related-disorders/non-celiac-gluten-sensitivity/
- Lebwohl B, Ludvigsson JF, Green PHR. Celiac disease and non-celiac gluten sensitivity. BMJ 2015;351;h4347
- Volta U, Bardella MT, Calabro A et al. An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Medicine. 2014;12:85.
- Kabbani TA, Vanga RR, Leffler DA et al. Celiac disease or non-celiac gluten sensitivity? An approach to clinical differential diagnosis. Am J Gastroenterol. 2014;109;(5);741-6
- Canadian Celiac association. (n.d.). Non-Celiac Gluten Sensitivity: How to Diagnose and Differentiate it from Celiac Disease. Lebwohl B, Ludvigsson JF, Green PHR. Celiac disease and non-celiac gluten sensitivity. BMJ 2015;351;h4347. https://www.celiac.ca/gluten-related-disorders/non-celiac-gluten-sensitivity/
- Anastasia V Balakireva, & Andrey A Zamyatnin. (2018). Properties of Gluten Intolerance: Gluten Structure, Evolution, Pathogenicity and Detoxification Capabilities. 10.3390/nu8100644