Gluten Sensitivity vs Celiac Disease

Celiac disease is most commonly confused with gluten intolerance. As Shakespeare might say, “What’s in a name?” Well, it turns out that they are two very different things. So, let’s go over a few things and see why it is important to differentiate between the two.

1. What is gluten sensitivity?

Gluten sensitivity is a condition where eating gluten leads to uncomfortable GI symptoms, including abdominal cramping, bloating and diarrhea. It does not lead to serious medical complications.

2. What is Celiac disease?

Celiac disease is an autoimmune disorder causing inflammation and damage in the lining of the small bowel with exposure to gluten. It can lead to serious medical complications, and it improves with a strict gluten-free diet.

3. What is gluten?

Gluten is a protein found in certain foods we eat, including wheat, rye, oats and barley.

4. How common is Celiac disease?

Celiac disease affects about 1 in 141 people. It is estimated that at least 3 million Americans have this condition.

5. What are some of the deficiencies we see in Celiac disease?

Because Celiac disease affects the lining of the small bowel, it affects the absorption of different nutrients. We see malabsorption of essential vitamins and minerals, including folate, iron, vitamin D, vitamin B12, calcium, copper, magnesium and zinc.

6. How does it manifest? GI and other organ systems?

Classically people present with malodorous diarrhea with floating stools. Additionally, people may experience abdominal discomfort, bloating and increased flatulence (passage of excessive gas). Celiac disease can lead to growth failure (mainly in children) or weight loss, anemia, neurological disorders from a deficiency of vitamins, and bone loss/osteopenia from a deficiency of vitamin D and calcium. It is also commonly associated with other autoimmune disorders, such as type 1 diabetes and thyroid disorders. Though not very common, the most serious complications in patients with Celiac disease who continue to eat gluten include lymphoma and other cancers of the small bowel.

7. Why is it important to differentiate the two?

As you may have guessed, while having gluten sensitivity leads to uncomfortable GI symptoms, it does not lead to serious nutritional deficiencies or cause the complications listed under #6.

8. How can one tell the difference between Celiac disease and gluten sensitivity?

As you may have noticed, the GI symptoms are very similar between the two. As such, it can be challenging to tell one from the other. Formal medical testing is often needed to ensure patients with Celiac disease are identified and get the care they need.

9. What are some of the tests available to look for Celiac disease?

There are blood tests, genetic tests, and endoscopy. During endoscopy, the small bowel may appear grossly abnormal in some cases. Additionally, endoscopy offers the chance to take tissue biopsies to look for microscopic changes seen in Celiac disease.

10. Finally, what is the treatment you ask?

Celiac disease is treated with a strict gluten-free diet. By being vigilant about what one eats, including diligently reviewing all the ingredients in your diet, one can lead a life free of the complications mentioned above. The good news is that awareness to this condition has been heightened and numerous gluten-free food products and restaurants are available. Excellent resources to utilize for more information are www.celiac.org and www.mayoclinic.org/diseases-conditions/celiac-disease/symptoms-causes/syc-20352220.

Digestive Health Specialists is here to help you if you, or someone you know, would like more information, or if you are experiencing any of the above symptoms and would like further evaluation. To make an appointment, feel free to give us a call at 336-768-6211.

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