FeaturesApr/May 2012 Issue

Celiac Disease: What’s the Difference?

Wheat allergy, gluten intolerance, gluten sensitivity


Wheat allergy occurs when the body produces antibodies(usually IgE) in response to wheat (i.e., gluten, the protein found in wheat). These antibodies circulate throughout the blood stream, triggering an immune response (an allergic reaction), which occurs within seconds or up to several hours after ingestion.

Gluten intolerance is widely used to describe anyone who has symptoms after eating gluten that are relieved when it’s removed from the diet. If you have celiac disease, you are, by definition, gluten intolerant. But it is possible to be gluten intolerant and not have celiac disease.

Many people say they are gluten intolerant after feeling better on the glutenfree diet. They may diagnose themselves out of frustration after various doctors cannot agree on what is causing their symptoms. There is little doubt that increasing awareness of gluten intolerance has spurred a huge growth in gluten- free food options currently in restaurants and markets.

Gluten sensitivity is another widely used term when the ingestion of gluten causes various symptoms and its removal resolves the issues. Again, if you have celiac disease, you are by definition gluten sensitive but not everyone with gluten sensitivity has celiac disease. Gluten sensitivity and gluten intolerance are terms that are frequently used interchangeably.

Gluten sensitivity is believed by some experts to be a disease entity with its own immune mechanisms that affect different parts of the body. This means that the response to gluten in some patients occurs in organs other than the digestive system. Symptoms may be neurological— gluten ataxia (clumsiness in gait or coordination) and gluten neuropathy (numbness and tingling in hands or feet) being the most common. In fact, many people have neurological manifestations of gluten sensitivity with little or no intestinal involvement. This lack of damage to the gut is also seen in some people with dermatitis herpetiformis, or DH, the skin manifestation of celiac disease. While gluten is the common trigger, there are still many questions regarding how and why these conditions develop in response to gluten. In particular, gluten sensitivity as a separate disease entity warrants further study.

Until there are more definitive answers, if you get sick when ingesting gluten, you may be gluten sensitive and may benefit from the gluten-free diet.

Important: Do not self-diagnosis celiac disease. It is a serious medical condition that requires a doctor’s care and the strict, life-long adherence to the glutenfree diet. Experts strongly recommend that people be screened for celiac disease before embarking on the gluten-free diet.


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