Gluten Intolerance Vs Celiac Disease

People often assume gluten intolerance and celiac disease are one and the same. While celiac disease is a gluten sensitivity, it is possible to exhibit clear signs of a gluten sensitivity without testing positive for celiac sprue disease. One accurate way to look at it is to view celiac disease as a severe and more clearly diagnosed subset of a gluten intolerance. Let's walk through some of the similarities and differences between gluten intolerance vs celiac disease.

Similar Symptoms

One obvious similarity is that the symptoms experienced by someone who is intolerant to gluten and someone diagnosed as a celiac will be very similar. The primary symptoms will include alternating bouts of constipation and diarrhea, excessive foul-smelling flatulence, intestinal bloating and cramping, lethargy, weight-loss and sore joints.

Similar Microvilli Response To A Gluten-Free Diet

One way doctors try to diagnose people as celiac or not is to take a biopsy of the small intestine wall before having the patient subscribe to a strict gluten-free diet and then after that patient has been on that diet for some time (usually at least six weeks).

Along the walls of the small intestines are little finger-like hairs called villi or microvilli. Someone suffering from both gluten intolerance and celiac disease will have damaged microvilli, and after subscribing to a strict gluten-free diet for a good period of time, the microvilli will start to recover.

Different Presence of Antibodies

The most common blood test for celiac sprue disease involves checking for raised levels of specific antibodies that are triggered by consuming gluten. These antibodies are AGA, EMA, and Anti-tTG. However, there have been cases where someone who broadly exhibits negative effects from consuming gluten won't always show a clear sign of having these antibodies at a raised level. In some people, these antibody levels may fluctuate, so testing them at different times may create different results.

While the presence of these antibodies strongly suggests celiac disease is present, some people have exhibited a clear negative response to consuming gluten despite testing negatively for this blood test, so it can be a difference.

Different Presence of Specific Genes

If DNA testing is conducted, a pretty stark line can be drawn between gluten intolerance vs celiac disease. If you exhibit symptoms of a sensitivity to gluten and you have the HLA-DQ8 or HLA-DQ2 genes, than you have celiac disease. If you show all the signs of being gluten sensitive but you don't have these genes you will be diagnosed as having an intolerance to gluten but you may not be diagnosed a celiac sufferer.

However, the genes associated with various degrees of gluten sensitivity are currently being researched and our understand of this matter appears to be evolving. But for now, this is another difference between those who would be considered gluten intolerant compared to those who would be officially diagnosed as having celiac disease.

Just because you test negative for celiac disease doesn't mean you aren't suffering from some form of gluten sensitivity. Please see your doctor before defining yourself either way. Specifically, I encourage you to discuss the matter with an immunologist who has specific experience with gluten sensitive patients.