Celiac disease is an autoimmune disorder that is typically due to aggressive intolerance to gluten, a protein that is found in wheat, rye, and barley. Gluten sensitivity, also known as non-celiac gluten intolerance, is characterized by an inability to digest gluten. It is not a genetic or autoimmune disorder. 

What is celiac disease?

Definition:

Celiac disease is an autoimmune disorder that is typically due to aggressive intolerance to gluten, a protein that is found in wheat, rye, and barley.

Etiology:

Celiac disease is autoimmune. It is characterized by the body’s immune system attacking and destroying the small intestine after gluten intake.

Signs and symptoms:

The signs and symptoms of celiac disease include stomach pain, bloating, weight loss, foul-smelling diarrhea, fatigue, dental erosion, short stature or stunted growth, body rash, and pallor skin.

Risk factors:

The disease is more common in females, in the European population, and in those with other autoimmune disorders such as type 1 diabetes, autoimmune hepatitis, thyroid disorders such as Hashimoto thyroiditis and Graves’ disease, and Addison’s disease.

Diagnosis:

The diagnosis of celiac disease requires genetic testing via blood tests or biopsy for the DQ2 or DQ8 genes. Important tests in celiac patients are antibodies for gliadin and tissue transglutaminase. Additionally, small intestine endoscopy and biopsy are needed to identify the histopathological changes in the intestinal lining.

Treatment:

A gluten-free diet is a definitive treatment for celiac disease.

What is gluten sensitivity?

Definition:

Gluten sensitivity, also known as non-celiac gluten intolerance, is characterized by an inability to digest gluten. It is not a genetic or autoimmune disorder. 

Etiology:

It is a digestive disorder, however, there is some evidence of the presence of DQ2 and DQ8 genes in gluten sensitivity.

Signs and symptoms:

The signs and symptoms of gluten sensitivity often overlap those of celiac disease. The major symptoms of gluten sensitivity are abdominal distension, bloating, stomachache, long-term diarrhea, chronic fatigue, malaise, headache, and anxiety. 

Diagnosis:

The diagnosis of gluten sensitivity is made via genetic testing and blood testing for antibodies.

Treatment:

A gluten-free diet is the mainstay treatment for gluten sensitivity.

Difference between Celiac disease and Gluten sensitivity

Definition:

Celiac disease is an autoimmune disorder that is typically due to aggressive intolerance to gluten, a protein that is found in wheat, rye, and barley.

Gluten sensitivity, also known as non-celiac gluten intolerance, is characterized by an inability to digest gluten. It is not a genetic or autoimmune disorder. 

Etiology:

Celiac disease is autoimmune. It is characterized by the body’s immune system attacking and destroying the small intestine after gluten intake.

Gluten sensitivity is a digestive disorder, however, there is some evidence of the presence of DQ2 and DQ8 genes in gluten sensitivity.

Signs and symptoms:

The signs and symptoms of celiac disease include stomach pain, bloating, weight loss, foul-smelling diarrhea, fatigue, dental erosion, short stature or stunted growth, body rash, and pallor skin. The signs and symptoms of gluten sensitivity often overlap those of celiac disease. The major symptoms of gluten sensitivity are abdominal distension, bloating, stomachache, long-term diarrhea, chronic fatigue, malaise, headache, and anxiety. 

Diagnosis:

The diagnosis of celiac disease requires genetic testing via blood tests or biopsy for the DQ2 or DQ8 genes. Important tests in celiac patients are antibodies for gliadin and tissue transglutaminase. Additionally, small intestine endoscopy and biopsy are needed to identify the histopathological changes in the intestinal lining. Similarly, the diagnosis of gluten sensitivity is made via genetic testing and blood testing for antibodies.

Treatment:

A gluten-free diet is a definitive treatment for both celiac disease and gluten sensitivity.

Table of differences between Celiac disease and Gluten sensitivity

FAQs

Can someone with gluten sensitivity still eat gluten in small amounts?

Small amounts of gluten do not cause an adverse reaction in patients with gluten sensitivity; however, gluten should be avoided at maximum.

Is celiac disease more severe than gluten sensitivity?

Yes. Celiac disease is more severe than gluten sensitivity.

Are the treatments for celiac disease and gluten sensitivity the same?

Yes, the treatment of both celiac disease and gluten sensitivity is a gluten-free diet.

Is it possible to have both celiac disease and gluten sensitivity?

No, these are two different conditions.

Can gluten sensitivity develop into celiac disease?

Not really.

Are there any long-term complications associated with celiac disease and gluten sensitivity?

Complications of celiac disease and gluten sensitivity include intestinal lymphoma, osteoporosis, malnutrition, and anemia.

Is it necessary to completely avoid gluten if you have gluten sensitivity but not celiac disease?

Yes.

How common are celiac disease and gluten sensitivity? 

Celiac disease is prevalent in 1% of the US population whereas gluten sensitivity occurs in 6% of the US population.

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