When you talk about what celiac disease is, you often have to talk about what the disease is not.
While ‘celiac disease’, ‘gluten allergy’, and ‘gluten sensitivity’ or ‘intolerance’ are often lumped together in the media, they are three different gluten related disorders. While these medical issues frequently share similar outward symptoms, the causes of each issue are drastically different.
Celiac disease is an autoimmune disorder. When an individual with celiac disease ingests gluten, the molecules attack their small intestine. Your small intestine is where you absorb life-giving nutrients. Villi (the long, squiggly protrusions the picture on the right) aid your body in soaking up as many nutrients as possible by increasing surface area in your small intestine.
Gluten molecules attack these villi, blunting them. This reduces the surface area of the small intestine, causing malnutrition as well as a host of other health issues, including neurological issues like depression and anxiety.
Celiac disease is the easiest of the three gluten disorders to test. Blood tests pick up the gene that causes celiac disease, and endoscopies clearly reveal damaged villi.
Doctors aren’t sure what causes celiac disease. Evidence increasingly suggests that the disease is genetic.
There is no cure for celiac disease. The only way to heal and preserve the intestines and get better is to abstain 100% from gluten. Even tiny molecules of gluten can cause a severe reaction. Unlike individuals with gluten sensitivity, those with celiac disease cannot ‘cheat’. Even when outward symptoms are not present, damage is being done to an individuals insides.
A gluten allergy is exactly what is sounds like – an allergy to gluten. Gluten allergies are extremely rare. Most individuals with a suspected gluten allergy instead have celiac disease or gluten sensitivity.
(Note: Being allergic to wheat is different than being allergic to gluten. Wheat allergies are one of the ‘big 8’ most frequent allergies, alongside milk, eggs, peanuts, tree nuts, fish, shellfish, and soy.)
When you have a gluten allergy, your body mistakes gluten proteins as harmful. Your immune system strikes back, triggering an allergic reaction in the body.
The symptoms of a gluten allergy differ from those of celiac disease or gluten sensitivity. Symptoms of a gluten allergy are similar to those experienced with other allergies, including hives, swelling, difficulty breathing, etc.
Gluten intolerance, also called gluten sensitivity, is tricky. It is tricky to diagnose and near impossible to accurately test.
Individuals with gluten intolerance exhibit near identical symptoms to celiac disease, but their blood tests and endoscopies do not reveal damage to the lower intestine.
Through process of elimination or simply a period of eating a strict gluten-free diet, an individual may self-diagnose an issue with gluten despite the presence of the molecules that would cause a negative reaction to gluten.
Doctors have yet to determine what causes gluten intolerance, and what damage it causes to the body. Many doctors dispute the existence of gluten intolerance, claiming that a lack of cohesive testing practices, symptoms, and visible intestinal damage prevents them from labeling it as a disease. Most doctors do agree that celiac disease should be ruled out before going on a gluten-free diet.
Individuals with gluten intolerance may choose to ‘cheat’ on the gluten-free diet, as there is no proof that gluten molecules cause any damage to the body. However, because the symptoms are so similar to celiac disease, many individuals abstain from gluten 100% for their own comfort and quality of life.
(Image Source: Tiggy)