The main difference between celiac disease and gluten intolerance is that celiac disease is an inherited autoimmune disorder that affects the digestive process of the small intestine, whereas gluten intolerance causes the body to mount a stress response which is different from the immunological response that occurs in celiac disease.
Celiac disease and gluten intolerance are two medical conditions triggered by a protein known as gluten. This protein is present in cereals such as rye, wheat, and barley. These two terms are often used interchangeably, even by healthcare professionals, due to several common features they share.
Key Areas Covered
1. What is Celiac Disease
– Cause, Signs and Symptoms, Diagnosis, Treatment and Management
2. What is Gluten Intolerance
– Cause, Signs and Symptoms, Diagnosis, Treatment and Management
3. Difference Between Celiac Disease and Gluten Intolerance
– Comparison of Key Differences
Key Terms
Celiac Disease, Gluten Intolerance
What is Celiac Disease
Celiac disease is an auto-immune disorder which is triggered by consuming Gluten, a protein present in cereals like wheat and barley. As far as the pathophysiology of this disease is concerned, gluten damages the gut lining and its villi, resulting in poor digestion and malabsorption of nutrients over time.
Most individuals diagnosed with this condition have a positive family history; this supports the fact that celiac disease has a genetic predisposition. Furthermore, this can be triggered by stress, viral infections and environmental factors; it can also be triggered during pregnancy or following surgery. Individuals with underlying autoimmune thyroid diseases and Sjogren’s syndrome ( an autoimmune disorder with dry mouth and eyes) are also at a high risk.
Patients with Celiac disease will mainly experience signs and symptoms related to the gastrointestinal system, but there can also be extra-intestinal features.
Intestinal symptoms:
Diarrhea, pale-foul smelling stools, abdominal pain, loss of weight and appetite, constipation, acid reflux and heartburn
Extra-intestinal manifestations:
Headache, itching, rashes, anemia, osteoporosis, fatigue and joint pains
Effects of celiac disease during critical growth:
Failure to thrive in infants, delayed puberty in adolescents, short stature, irritability in the mood, weight loss, and dental enamel defects.
To make a proper diagnosis, a complete history of signs and symptoms, their duration, associated factors, diet and family history should be taken from the patient. A thorough physical examination will also be helpful to diagnose other associated diseases like autoimmune thyroid diseases and exclude other conditions that might mimic celiac disease.
Figure 1: Biopsy of small intestine showing celiac disease
Upper endoscopy along with duodenal biopsy (show villous atrophy) and serological screening for coeliac disease assessing positive levels of HLA DQ2/DQ8 typing (the commonest gene associated with coeliac disease) will confirm the diagnosis.
Being a chronic and lifelong condition, there is no permanent cure for celiac disease. However, a properly tailored treatment plan together with a gluten-free diet (avoid canned food, medication, and almost every eatable possibly containing gluten) will improve the symptoms.
What is Gluten Intolerance
Also known as Non-Celiac Gluten Sensitivity (NCGS), gluten intolerance characteristically causes signs and symptoms similar to that of celiac disease without having an underlying celiac disease or wheat allergy. Researchers are still trying to find a clear-cut etiology for this condition.
Patients will usually experience symptoms like mental fatigue (brain fog), physical fatigue, bloated feeling in the abdomen and headache.
Figure 2: Gluten-Free Bread
Gluten intolerance is a diagnosis made by exclusion of other conditions like celiac disease and allergies to wheat in patients who are developing signs and symptoms following meals with Gluten. However, since there is no exact test to confirm the diagnosis, most physicians will advise patients to maintain a ‘Food and Symptom journal’ in relation to every meal they consume so that a confirmed etiology of Gluten-diet could be revealed.
After confirming the above feature, a gluten-free diet will be initiated, which must be continued throughout life.
Difference Between Celiac Disease and Gluten Intolerance
Definition
Celiac disease is an inherited autoimmune disorder that affects the digestive process of the small intestine. Gluten intolerance causes the body to mount a stress response different from the immunological response that occurs in celiac disease. Individuals with gluten tolerance do not show any signs of intestinal damage or increased permeability.
Symptoms
Celiac disease can indicate both intestinal symptoms and extra-intestinal manifestations. Intestinal symptoms include diarrhea, pale-foul smelling stools, abdominal pain, loss of weight and appetite, constipation, acid reflux and heartburn. Meanwhile, extra-intestinal manifestations include headache, itching, rashes, anemia, osteoporosis, fatigue and joint pains. On the other hand, gluten intolerance symptoms include mental fatigue (brain fog), physical fatigue, bloated feeling in the abdomen and headache.
Diagnosis
Both these conditions are triggered by the consumption of gluten. Celiac disease is diagnosed by a duodenal biopsy and serological screening. But gluten intolerance will be diagnosed by excluding possible causes of wheat allergy and underlying celiac disease.
Conclusion
Celiac disease is an inherited autoimmune disorder that affects the digestive process of the small intestine. However, gluten intolerance causes the body to mount a stress response different from the immunological response in celiac disease. Thus, this is the main difference between celiac disease and gluten intolerance.
Image Courtesy:
1. “Coeliac path” By Samir at the English language Wikipedia (CC BY-SA 3.0) via Commons Wikimedia
2. “Gluten Free Bread” by @joefoodie (CC BY 2.0) via Flickr
