Is gluten intolerance the same as coeliac disease?

8 December 2020

Is gluten intolerance the same as coeliac disease?

Is gluten intolerance the same as coeliac disease?

No, gluten or wheat sensitivity (or gluten/wheat intolerance) is not the same as coeliac disease.

Whilst our understanding of coeliac disease is very clear, with a defined diagnosis pathway, more research is required into gluten/wheat sensitivity as there are still a number of unanswered questions about this condition.

Coeliac disease and gluten/wheat sensitivity can both present with similar symptoms, including:

  1. Diarrhoea
  2. Abdominal pain
  3. Wind
  4. Bloating
  5. Constipation
  6. Headaches
  7. Tiredness

Although they have similar symptoms, there are a number of key differences between coeliac disease and gluten/wheat sensitivity.

Check out our handy infographic here for more information! Or our symptom checker 

Is it gluten or wheat?

For someone with coeliac disease, it is gluten they need to avoid, and following a gluten free diet is essential.

Gluten sensitivity is less clear. Some experts believe that it is not gluten that is causing symptoms, but the issue could be with other components found in wheat, therefore gluten sensitivity is sometimes known as wheat sensitivity.

How strict does the gluten free diet need to be?

Coeliac disease is a lifelong autoimmune condition, managed by following a gluten free diet for life. It is important that this diet is followed strictly, including taking measures to prevent cross contamination, to help reduce the risk of developing associated long-term health complications.

It is currently not known if gluten sensitivity is a lifelong condition. People with gluten sensitivity may be able to tolerate small amounts of gluten without any adverse consequences.

How common are the conditions?

Coeliac disease affects 1 in 100 people, however, only approximately 30% of people are diagnosed with the condition. Gluten sensitivity is thought to affect many more people with some studies showing that up to 13% of the UK population report that they have a problem with gluten or wheat.

What changes take place in the gut?

The lining of the gut has microscopic finger-like projections, called villi, to help increase the area over which nutrients can be absorbed from the food we eat. These villi become flattened in untreated coeliac disease or if a strict gluten-free diet is not followed. This means that the body is less able to absorb essential nutrients from food and can result in nutritional deficiencies.

In people with gluten sensitivity, this flattening of the villi does not occur, however, there may still be some less obvious changes in the gut taking place associated with the immune system.

How do you find out if you have coeliac disease or gluten sensitivity?

There are no tests to diagnose gluten sensitivity, therefore it is essential that before you remove gluten from your diet you should first rule out coeliac disease. The reason to continue to include gluten in your diet is that if you remove it before you are tested, it could produce a false negative result. Coeliac disease is a lifelong condition with associated long-term health complications if left untreated or if the diet is not strictly followed and therefore requires careful follow up and management.

You should visit your doctor in the first instance, who will arrange a blood test. If the blood test result is positive for coeliac antibodies they will then refer you to a gastroenterologist who will confirm your diagnosis, sometimes by performing a biopsy.

You can find out more about getting diagnosed with coeliac disease here.

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