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Gluten Sensitivity vs Celiac Disease

If you find yourself regularly experiencing pain, bloating, fatigue or other symptoms after consuming gluten, you may automatically suspect celiac disease. But recent research shows that far greater numbers of people are actually suffering from gluten sensitivity, a condition with certain celiac-like symptoms that is only now being understood.

If grains are definitely getting you down but you’re not sure whether celiac disease or gluten sensitivity is to blame, here’s a guide of the differences between the two conditions to clear away the confusion and help you get to the root of your problem.

1. Antibodies

Celiac disease is an inherited autoimmune disorder triggered by gluten consumption and often resulting in permanent intestinal damage. Gluten sensitivity is considered a non- inherited intolerance to gluten. While both conditions can share symptoms such as fatigue and joint pain, that’s where the similarity ends.

Celiac sufferers show tissue transglutaminase (tTG) antibodies in their blood, evidence of a negative response to the proteins found in gluten, while those with gluten sensitivity show no signs of these antibodies.

2. Differing Diagnoses

Celiac disease is mainly diagnosed through blood tests that screen for antibodies and duodenal biopsies looking for damage in the small intestine.

On the other hand, there are no biomarkers currently available for testing gluten sensitivity. Gluten sensitivity doesn’t show up in blood tests or biopsies and is primarily diagnosed by first eliminating the possibility of celiac disease with a blood test. If the test shows no evidence of celiac disease but the individual is regularly experiencing pain or other symptoms after consuming gluten, doctors will then recommend an elimination diet.

All gluten is removed from the diet for up to a month and the individual monitors their symptoms. If their symptoms improve or disappear on a completely gluten-free diet, doctors will counsel that gluten be reintroduced. The individual is then closely screened.

If an increase in symptoms is seen and no other autoimmune cause can be found for this increase, the individual is given a diagnosis of NCGS or Non-Celiac Glutens Sensitivity (gluten sensitivity, for short).

3. Gut VS Brain

Although abdominal pain is a common symptom of both conditions, celiac sufferers often present with severe intestinal inflammation that leads to destruction of the intestinal villi, while those with gluten sensitivity don’t. Celiac disease tends to predominantly target the small intestine, showing up as abdominal pain, nausea, constipation and diarrhea.

Celiac disease also frequently causes malabsorption, a condition in which the intestines are so badly damaged that they can no longer absorb nutrients from food. This leaves those with celiac disease lacking in nutrients such as vitamin B12, vitamin D and calcium. Because of these deficiencies, individuals with celiac disease often suffer from unexplained weight loss, damaged tooth enamel and osteoporosis.

In contrast, those with gluten sensitivity don’t generally present with malabsorption and tend to experience fewer abdominal symptoms. Instead, they’re much more likely to complain of symptoms affecting the central and peripheral nervous system, with everything from migraines, “brain fog” and ADD-like concentration problems, to nerve tingling, and even depression being commonly reported by sufferers.

4. Incidence rates

According to available testing, celiac disease is relatively rare, with approximately 1 out of every 100 people affected globally. Gluten sensitivity, on the other hand, may be up to 6 times as prevalent, though it’s believed that both celiac disease and gluten sensitivity are under-diagnosed, so actual numbers may be much higher.

5. Treatment of symptoms

For those with celiac disease, consuming even a tiny amount of gluten is considered a major health risk and celiac sufferers are advised to maintain a completely gluten-free diet for the rest of their lives or risk serious complications including infertility, loss of mobility, intestinal cancer and even death.

Those with gluten sensitivity may experience considerable symptomatic relief from a gluten-free diet but current research does not conclusively point to eliminate gluten permanently. Still, many gluten sensitive individuals do end up deciding that the pain-free payoff of a gluten-free lifestyle is worth the effort.

While both celiac disease and glutens sensitivity are just beginning to be truly understood, many doctors believe celiac disease may be a much more severe and dangerous condition, that if left untreated, may increase the risk of death up to four-fold. For this reason, it’s essential to consult with a doctor and receive proper celiac screening if you suspect you have a problem with gluten, rather than simply trying to self-diagnose.

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-BS Pharm, PharmD, RPh

Dr. Paul Zickler is a graduate of the University of Wester Ontario in 1972. After graduating from the faculty of medicine, Dr. Zickler practiced as an Emergency Physician for 18 years. He has then operated ambulatory medical and travel clinics for 12 years. Dr. Zickler has become an Associate Professor of Emergency Medicine at the University of British Columbia, a Director of Professional Programs for the Justice Institute of British Columbia (paramedic academy), a principal investigator for Phase 2 and 3 studies researching vaccines, and a founding member of the Canadian International Pharmacy Association. Dr. Zickler is passionate about combining western prescription medicine and natural medicines.

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