What Makes Gluten Intolerance Different From Celiac Disease?

Sarah Bence
·6 min read

Medically reviewed by Melissa Nieves, LND

Gluten intolerance and celiac disease are different conditions with similar symptoms. Celiac is an autoimmune disease in which the body's immune system destroys the lining of the small intestine when you consume gluten. Gluten intolerance is when you react negatively to gluten but do not have autoimmune markers, which are indicated on blood tests. The only way to differentiate gluten intolerance from celiac is with proper diagnosis and testing.

In this article, learn more about gluten intolerance and how it differs from celiac disease.

<p>Illustration by Michela Buttignol for Verywell Health</p>

Illustration by Michela Buttignol for Verywell Health

Gluten Intolerance, Non-Celiac, and Sensitivity: Terms to Know

Gluten intolerance is also known by the terms "non-celiac gluten sensitivity" or "gluten sensitivity." All of these terms refer to the same condition.

When someone reacts negatively to gluten but does not have the autoimmune response that is characteristic of celiac disease, nor the allergic reaction that is characteristic of wheat allergy, they may be diagnosed with gluten intolerance (non-celiac gluten sensitivity).

Gluten Intolerance

  • Not autoimmune

  • No damage to small intestine

  • No identified biological markers

  • Symptoms triggered by consuming gluten

  • Treated with a gluten-free diet

Celiac Disease

  • Autoimmune

  • Causes damage to small intestine

  • Genetic

  • Symptoms triggered by consuming gluten

  • Treated with a gluten-free diet

Intolerance Symptoms From a Gluten Reaction

Gluten intolerance shares the same symptoms as celiac disease. These symptoms can be gastrointestinal and non-gastrointestinal.

Symptoms of gluten intolerance include:

Everyone's experience of gluten intolerance is different. For some people, the first signs of gluten intolerance are bloating or diarrhea after a big pasta meal. For others, it may be fatigue, brain fog, or depression that comes on gradually and is more challenging to associate with eating a specific meal.



Causes and Risk Factors of Gluten Intolerance

Scientists and medical providers don't fully understand the cause of gluten intolerance, and this is an active area of research. According to some researchers, gluten intolerance results from an immune response in some people when they consume gluten. However, not all scientists agree.



If You Think You Have Gluten Intolerance: Self-Guided Questions

If you think that your body is having a negative reaction to gluten, consider starting a symptom diary. In it, record what you eat and the symptoms that result.

Self-guided questions to ask yourself regarding gluten intolerance and celiac disease include:

  • Does anyone in your family have celiac disease, irritable bowel syndrome, wheat allergy, or gluten intolerance diagnosis?

  • Do you have any of the (above) symptoms of gluten intolerance?

  • Do your symptoms get worse after eating some meals but not others?

  • Have you noticed any particular food that triggers symptoms?

  • How are these symptoms impacting your life?

  • Do you have anemia, fatigue, or vitamin deficiencies?

  • Do you have any existing diagnoses (autoimmune or otherwise)?



How to Talk to a Gastrointestinal (GI) Specialist

If you suspect that you are having a reaction to gluten, schedule an appointment with a reputable digestive-tract-disease specialist known as a gastroenterologist. You may even be able to find one at a medical center that specializes in celiac disease and gluten intolerance. Before your appointment, try to keep a log of your symptoms and what you eat.



Common Intolerance-Causing Gluten Foods

Gluten is a protein found in wheat, barley, and rye; it is prevalent in the Western diet. Most people consume gluten every single day in varying amounts.

Here are some of the most common gluten-containing foods:

  • Bread

  • Pasta/noodles

  • Cookies

  • Cake

  • Baked goods

  • Crackers

  • Beer

  • Flour

  • Oats (that are not certified gluten-free)

  • Couscous

  • Certain salad dressings, marinades, stock cubes, candies, and more

How Providers Diagnose Gluten Intolerance

The only way to differentiate gluten intolerance from celiac disease or wheat allergy is to go through the proper diagnostic process to rule out those conditions first.

Testing typically involves the following:

  • An allergy test to rule out wheat allergy

  • A blood test for celiac disease markers

  • An endoscopy and biopsy to retrieve and test tissue samples of the intestines if the blood test is borderline

People with gluten intolerance will test negative on blood tests and biopsies. However, they still have a suspected response to eating gluten.

If you have a negative blood test, your healthcare provider may guide you through an elimination diet or gluten challenge to confirm that your symptoms are truly coming from eating gluten and not something else. A dietitian and gastroenterologist specializing in gluten-related disorders can help you with this.



Continue Eating Gluten Before Testing

Celiac disease tests only work accurately if you have gluten in your system, so continue eating gluten before getting tested. If you go gluten-free before testing, you may get a false negative result.

For accurate testing, you would have to start eating gluten again, which could cause symptoms. For this reason, some people with gluten intolerance may not know if they have celiac disease or not.



Treatment for Gluten Intolerance Side Effects

As with celiac disease, the only medical treatment for gluten intolerance is to follow a gluten-free diet. However, the degree of strictness of this gluten-free diet may differ for people with gluten intolerance vs. people with celiac.

People with celiac disease must avoid all cross-contact with gluten since microscopic amounts can trigger an autoimmune response and damage the small intestine, even without symptoms. This means using clean cutting boards and utensils, clean water to boil gluten-free pasta, uncontaminated frying oil, and more.

People with gluten intolerance do not have the same internal damage when they eat gluten. As such, minimal gluten consumption is acceptable up to the point that it causes symptoms. For this reason, someone with gluten intolerance may be able to tolerate amounts of cross-contact.

How to Eat Less Gluten (Plus Gluten-Free Alternatives)

Going gluten-free doesn't mean you must cut out your favorite foods. These days, there are many gluten-free alternatives on the market for your favorite breads, pastas, cakes, cookies, and more.

Gluten-free foods will probably taste different from what you're used to, but for most people, it's worth feeling better.

There are also many hidden sources of gluten, from ingredients including (but not limited to) the following:

  • Malt

  • Brewer's yeast

  • Soy sauce

  • Beer

  • Flour-thickened marinades

You will have to learn how to read labels and recognize gluten-containing ingredients.

It's normal to struggle to adjust to a gluten-free diet. It is hard to learn an entirely new way of eating and living. Consider seeing a dietitian who specializes in the gluten-free diet to help you with this process.

Related: Other Names for Gluten

Summary

Gluten intolerance is different from celiac disease because there is no autoimmune process. However, people with gluten intolerance can have all the same symptoms as celiac, including bloating, nausea, vomiting, diarrhea, skin rashes, constipation, brain fog, and more. The only treatment for gluten intolerance and celiac disease is a gluten-free diet.

Read the original article on Verywell Health.