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What is the difference between celiac disease and gluten intolerance?

Robynne K. Chutkan, MD
Gastroenterology
Most of us don't have celiac disease, but many of us have gluten intolerance, which means your body feels better when you're avoiding gluten-containing foods. Most people who are gluten intolerant can ingest small amounts of gluten without too much of a problem. But if you have celiac disease, you need to be super vigilant about completely eliminating gluten, so that your small intestine can heal, and also to avoid some of the conditions associated with untreated celiac disease, like esophageal cancer, lymphoma, arthritis, osteoporosis, anemia, and even infertility

Individuals with celiac disease can’t tolerate specific proteins, collectively called “gluten” that are found in the grains, wheat, barley, rye, and triticale (a cross between wheat and rye). When these individuals consume gluten, it triggers an inflammatory response in their bodies that damages the lining of the small intestine and interferes with the digestion and absorption of the nutrients in food. This leads to numerous vitamin, minerals, and other nutrient deficiencies, as well as their corresponding short-term health problems, such as depression, anemia, abdominal pain, irritability, nausea, weight loss, diarrhea, and fatigue – to name a few. Over the long-term, complications such as osteoporosis, infertility, liver diseases, and intestinal cancers can occur.

Since there isn’t any cure for celiac disease, the only treatment is a lifetime of adhering to a gluten-free diet. Unfortunately, even traces of gluten in the diet can cause problems. Gluten can also be added to foods, such as soup, cold cuts, seasoned frozen vegetables, and even products such as vitamins and lipstick. Consequently, reading ingredients labels when shopping is mandatory to avoid even a morsel of gluten.

Some individuals have gluten sensitivity or gluten intolerance, which means that while they don’t have the full-fledged, autoimmune response seen in celiac disease, they may still suffer from some of the gastrointestinal discomfort as well as other symptoms.

Individuals with gluten sensitivity or gluten intolerance may be able to safely tolerate small amounts of gluten. All individuals, whether with celiac disease or gluten sensitivity, should work with a registered dietitian to develop a healthy, well-balanced diet. You can find a local registered dietitian at: www.eatright.org.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.