The Difference Between Celiac Disease, Gluten Intolerance, and Wheat Allergy

Do you ever experience unpleasant symptoms after eating gluten-rich foods like bread or pasta, and wonder if you have celiac disease, gluten intolerance, or possibly a wheat allergy? Although the three conditions share similar symptoms, there are distinct differences in the way a person’s body reacts to gluten. The types of tests a doctor uses to diagnose each condition are also very different. Let’s take a closer look at the symptoms of celiac disease, gluten intolerance, and wheat allergy and see if one of these three conditions is causing your unwanted symptoms.

Celiac Disease

Celiac disease is an autoimmune disorder that causes genetically susceptible individuals to negatively respond to gluten, a protein found in wheat, barley, and rye. Over time, as gluten triggers immune responses, the small intestine’s lining becomes damaged. Without a diagnosis and appropriate treatment, it is likely that individuals with celiac disease will suffer from malabsorption, the inability for the small intestine to absorb nutrients into the bloodstream.

Symptoms of Celiac Disease

There are many common signs of celiac disease that are directly related to the body’s inability to properly digest food. These include:

• Diarrhea
• Weight loss
• Bloating and gas
• Abdominal pains
• Constipation
• Vomiting

There are also signs that you may not originally associate with celiac disease since they are not directly related to the digestive system. These other symptoms of celiac disease can include:

• Itchy skin
• Headaches and fatigue
• Bone and joint pain
• Acid reflux and heartburn
• Mouth ulcers
• Seizures

Celiac disease is a serious disorder. If you are diagnosed with celiac disease, the most effective way to manage the symptoms is to completely cut gluten from your diet.

Gluten Intolerance

Gluten intolerance, also known as non-celiac gluten sensitivity, has similar symptoms to celiac disease. Although both conditions cause the body to have a negative response to gluten, the two types of responses do not have the same longevity or consequence. When a celiac person ingests gluten, his or her immune system will attack against its own body’s tissue. Whereas, if a person is gluten intolerant, the consumption of gluten will cause short-term bloating and belly pain. Unlike celiac disease, gluten intolerance doesn’t usually cause long-term harm to the body.

Symptoms of Gluten Intolerance

There are many symptoms of gluten intolerance, most of which are gastrointestinal symptoms. If you see some of these signs after eating foods with gluten, it’s possible that you may be gluten intolerant. Some common signs of gluten intolerance include:

• Diarrhea
• Fatigue
• Bloating
• Stomach ache
• Nausea
• Gas
• Constipation

Like celiac disease, there are other signs that may not commonly be associated with gluten intolerance. These symptoms include:

• More sever stomach pain (not just an upset belly). This type of pain is not normal and may require medical attention.
• Headache
• Joint and muscle pain
• Confusion

Notice that there are slight differences between the less common symptoms of celiac disease and gluten intolerance; mouth ulcers, seizures, and itchy skin can be associated with celiac disease, but aren’t likely to result from gluten intolerance.

Individuals with gluten intolerance may find relief by supplementing with digestive enzymes to help alleviate the symptoms, reducing the volume of gluten in their diet, or eliminating gluten from their diet entirely.

Wheat Allergy

Those with a wheat allergy experience a response (by the immune system) to a number of food proteins found in wheat, including gluten. However, unlike celiac disease, this immune response is most often temporary. Also, a wheat allergy does not cause ongoing harm to the small intestine unless the reaction causes anaphylaxis, the most serious type of allergic reaction. Unlike celiac disease and gluten intolerance, a wheat allergy can actually be outgrown.

Symptoms of Wheat Allergy

You will notice that many of the symptoms of wheat allergies are very similar to gluten intolerance. The symptoms are also comparable to any other kind of food allergy. Symptoms of wheat allergy include:

• Stomach cramp
• Nausea and/or vomiting
• Headache
• Nasal congestion
• Skin rash
• Difficulty breathing
• Anaphylaxis

Although a wheat allergy won’t cause permanent damage to your intestines, the risk of anaphylaxis should be taken very seriously. If you are diagnosed with a wheat allergy, your doctor may suggest antihistamines, epinephrine, and/or a wheat-free diet.

Visiting Your Family Doctor

If you believe that you may have celiac disease, gluten intolerance, or a wheat allergy, a visit to your family doctor is recommended. Since your doctor will need the full history of your symptoms, it is important that you stick to your current diet until your doctor gives you specific instructions to reduce, or eliminate gluten from your diet. This way, the physician can tell if gluten is the culprit behind your symptoms.

Since the symptoms of all three conditions are so similar, your doctor might conduct a number of tests. Each condition has its own test that can appropriately determine a diagnosis:

1. Celiac Disease: This is the most invasive of the three tests. To test for celiac disease, the doctor will take a small biopsy of your small intestine. Using this sample, the doctor can identify if there are specific antibodies in your blood that correspond to celiac disease.

2. Gluten Intolerance: Gluten intolerance is less understood by doctors than celiac disease and wheat allergies. Therefore, your doctor will only be able to diagnose you as gluten intolerant by ruling out celiac disease and wheat allergy by using the applicable tests.

3. Wheat Allergy: Much like other allergy tests, the doctor may use a skin prick test or blood test to identify if you have a wheat allergy. The doctor may also try eliminating gluten from your diet so that he or she can determine if there are any significant changes in your symptoms. An oral food challenge, a test in which an allergist will feed you suspect foods in measured doses, may also be conducted. This type of test should be done at a medical facility so that you are surrounded by the appropriate medications and equipment in case anaphylaxis occurs.

The most important thing to recognize is that while the symptoms of celiac disease, gluten intolerance, and wheat allergy can be very similar, they also have their unique differences. Therefore, it is extremely difficult to diagnose yourself and visiting your family doctor is highly recommended if you experience any of the symptoms listed above.

If you have been diagnosed with celiac disease, gluten intolerance, or wheat allergy, and you’re required to reduce or eliminate gluten from your diet, our Registered Dietitians can help recommend proper dietary choices for your specific needs.