What's the Difference Between a Gluten Allergy, Intolerance, Sensitivity and Celiac Disease?

There are lots of confusing messages out there about Gluten Intolerance or Gluten Sensitivity or Gluten Allergy. You may be wondering if you have any of these.

Gluten is the protein found in all WHEAT products, BARLEY, OATS and RYE. It is comprized of two proteins Gliadin and Glutenin. It is the product that makes bread and cakes light and fluffy.

Gluten Sensitivity is the all-encompassing terminology used to describe a whole range of reactions and conditions where gluten is the culprit. These ranges from the auto-immune disease of Celiac Disease, to wheat allergies, to skin ailments, asthma, migraines and autism.

The most serious of these is Gluten Sensitive Enteropathy or as it is more commonly known as Celiac disease (Celiac Disease). Celiac disease is not an allergy to gluten, like a wheat allergy is. It is in fact an auto-immune disease, where the body mistakenly attacks its own tissues seeing them as a foreign substance. When a person with Celiac Disease eats any food containing gluten, the body reacts to those proteins found in the gluten and attacks the small finger like projections in the small intestine called villi, then preventing absorption of food. The symptoms are not immediate, but usually take a while for the reactions to occur and then the gut becomes slowly damaged.

This leads to all sorts of digestive problems, including bloating, diarrhea, flatulence, anemia and weight loss. Celiac Disease can be diagnosed by blood tests, which check for the antibodies (IgG and IgA) to those proteins and by a biopsy of the small intestine (done by gastrocscopy), which can see the flattened villi of the small intestine. Very often someone who thinks they may have a problem with gluten cuts it out of their diet, making diagnosis very difficult. Always maintain your usual diet until all tests have been confirmed.

A Wheat allergy or Gluten Allergy on the other hand is an immune response to eating wheat / gluten, in the same way that someone may have an allergy to peanuts. The symptoms can range from hives, eczema, asthma, migraine or even anaphylaxis. It is caused by an immune response of IgE antibodies. These are usually very quick reactions and can happen in a matter of minutes. There are fifty different proteins in gluten that one can react to so there can be a reaction to any one of them. The diagnosis for this is a skin prick test to test for allergic response.

Many people with a whole range of conditions find that gluten or wheat on its own may be the culprit of certain disorders even without a true allergy or celiac disease. One may have a reaction to gluten that although not register an immune response in the body, it can still make you ill. These are not allergies, but are idiopathic reactions (we do not know the cause). Even though the body reacts to gluten, there is no damage to the small intestine.

Once Celiac disease and an IgE allergy response is ruled out, but a reaction to gluten occurs, we term this a Gluten Intolerance. In many ways similar to a lactose intolerance and in fact many people find they may have both.

One of the main symptoms of this is chronic fatigue and chronic pain. Some people also find that their migraines worsen on gluten, as do skin ailments, sinus problems and other digestive disorders as well as autism and other neurological disorders. There is no test for this, the only way to check for it, is an elimination diet. There is no research known as to whether an intolerance now, can lead to Celiac Disease later in life.

So it is important to get a diagnosis, to work out which is your body's response to gluten, so that a correct eating plan and treatment can be followed.