Celiac vs Gluten Sensitive

Is there a difference? 
Gluten sensitivity is very similar to celiac disease; they are both genetic conditions, both are known to affect most systems of the body, and both require a lifelong gluten-free diet.
There is some thought that gluten sensitivity is less serious than celiac disease, however, I have grown to believe this is not true. Both conditions can shorten life expectancy and create hundreds of different symptoms and conditions. Celiac disease is, in itself, an autoimmune disease and gluten sensitivity is not. Some extrapolate this to mean that gluten sensitivity cannot be a causative factor in creating autoimmune disease, however, there are many doctors and other nutritional specialists who disagree.

And while there is some debate on the question, the truth is you can be intolerant to gluten while testing negatively for celiac disease. Some argue that simply means the celiac disease has not yet advanced far enough to trigger a positive test result, however, as you will learn in your journey, there are just some areas of research that are still coming about and too many doctors continue to think of Celiac and Gluten Sensitivity as, well, a fad in many of our opinions.

I have outlined some of the most commonly asked questions regarding the difference between a gluten sensitivity and celiac.

  • What’s the difference between celiac disease and gluten sensitivity?
    In my (and many others in the gluten-free community’s) opinion, nothing.  The problem we have encountered is that celiac disease is the only manifestation of gluten sensitivity that medicine has been able to diagnose.  And not very well at that considering it takes the average celiac patient 11 years before they’re given the proper diagnosis. You may have read elsewhere online, or here in the Wellness Dish, that gluten sensitivity and celiac are considered  “rare”, so it’s often believed that something considered to be rare is not often looked for.  The fact that there’s no drug to treat celiac or gluten sensitivity, means there’s no “easy” fix,  hence, another reason that doctors don’t place a huge priority on diagnosing it.  And what is largely believed is that since the only treatment is a dietary change, many doctors don’t want to “condemn” a patient to never eating wheat, rye or barley again, and therefore without concrete proof, they deny the option of gluten sensitivity as a real issue for their patient.
  • Celiac disease is just a subset of gluten sensitivity.  Celiac is just the tip of the iceberg of the greater issue called gluten sensitivity.  As you might recall,  1/40 people are gluten sensitive according to current research, while celiac disease affects only 1% of the population. Again, gluten sensitivity’s incidence is about 40% of the population! As far as I’m concerned, that takes it right out of the “rare” category and puts it squarely in the category of obesity which is considered to be an epidemic!
  • Diagnosis: The “gold standard” for diagnosing celiac disease is a positive intestinal biopsy revealing severe degradation of the surface of the small intestine (aka blunted villi).  Damage has to occur for many years before such a test is positive (if at all), not to mention all the secondary problems that have likely arisen during that time.  Yet we wait and wait for that positive test while in the meantime it’s considered perfectly fine to tell a patient to continue eating gluten if their test is negative. To put this “wait and see” philosophy into perspective, I ask you:  do we wait for a patient to have a heart attack before we assess risk factors for cardiovascular disease?  Of course not.  So why is it acceptable to allow a patient to get to the point of severe atrophy of their intestine with malabsorption, inflammation, and risk of autoimmune disease before we make a diagnosis?  I argue that it isn’t, and it’s a true shame that so many of us continue to suffer while being misdiagnosed.

When deciding to screen for a gluten allergy or sensitivity, most professionals recommend a lab such as Enterolab which offers an on-line home version (a stool test).  Several doctors will use both a blood and saliva testing for their patients with the stool test recommended for those living too far away to come into the office.   Remember though, more than 30% of all patients receive a false negative at some point in their quest for diagnosis related to gluten sensitivities and allergies, so if you find yourself in that grey area, I encourage the elimination method.   By evaluating a dietary change through elimination and provocation, you will eliminate gluten completely from your diet for a minimum of 6 to 8 weeks and see how you feel;  if you notice a change,  that’s proof enough!

In empowered, and good, health!

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