What’s the Difference Between Celiac Disease, Gluten Intolerance, and Wheat Allergies? A Registered Dietitian Explains

Gluten is a HUGE buzzword; everyone is talking about it. People avoid gluten for all different reasons - some do it because they think they’ll lose weight (not necessarily true) and others avoid gluten because it’s medically necessary. The latter fall into one of three categories; they have celiac disease, a gluten intolerance or sensitivity, or a wheat allergy. What’s the difference? As a Registered Dietitian (with a wheat allergy!) I am always asked what the differences are between these groups. Here’s how I explain them to my clients: Celiac disease is an autoimmune disorder. When people with celiac disease eat gluten, the cells in their body attack the lining of the small intestine, leading to inflammation and destruction. This leads to a decrease in the absorption of nutrients from food, and can cause detrimental deficiencies (vitamin B12, vitamin D, iron-deficiency, etc.). Common signs/symptoms include changes in bowels (diarrhea is more common, but constipation can also occur), unintended weight loss, bloating, abdominal pain/cramping, and fertility issues, among others. The only known treatment for celiac disease is following a strict gluten-free diet.* Gluten intolerance, or Non-Celiac Gluten Sensitivity (NCGS), is a term used to refer to people who do not have celiac disease, but experience similar symptoms, especially GI distress. In non-celiac gluten sensitivity, constipation is much more common than in those with celiac disease and there are often fewer nutrient deficiencies, as the intestinal wall remains intact. While there is no concrete medical explanation for how gluten is reacting in the body and why it's causing these symptoms, people with NCGS often find tremendous relief through a gluten-free diet. A wheat allergy triggers an immune response when wheat is eaten, similar to other food allergens like peanuts and shellfish. The effect usually occurs immediately but can also take up to a few hours to show. Symptoms can be mild and include rashes, hives, stomach distress and itching of the eyes/nose/throat, but can also be quite serious leading to tissue swelling, vomiting, diarrhea, and in severe cases, anaphylactic shock. In contrast to celiac disease, this allergic response is often time-limited, and does not cause lasting harm to body tissues. People with wheat allergies are often recommended to avoid gluten and not just wheat, because of the risk for cross-contamination. So what ties these three categories of gluten avoiders together? All follow a gluten-free diet! If you suspect you might be suffering from one of these disorders, talk with your doctor and/or a Registered Dietitian to see if a gluten-free diet is best for you. Then, check out some of these recipes for an inspired gluten-free life! *It is important to note that if you suspect you have celiac disease, DO NOT change your diet without consulting your doctor. Starting a gluten-free diet BEFORE being tested can result in a false negative when you do get tested.