Gluten Sensitivity vs Gluten Allergy vs Celiac Disease

One of the most popular tests in our office is a Food Sensitivity Panel. With a simple blood test, it screens the body's antibody production to 96 different foods. Using this information, a dietary plan is formulated with detailed menus, suggestions for substitutions, and references to outside resources. Among the most common sensitivities that results from this screening include gluten and gluten-containing grains.

What is Gluten?
Gluten is a protein that is most commonly associated with wheat, barley, and rye. It gives structure and elasticity to breads and doughs and can be found in most baked goods, breads, cereal grains, and pastas. It is what gives doughs like pizza crust a chewy texture--high-gluten flours are commonly used for this purpose.

Health problems associated with gluten are increasingly common and can be generally classified in three categories:

Celiac Disease
In patients who have been diagnosed with Celiac Disease, there is significant damage to the lining of the gut (large intestine, colon) caused by exposure to gluten. The symptoms of Celiac Disease can be quite severe, including bloating, digestive distress, constipation and/or diarrhea, weight loss, malnutrition, and depressed immune system. In many of these cases, even mild exposure to gluten-containing foods causes significant damage and illness. The gold standard for this diagnosis is biopsy of the intestine.

Gluten Sensitivity
The symptoms of Gluten Sensitivity tend to be much more vague than that of Celiac Disease. Symptoms related to digestive problems are still quite common, but they tend to be less severe. Additionally, Gluten Sensitivity may not cause digestive problems at all, instead producing other symptoms like headache, sinusitis, fatigue, rash and itching, joint pain, and other inflammatory conditions. To add to the confusion, it is not uncommon for reactions to gluten to slowly emerge over the course of 72 hours.

Over the long term, Gluten Sensitivity may give rise to autoimmune disease, including Systemic Lupus Erythematosus (SLE), Fibromyalgia, Rheumatoid Arthritis, Eczema, and Chronic Fatigue Syndrome. Currently, there is emerging evidence that gluten sensitivity may contribute to neurological conditions like Attention Deficit Disorder (ADD) and disorders on the Autism Spectrum.

Gluten Allergy
A true Gluten allergy expresses itself in the same way as any other contact allergy like peanuts or bee stings. Contact with Gluten, either by eating or by contact with the skin, causes a rapid response ranging from swelling and itching at the point of contact to dangerous and immediate inflammation as in anaphylaxis.