These days, gluten seems to be a household term, and there are a great deal of items in the grocery store labeled “gluten-free.” But what exactly is gluten and why are people avoiding it? Gluten is a protein found in wheat, barley, rye, and any products that contain these grains. People who have celiac disease follow a gluten-free diet, and, recently, more and more people are being diagnosed with gluten sensitivity. So, what’s the difference?
Celiac disease is an autoimmune disorder that affects 1 in 100 people worldwide. Damage to the small intestine occurs with the ingestion of gluten that results in flattening of the cells that line the small intestine. This leads to malabsorption and, in turn, nutritional deficiencies. Celiac disease can also cause abdominal pain, cramping, diarrhea, bloating, anemia, infertility, behavioral changes, and fatigue. People with celiac disease are genetically predisposed and can be diagnosed at any age. The diagnosis entails a blood test and biopsy of the small intestine.
Gluten sensitivity, on the other hand, is not well defined as research is limited. People with gluten sensitivity experience similar gastrointestinal distress as those with celiac disease but do not test positive for celiac disease. Since there is no biomarker for gluten sensitivity, it is diagnosed by ruling out celiac disease, an allergy to wheat, and other possible causes. If symptoms resolve with the elimination of gluten, then it is considered to be gluten sensitivity. A recent study from Columbia University published in 2016 found that study participants with gluten sensitivity had increased blood levels of a marker that indicates epithelial cell damage, or a weakened intestinal barrier, and of inflammatory markers that suggest a systemic immune response. With further research, gluten sensitivity will be better understood, and perhaps biomarkers for diagnosis will be discovered.
Celiac disease and gluten sensitivity can be treated with the elimination of gluten from the diet. Working closely with a team of experts that includes a gastroenterologist and registered dietitian (and AVA, of course!) is another important factor in treatment. If you do not have celiac disease or gluten sensitivity, however, gluten can be included as part of a healthy diet.
"Celiac Disease, Non-Celiac Gluten Sensitivity or Wheat Allergy: What Is the Difference?" The Gluten Intolerance Group of North America. 25 May 2017. Web. 12 July 2017.
"Columbia Researchers Find Biological Explanation for Wheat Sensitivity." Columbia University Medical Center. 31 Aug. 2016. Web. 12 July 2017.