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Celiac Disease vs. Gluten Intolerance/Sensitivity…. 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, not much. 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, its estimated that up to 1/7 people are gluten sensitive according to current research, while celiac disease affects only 1% of the population. Again, gluten sensitivity’s incidence is thought to be up to 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!
Ten Facts About Food Intolerance according to the folks at Foodintol…
Here is a summary of food intolerance:
1. Food intolerance is common:
Medical evidence shows food intolerance or food sensitivity is much more prevalent than the small minorities usually quoted. (eg. Gluten sensitivity is now thought to be ~15% of Americans, rather than ½%. And Lactose intolerance is now known to be so prevalent (~75% are affected to some extent) that those who are not lactose intolerant (the minority) have been described using a new term: lactase persistent. This is to emphasise that they still produce lactase, the enzyme that breaks down lactose. Most humans stop producing lactase at weaning, or around two years of age. Therefore most adults are lactose intolerant – even if they do not yet have obvious symptoms.
2. Food intolerance is genetic:
Food sensitivity is built into your genes, therefore it ‘runs in the family’. You got it from your parents and grandparents. In turn – if you have children – you have already passed it on to them. Celiac Disease (or Gluten sensitivity) for instance occurs in 10% of all first degree relatives of Celiacs – sisters, brothers, parents and children. The same food sensitivities can appear within the same family – but with entirely different symptoms.
3. Food intolerance is poorly diagnosed:
Even doctors themselves admit that food sensitivity is poorly diagnosed by clinical methods. See references below. Clinical testing (blood test, biopsy, breath test etc.) is never as accurate as using the Journal Method (Elimination Diet method).
4. Symptoms of food intolerance can take days to appear:
Bad reactions to foods can take up to 48 hours to appear after eating. So it is difficult to make a connection between the symptom and the food which caused it. Most people keep buying symptom relief (over-the-counter medications) for years without ever realising they have food intolerance.
5. Low awareness of food intolerance:
Few people understand the effects of food intolerance. It is often confused with food allergy. And because many symptoms are chronic (never seem to go away) they are often attributed to something else. Low awareness contributes to poor diagnosis and even a tendency to tag symptoms as ‘incurable’. Don’t let this happen to you! Investigate whether your symptoms could be food intolerance – using the Detection Diet Journal.
6. Food intolerance gets worse with age:
As with everything else – all the symptoms of food intolerance get worse as we get older. As children and young adults we may have been healthy enough to ‘tolerate’ wrong foods – without symptoms. But with age our bodies become much less tolerant - and symptoms appear that we have never had before. The secret is to get your diet right by first identifying your food intolerance.
7. Food intolerance makes you sick:
Symptoms of food sensitivity tend to be those we ‘put up with’ on a daily basis: itching skin, mild diarrhea, coughing, tiredness, mouth ulcers, stomach bloating, stiff joints or back ache and headache. By the time food sensitivity is properly diagnosed – the health can be compromised, with a much greater risk of serious disease. But with corrected diet symptoms evaporate and pre-disease conditions can heal.
8. Food intolerance can be triggered:
Food intolerance suddenly appear later in life. People are frequently surprised to discover they are Dairy intolerant or sensitive to Fructose or Gluten – when they reach ages of 20, 30, 40 or older. The things that trigger intolerance are ‘life events’ like birth of a child, death of a family member, divorce, sickness, losing your job etc. Until that point – the body had been compensating. But after serious stress, the symptoms begin to appear.
9. Food intolerance is easily fixed:
Despite the risk of serious disease if left untreated, Food intolerance is easy to fix with a changed diet. First, the offending food must be positively identified using an Elimination Diet. Then the new diet is very successful in bringing back good health, better resistance to disease and fresh personal motivation.
As you can see from the table above Food intolerance is common. Lots of people have it but don’t realise. ANY symptoms are signals from your body! Don’t ignore the signals! To get started look at the Symptoms Matrix
10. Food Intolerance is the Great Imitator
Sensitivity to certain foods or food intolerance is often known as the Great Imitator because its symptoms are just like other conditions. Food intolerance or food sensitivity is therefore easy to misread or misdiagnose – even by doctors.
Food sensitivity (or food intolerance) is responsible for unnecessary suffering in millions of people. Previously it was thought to be quite rare. But the scientific research evidence points to the opposite – it’s rather common.
People who are unaware of their food intolerances – are at increased risk of diseases later in life – like diabetes, obesity, bowel cancer and athritis. So it is really important to investigate any chronic symptoms (the ones that never seem to go away).
In empowered, and good, health!
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