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Military Health System

The difference between Celiac Disease & Non-celiac Gluten Sensitivity

Image of Close up picture of slices of bread . Celiac disease occurs when the immune system recognizes gluten, commonly found in wheat or other grains, as harmful (Photo by: Mark Oswell, Defense Health Agency).

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Eating gluten free has become very popular in recent years.

Many people who try it claim that it makes them feel healthier and have less gastrointestinal sensitivity, even when they do not have celiac disease --an autoimmune disease for which the only treatment is eating a gluten-free diet.

While eating a gluten-free diet is essential for those living with celiac disease, more and more people seem to claim that they are "gluten sensitive."

Contrary to popular belief, celiac disease is not a food allergy. It is an autoimmune disease that, when left untreated, can cause symptoms such as chronic or recurrent diarrhea, constipation, abdominal pain/distension, unintentional weight loss, vomiting, anorexia, dermatitis herpetiformis, dental enamel hypoplasia, anemia and hepatitis.

Celiac disease is diagnosed through a blood test with the presence of higher tissue transglutaminase enzymes; and a subsequent conformational intestinal biopsy. Currently the only treatment is eating a gluten-free diet.

Non-celiac Gluten Sensitivity (NCGS) is not an autoimmune disease and there is no single blood test for diagnosis. Symptoms can include abdominal pain, eczema and/or skin rash, headache, "foggy mind," fatigue, diarrhea, depression, anemia, numbness of legs/arms/fingers and joint pain. NCGS is a gluten reaction in which both allergic and autoimmune mechanisms have been ruled out. In other words, it is diagnosed by exclusion criteria including a negative immune-allergy test to wheat, a negative celiac disease blood test in which immunoglobulin, or IgA, deficiency has been ruled out, a negative intestinal biopsy, presence of biomarkers of gluten immune-reaction (AGA+), presence of clinical symptoms that can overlap with celiac disease or wheat allergy and resolution of the symptoms following a gluten-free diet.

If you are have been diagnosed with celiac disease or non-celiac gluten sensitivity and need help with your diet, a registered dietitian can help you implement a gluten-free eating plan. For more information, contact your local military medical treatment facility's dietitian or nutritionist.

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Last Updated: March 26, 2021
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