The Difference Between a Gluten Sensitivity and Celiac Disease


Celiac disease is more than sensitivity to gluten. This digestive disorder can destroy the villi in the small intestine through inflammation and can carry long-term health risks. 

For those who suffer from celiac disease, abstaining from all foods that contain the gluten protein helps resolve problems created by this autoimmune disorder. 

It may seem simple—you avoid these foods and your condition improves. But it is truly a minute-by-minute endeavor, said Dr. Randall Pellish, a gastroenterologist, and Director, Inflammatory Bowel Disease Center at Lahey Hospital & Medical Center in Burlington. 

You might not know, 100 percent, if there is gluten crossing paths with your food,” Dr. Pellish said. “You have to be very careful about cross-contamination when you go out to eat.”

One example Dr. Pellish gave is french fries. Some restaurants will fry them in oil that was previously used to fry chicken fingers and the breading often contains gluten, leading to contamination of the french fries with gluten. 

Gluten is a protein found in foods made with wheat, barley, and rye. But you can ingest gluten by eating other foods, such as oats, that are processed in plants where gluten-containing foods are made.

Some have a sensitivity to gluten, but this is not celiac disease. Celiac disease is diagnosed by a blood test or a biopsy of the small intestine that looks for inflammation. Not only can celiac disease be extremely uncomfortable, and often painful, it can cause other health problems down the line. 

With celiac disease, the immune response to gluten creates inflammation that destroys the villi, tiny finger-like protrusions inside the small intestines. When the villi are damaged, the body is unable to absorb nutrients from food. It can lead to malnutrition, and untreated celiac disease can be associated with other autoimmune diseases such as diabetes and multiple sclerosis. Small bowel cancers can also occur in very rare cases. 

There is a genetic component to celiac disease, though the cause is multifactorial. People with a first degree relative with celiac disease have a 1 in 10 chance of developing it, according to the Celiac Disease Foundation.

Dr. Pellish said symptoms may present like those in irritable bowel syndrome—gas, bloating and stomach pains are all common. 

“If you have unexplained gastrointestinal symptoms, it’s worth having the blood test,” he said. “Early diagnosis is helpful in getting control of your symptoms.” 

For more information on celiac disease, speak with your health care provider.

*The content on this website is for informational purposes only and is not medical advice. Please consult a physician regarding your specific medical condition, diagnosis and/or treatment.

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