So, what is the difference between being gluten intolerant and having coeliac disease?
Coeliac disease is an autoimmune disorder caused by a permanent intolerance to gluten. Gluten is a protein found in grains such as wheat, barley and rye. In those individuals who have coeliac’s disease the gluten causes the immune system of the individual to attack and damage the lining of the gut and effectively erodes it away, hence preventing the absorption of nutrients from your diet. It is the body’s reaction to gluten and not the gluten itself that causes the damage.
This produces certain symptoms that are listed below:
|Weight loss / inability to gain weight||Fatigue|
Doctors will describe that in children, it often results in a ‘failure to thrive’. It can, in fact, manifest itself at any age and many people struggle to obtain a diagnosis. Indeed, Coeliac UK report that only 10-15% of sufferers are clinically diagnosed when it is estimated that 1 in 100 people are thought to have the condition. The problem is that the symptoms can vary greatly and not everyone presents with the more typical symptoms above. Other common symptoms include:
|Joint pain||Muscle cramps|
|Bone loss||Nerve problems|
Diagnosis is made initially from a blood test to show specific autoantibodies but is confirmed by a biopsy taken from the gut in order to show the erosion occurring to the gut wall.
There is no cure for coeliac’s disease but the good news is that if the individual completely removes gluten from their diet the gut can heal and normal absorption of nutrients can resume. And nowadays, there is a huge range of gluten free products that you can choose from at the supermarket. Just check out the ‘free from’ sections to see what there is available. It is also easier to eat out now as most restaurants label their gluten free options.
So, what is gluten intolerance then?
Gluten intolerance is a more controversial topic as research is only just emerging and some doctors do not acknowledge its existence yet. It is believed that in some individuals gluten affects what is known as the tight junctions of the gut. These junctions allow digested food through into the bloodstream and in normal individuals closely regulate what can pass through. However, in sensitive individuals the gluten irritates these junctions causing them to open wider than normal so undigested gluten can now pass through triggering an immune response to the ‘foreign’ material. The body’s immune system attacks the gluten protein itself instead of the lining of the gut as it does in coeliacs. This is what is referred to as ‘leaky gut’ as effectively the gut has wider ‘holes’ in it. Gluten intolerance doesn’t cause the erosion of the gut like in coeliac’s disease but it can still result in inflammation both in and outside the gut (i.e. in the rest of the body) and results in similar symptoms as above. The coeliac blood test for these people comes up negative, however the removal of gluten from their diet still results in an improvement in their health. Other symptoms of intolerance include:
|Sleep problems||Weight problems|
|Menstrual problems||Mood swings|
|Migraines||Osteoporosis or osteopenia|
|Joint pain or aches||Memory problems|
One big difference between gluten intolerance and coeliac is that it is not always permanent. If you remove gluten for at least three months it is possible, sometimes, that you can reintroduce it with little or no problems. That is if you have also eaten the right things in that time to help your gut to repair itself. It can, obviously, take longer than this depending on the severity of your problem.
So, what food can gluten be found in? They are listed in the table below:
|Batter||Beer / Whisky / Vodka / Gin|
|Biscuits||Bread inc. bagels / croissants / croutons / crackers / crumpets / naan / tortillas|
|Crisps – check label, some are allowed||Flour|
|Ice cream (wheat)||Ketchup|
|Mustard||Pasta inc. ravioli / noodles|
|Pork Pie||Ready meals|
|Sauces – pre made and includes soy sauce||Sausages – hot dogs|
|Soups – tinned||Stock cubes|
|Sweets||Food additives, such as malt flavoring, modified food starch, MSG and others|
|Medications and vitamins that use gluten as a binding agent|
If you think that you could have an intolerance to gluten or indeed, coeliac disease you’re first port of call is your GP. Go and get yourself tested for coeliac disease with the blood test. Do NOT remove gluten from your diet because in order for them to do the test they will tell you that you have to be eating gluten 6 times a day, for 6 weeks to ensure that the test gives you a proper result (that’s what our GP told us anyway). Now if you remove gluten and your symptoms improve and then you go to your GP they will ask you to restart eating gluten to do the test. That means enduring your symptoms again just to get the test done. So, see your GP first and if you get a negative result you’ve then 2 options. The first one being to go it alone and remove the above foods from your diet and see how you get on.
The second option is to see a nutritional therapist because they will look at the whole picture and will review all of your body systems to see if anything else is contributing to your symptoms.
We rarely have just one problem and getting a diet programme to address all of the issues at the same time will not only be more effective but it will also ensure that something that you put into place or remove doesn’t affect something else. The other really important reason to see a nutritional therapist is that you will need to also eat to help your gut to heal itself and we can advise on what best to try. If you are at all unsure and would like to discuss your options further please call The Food Physio™ on 0800 024 8460 or if you want to proceed with an assessment book online now
Digestive Wellness, Lipski 2012
Textbook of Functional Medicine, The Institute of Functional Medicine, 2010