Celiac Disease vs. Gluten Sensitivity: Understanding the Difference
Celiac Disease vs. Gluten Sensitivity: Understanding the Difference
Many people experience bloating, gas, stomach pain, or irregular bowel movements after eating foods that contain gluten. These symptoms can stem from either celiac disease or non-celiac gluten sensitivity, and while the symptoms often overlap, the root causes are different.
Celiac Disease: An Autoimmune Reaction
Celiac disease is an autoimmune condition where the body reacts to gluten, a protein found in wheat, barley, and rye, by attacking the small intestine. This immune response damages the intestinal villi, the tiny finger-like projections responsible for nutrient absorption. When the villi become flattened, nutrient absorption drops, leading to fatigue, nutrient deficiencies, anemia, and digestive discomfort.
Testing for Celiac Disease
To confirm a diagnosis, healthcare providers often use antibody blood tests that measure immune reactivity to gluten, including:
Anti-tissue transglutaminase (anti-TTG)
Anti-endomysial antibodies (EMA)
Deaminated gliadin peptide (DGP)
These tests are highly accurate, with sensitivity and specificity between 90 and 99 percent. Because some individuals with celiac disease have IgA deficiency, IgA levels are also measured. If results suggest celiac disease, a capsule endoscopy or intestinal biopsy can confirm intestinal damage.
Gluten Sensitivity: A Different Pathway
Non-celiac gluten sensitivity causes many of the same symptoms as celiac disease, such as bloating, abdominal pain, diarrhea, or constipation, but it does not involve autoimmune damage.
Currently, there is no definitive lab test for gluten sensitivity. Diagnosis usually involves ruling out celiac disease and wheat allergy, followed by a gluten-free diet trial to see if symptoms improve.
The Functional Nutrition Approach
Whether symptoms stem from celiac disease or gluten sensitivity, identifying the root cause is key. Functional nutrition testing can uncover related issues like gut inflammation, microbiome imbalance, or intestinal permeability (also known as “leaky gut”) that may contribute to ongoing discomfort.
At Renewed Roots Nutrition, I help clients interpret labs, restore gut integrity, and design personalized gluten-free plans that support digestion, energy, and long-term wellness.
