Our body has the ability to digest and use a variety of foods for its maintenance and survival. However, there are some forms of foods that cannot be tolerated by the digestive system in some people, causing adverse reactions. The intolerance to foods containing gluten, a protein found in wheat, barley and rye, and a common ingredient of bakery products can affect people. There are two disorders that fall under this food intolerance – celiac disease and gluten sensitivity. Although they have similar symptoms, they have different implications to your health and need to be diagnosed differentially in order to provide effective treatment.
Celiac disease is an autoimmune disease where the body’s immune system attacks and damages the lining of the small intestine when gluten-rich foods are eaten. Seen in about 1 in every 133 people, the condition has a genetic link, usually occurring within family members. Symptoms usually include diarrhea, constipation, abdominal bloating, osteoporosis, fatigue, weight loss, iron deficiency anemia and malnutrition.
Gluten sensitivity, also called non-celiac gluten sensitivity, causes similar symptoms in response to gluten-rich foods. This, unlike celiac disease is not an autoimmune disease and does not cause damage to the small intestine. So, what causes the similar symptoms? Sadly, the underlying cause for gluten sensitivity is still poorly understood.
Differential diagnosis is critical for the proper management of the two conditions. Since symptoms for both diseases are similar and there are currently no diagnostic tests, gluten intolerance can be detected by ruling out celiac disease. When you visit your doctor with unpleasant abdominal problems, your doctor will order blood tests, the most sensitive being the tissue transglutaminase antibodies (tTG-IgA) test, and a genetic test to check for celiac disease. An endoscopic biopsy may be ordered, where a long lighted tube with a camera is inserted inside the mouth, through the esophagus, to view and collect a sample of the small intestine tissue. While the biopsy can confirm the presence of celiac disease, negative results for all these tests can indicate that you may be free of celiac disease, but suffering from gluten sensitivity instead.
The treatment for both celiac disease and gluten sensitivity involves following a strict gluten-free diet. However, in view of the genetic component, the differential diagnosis can help in advising loved ones to get tested early for celiac disease and avoid long-term complications such as iron deficiency anemia, early onset osteoporosis, infertility and miscarriage, nervous system disorders, GI cancers, epileptic seizures and dementia.
At Greater Houston Gastroenterology, we provide specialized services and treatments for a wide range of gastrointestinal conditions. Our dedicated clinical staff and physician assistants are available to assist in delivering high-quality treatment and expert care. As the largest GI group in the greater Houston area, we offer 17 locations for your convenience.