Celiac disease or gluten intolerance?

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My sister-in-law called to tell me that she had made a terrific new recipe for a chicken salad. “But, of course, Larry wouldn’t eat it the chicken. And, Eddie picked out the green peppers. And, Jenny couldn’t eat the croutons because she’s gluten-free. So, I ate the whole thing,” she said.

Rather than commiserate that she’d made a dish that no one would eat, I asked, “Does Jenny have celiac disease, or is she gluten intolerant?” SIL said, “What’s the difference?”

In simple terms, celiac disease is the most severe form of gluten intolerance. It’s an autoimmune disease that affects about one percent of the population and may lead to damage in the digestive system.

However, as many as thirteen percent of the population may have non-celiac gluten sensitivity, a milder form of gluten intolerance, that can still cause problems. Both types of gluten intolerance can cause widespread symptoms that have nothing to do with digestion.

The basic difference is that those who are gluten intolerant may suffer temporary symptoms, while those with celiac disease can actually cause long-term harm to their body. It’s important to note that there is no cure for either condition, and the treatment is to eliminate all gluten from one’s diet.

Healthline identifies 14 of the most common symptoms, but only your primary care provider can be the diagnostician:

1. Bloating. Although bloating is very common and can have many explanations, it may also be a sign of gluten intolerance. In fact, feeling bloated is one of the most common complaints of people who are sensitive or intolerant to gluten.

2. Diarrhea, constipation, and smelly feces (yeah, mine smells like rose petals, too). Seriously now, occasionally getting diarrhea and constipation is normal, but it may be a cause for concern if it happens regularly. Individuals with celiac disease experience inflammation in the small intestine after eating gluten. This damages the gut lining and leads to poor nutrient absorption, resulting in significant digestive discomfort and frequent diarrhea or constipation.

How-ever, gluten may also cause digestive symptoms in some people who don’t have celiac disease. More than 50 percent of gluten-sensitive individuals regularly experience diarrhea, while about 25 percent experience constipation. Furthermore, individuals with celiac disease may experience pale and foul-smelling feces due to poor nutrient absorption.

3. Abdominal pain. It is the single most common symptom of intolerance to gluten. Up to 83 percent of those with gluten intolerance experience abdominal pain and discomfort after eating gluten.

4. Headaches. Studies have shown that gluten-intolerant individuals may be more prone to migraines than others.

5. Feeling tired. Gluten-intolerant individuals are prone to fatigue, especially after eating gluten. Plus, gluten intolerance can cause iron-deficiency anemia, which in turn causes more tiredness and lack of energy.

6. Skin problems. A blistering skin condition called dermatitis herpetiformis is the skin manifestation of celiac disease. Other skin diseases such as psoriasis, alopecia areata, and chronic urticarial may also improve with a gluten-free diet.

7. Depression. Especially common among those with celiac disease, people with digestive issues seem to be more prone to both anxiety and depression compared to healthy individuals.

8. Unexplained weight loss. In one study in celiac disease patients, two-thirds had lost weight in the six months leading up to their diagnosis.

9. Iron-deficiency anemia. In celiac disease, nutrient absorption in the small intestine is impaired, resulting in a reduced amount of iron being absorbed from food. Iron deficiency anemia may be among the first symptoms of celiac disease that your doctor notices.

10. Anxiety. Individuals with gluten intolerance seem to be more prone to anxiety and panic disorders than healthy individuals.

11. Autoimmune disorders. Having celiac disease makes you more prone to other autoimmune diseases such as autoimmune thyroid disease.

And people with other autoimmune diseases may be more prone to developing celiac disease.

12. Joint and muscle pain. The theory is that those with celiac disease have a genetically determined over-sensitive, or over-excitable nervous system and, therefore, may have a lower threshold to activate sensory neurons that cause pain in muscles and joints.

13. Leg or arm numbness. The cause isn’t known, but those with celiac disease and gluten sensitivity seem to experience arm and leg numbness more frequently.

14. Brain Fog. Having difficulty thinking, mental fatigue, and forgetfulness are common symptoms of gluten intolerance.

Kathy Hubbard is a member of Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com.

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