The digestive disorder celiac disease affects about 1 in 133 people in the United States, according to the National Digestive Diseases Information Clearinghouse.
When an individual has celiac disease, she cannot consume food that contains gluten. In reaction to these foods, the individual’s immune system damages or destroys the villi in the small intestine, which affects absorption of nutrients.
Several symptoms can occur with celiac disease. For example, a child can experience weight loss, vomiting, and abdominal bloating and pain. Constipation and chronic diarrhea may occur. Some individuals may have stool that is foul-smelling, pale or fatty.
Adults may not have these digestive symptoms, noted the National Digestive Diseases Information Clearinghouse. Instead, they may experience fatigue, depression, seizures, joint pain and missed menstrual periods.
The treatment for celiac disease is to eat a gluten-free diet. This involves avoiding foods such as barley, wheat, triticale and rye, and instead eating foods such as beans, fruits, hominy and soy.
The gluten-free diet alleviates symptoms for individuals with celiac disease, as well as healing existing and preventing further damage.
Eating a gluten-free diet may provide relief for individuals who have symptoms similar to celiac disease, but do not have the disorder. The condition, called non-celiac gluten sensitivity, is less severe than celiac disease.
The National Foundation for Celiac Awareness noted that non-celiac gluten sensitivity “is not accompanied by the enteropathy, elevations in tissue-transglutaminase, endomysium or deamidated gliadin antibodies, and increased intestinal permeability that are characteristic of celiac disease.”
While research on non-celiac gluten sensitivity is relatively new, the National Foundation for Celiac Awareness estimated that about 18 million people have the condition.
Individuals with this condition often have non-gastrointestinal symptoms, such as joint pain, headaches and numbness in the extremities when they consume gluten.
The immune systems of individuals with non-celiac gluten sensitivity react differently to gluten when compared with individuals with celiac disease. For example, individuals with non-celiac gluten sensitivity did not have flattened villi, according to the study conducted by Sapone et al.
The study also found differences in the immune system responses. With celiac disease, the immune response is an adaptive response. With non-celiac gluten sensitivity however, the response is an innate response, meaning it does not respond to a specific antigen.
There is no specific test for non-celiac gluten sensitivity. A diagnosis is made when other causes for the presenting symptoms are ruled out. The treatment is the same as treatment for celiac disease: a gluten-free diet.
Individuals considering a gluten-free diet should talk to their health care provider.
References
National Digestive Diseases Information Clearinghouse. Celiac Disease. Web. 26 February 2013.
http://digestive.niddk.nih.gov/ddiseases/pubs/celiac
MayoClinic.com. Gluten-Free Diet: What’s Allowed, What’s Not. Web. 26 February 2013.
http://www.mayoclinic.com/health/gluten-free-diet/my01140
Sapone, A. et al. “Divergence of Gut Permeability and Mucosal Immune Gene Expression in Two Gluten-Associated Conditions: Celiac Disease and Gluten Sensitivity.” BMC Medicine. Web. 26 February 2013.
http://www.biomedcentral.com/1741-7015/9/23
Wall Street Journal. Clues to Gluten Sensitivity. Web. 26 February 2013.
http://online.wsj.com/article/SB10001424052748704893604576200393522456636.html
New York Times. Gluten-Free, Whether You Need It or Not. Web. 26 February 2013.
http://well.blogs.nytimes.com/2013/02/04/gluten-free-whether-you-need-it-or-not/?nl=health
National Foundation for Celiac Awareness. What is Non-Celiac Gluten Sensitivity?. Web. 26 February 2013.
http://www.celiaccentral.org/non-celiac-gluten-sensitivity/introduction-and-definitions
National Foundation for Celiac Awareness. Should You Be Gluten-Free? Celiac Disease and Non-Celiac Gluten Sensitivity. Web. 26 February 2013.
http://www.celiaccentral.org/SiteData/docs/NFCACeliac/a5c2249c6b6762ab/NFCA_CeliacDisease_vs_NonCeliacGlutenSensitivity.pdf
Reviewed February 27, 2013
by MIchele Blacksberg RN
Edited by Jody Smith