What is the difference between celiac disease and gluten sensitivity?

By Karolina Baker, Health Testing Specialist at AlphaBiolabs
Last reviewed: 11/10/2023

In this article, we look at the difference between celiac disease and gluten sensitivity, and why it is important not to confuse the two.

What is celiac disease?

Celiac disease is an autoimmune disease that develops over time because of a sensitivity to gluten; a protein found in certain cereal grains including wheat, rye, and barley, and commonly used in food products such as cereal, bread, and pasta.

When a person with celiac disease eats gluten, this causes the body’s immune system to attack its own tissue, causing damage to the gut lining and preventing the body from adequately absorbing nutrients from food.

If left untreated, it can lead to severe complications, which can negatively impact on a person’s quality of life.

Celiac disease affects around 1 in 133 people in the US. However, it is estimated that up to 83% of Americans who have celiac disease are undiagnosed or misdiagnosed as having another condition, such as irritable bowel syndrome (IBS).

More information about celiac disease can be found at https://celiac.org/.

What are the symptoms of celiac disease?

Some of the most common symptoms of celiac disease include:

• An itchy rash (dermatitis herpetiformis)
• Anemia
• Bloating and flatulence
• Constipation or hard stools
• Diarrhea or loose stools
• Disorders that affect co-ordination, balance, and speech (ataxia)
• Indigestion
• Nausea, feeling sick and vomiting
• Nerve damage (peripheral neuropathy)
• Stomach aches and cramping
• Tiredness (fatigue) due to not getting enough nutrients from food (malnutrition)
• Unintentional weight loss

What is gluten sensitivity?

Gluten sensitivity – sometimes called non-celiac gluten sensitivity or gluten intolerance – is a condition whereby a person may experience similar symptoms to those of a person with celiac disease, after eating gluten.

However, unlike with celiac disease, it is not clear how the immune system might be involved with gluten sensitivity.

There also does not appear to be any damage to the gut lining in people who have a sensitivity to gluten.

Gluten sensitivity can be managed by removing gluten from the diet. However, if you are experiencing symptoms that could indicate gluten sensitivity, it is important to speak to your physician for further guidance.

This is because celiac disease – a more serious condition – can be misdiagnosed as gluten sensitivity or gluten intolerance, as the two share similar symptoms.

What are the symptoms of gluten sensitivity?

Some of the common symptoms of gluten sensitivity include:

• Abdominal/stomach pain 
• Bloating
• Diarrhea
• Constipation 
• Nausea
• Headaches
• Fatigue

What is the difference between celiac disease and gluten sensitivity?

Even though celiac disease and gluten sensitivity (sometimes called non-celiac gluten sensitivity) can present with similar symptoms, it is important to understand the difference between the two.

Celiac disease is an autoimmune disease that typically runs in families, with symptoms that can range from mild to severe depending on the person.

When a person with celiac disease eats gluten, this triggers an immune response that causes the body’s immune system to attack its own tissue.

Over time, this results in damage to the gut lining that impairs the body’s ability to absorb nutrients from food.

Non-celiac gluten sensitivity, sometimes called gluten intolerance, occurs when gluten is consumed but, although the symptoms are very similar to that of celiac disease, the effects on the body are different.

In a person with gluten sensitivity, the body produces different antibodies to gluten than it does in individuals with celiac disease. There also does not appear to be any damage to the gut lining in people with a gluten sensitivity.

Unlike with celiac disease, there is currently no specific test for non-celiac gluten sensitivity, and it is not entirely clear what causes the condition. It is usually diagnosed by excluding a diagnosis of celiac disease or a wheat allergy (when your body produces antibodies to the proteins found in wheat).

It is possible, however, to test for celiac disease, which can be a more serious condition.

For more information, see ‘How can I find out if I have celiac disease or gluten sensitivity?’

What is the difference between gluten sensitivity and gluten intolerance?

Non-celiac gluten sensitivity is sometimes referred to as gluten intolerance, and vice versa.

Both terms are commonly used to describe a condition whereby a person experiences uncomfortable symptoms after consuming gluten.

However, while the two terms are often used to describe the same symptoms, non-celiac gluten sensitivity is the more medically accurate way to refer to this condition.