Gluten is a group of proteins naturally found in wheat, barley, and rye. While gluten is harmless for most people, some individuals experience adverse reactions and need to avoid it. The three most common gluten-related conditions are celiac disease, non-celiac gluten sensitivity (often called gluten intolerance), and wheat allergy.
Celiac Disease
Celiac disease is a serious autoimmune condition in which the immune system attacks the lining of the small intestine when gluten is consumed. This damage can interfere with the body's ability to absorb nutrients and may lead to long-term health complications if left untreated.
Celiac disease affects approximately 1% of the population and often runs in families.
Non-Celiac Gluten Sensitivity (NCGS)
NCGS describes a condition in which people experience symptoms after consuming gluten but do not test positive for celiac disease or wheat allergy. Symptoms typically improve or disappear when gluten is removed from the diet.
NCGS is believed to be the most common gluten-related condition, with some estimates suggesting that up to 10% of the population may be affected, although many cases remain undiagnosed.
Wheat Allergy
A wheat allergy differs from both celiac disease and NCGS because it is an allergic reaction to wheat itself rather than an autoimmune response to gluten. Since wheat contains gluten, many people with a wheat allergy follow a largely gluten-free diet.
Wheat allergy is the least common of the three conditions, affecting approximately 0.2% of the population.
Symptoms
Celiac disease and NCGS often cause very similar symptoms, including:
• Abdominal pain
• Bloating and gas
• Nausea
• Fatigue
• Headaches
• Mood changes such as anxiety or depression
Symptoms usually improve when gluten is removed from the diet.
A wheat allergy may cause some of the same digestive symptoms but can also trigger allergic reactions such as skin rashes, itching, swelling, breathing difficulties, or, in severe cases, anaphylaxis. Even tiny amounts of wheat can cause a reaction in affected individuals.
Diagnosis
Diagnosing celiac disease and NCGS can be challenging. To accurately test for celiac disease, a person must continue consuming gluten before undergoing blood tests. For many individuals, this can be difficult because it may worsen their symptoms.
NCGS is generally diagnosed only after celiac disease and wheat allergy have been ruled out and symptoms improve on a gluten-free diet.
Because testing can be lengthy and costly, many people choose to self-manage their symptoms by eliminating gluten from their diet.
Treatment
Currently, the primary treatment for celiac disease, NCGS, and wheat allergy is avoiding the foods that trigger symptoms. This often requires carefully reading ingredient labels, preventing cross-contamination, and making informed food choices when eating away from home.
Understanding the differences between these conditions helps us better support friends, family members, and community members who rely on gluten-free foods for their health and wellbeing.