Giving Up Gluten: The Difference Between Celiac Disease and Gluten Intolerance

Gluten-free is one of the fastest-growing and most popular diet trends. More and more Americans are adopting a gluten-free lifestyle. But what’s the driving force behind getting rid of gluten? 

Nearly 21 million Americans experience an adverse reaction or digestive issues when they ingest food that contains gluten. Gluten refers to the proteins that are found in wheat, rye, and barley and is naturally occurring in most bread, pasta, and baked goods. But, gluten is sometimes used as an additive in many products that you wouldn’t suspect to contain it such as salad dressings, soy sauce, soups, medications and even non-food items such as soaps, shampoos, and lotions. 

What is Celiac Disease?

Celiac Disease is a genetic autoimmune disease and affects roughly 3 million Americans or about 1% of the population. When someone with Celiac Disease is exposed to gluten, the person’s immune system will attack their own body. During this immune response, the small intestine is attacked during digestion and the cells that line the small intestine can be damaged. As a result, the body cannot properly absorb nutrients from food which, if left untreated, can lead to malnutrition and other issues such as:

  • Diarrhea

  • Anemia

  • Itchy skin

  • Constipation

  • Bloating

  • Abdominal Pain

  • Osteoporosis

  • Arthritis

  • Migraines

  • Fatigue

  • Anxiety 

  • Depression

People diagnosed with Celiac Disease need to completely remove gluten from their diets indefinitely. 

What is Gluten Intolerance?

Gluten intolerance is often confused with Celiac Disease or thought of as a food allergy. There are about 18 million people in America that experience symptoms after they ingest gluten. However, people with a gluten intolerance don’t have the same antibodies and won’t face the same  intestinal damage as someone with Celiac Disease. Those with a gluten intolerance experience many of the same symptoms such as:

  • Gas

  • Bloating

  • Abdominal Pain

  • Fatigue

  • Lethargy

  • Foggy mind

Some people with a gluten intolerance may see an improvement in symptoms when following a gluten-free diet. 

Gluten intolerance is also not considered a food allergy. With a food allergy, the body’s immune system overreacts when a certain food comes in contact with the body and triggers a serious or potentially life-threatening reaction within minutes or a few hours of ingesting the food. An allergic reaction would include symptoms such as: 

  • Shortness of breath

  • Hives

  • Lightheadedness

  • Vomiting

What Should I Do If I Am Unsure Whether My Symptoms are a Result of Celiac Disease or Gluten Intolerance?

The first thing you should do is schedule a visit with your greater Boston area gastroenterologist. A simple blood test may be able to reveal whether or not your body is experiencing an immune response to gluten. In some cases, your gastroenterologist may have to perform an endoscopy to observe and biopsy the small intestine. In order for either of these testing methods to yield accurate results, you should not remove gluten products from your diet until instructed to do so by your doctor. 

If you are diagnosed with Celiac Disease by your doctor, you will begin your new journey of living a gluten-free life. Because so many foods today do contain gluten, it’s recommended that people diagnosed with Celiac Disease consult with a dietitian or nutritionist. 


If testing indicates you do not suffer from Celiac Disease, you may have a gluten intolerance which can be mitigated by eliminating gluten from your diet. Use an elimination diet method, reintroducing gluten after a period of time, to determine whether it was the cause of your digestive distress. If symptoms return when you reintroduce foods containing gluten, you should talk to your doctor about limiting or eliminating gluten from your diet permanently.