Celiac or gluten sensitivites? Does it matter? (image thanks to NIH.gov)

A recent article titled, “Irritable Bowel Syndrome and Gluten Sensitivity Without Celiac Disease: Notes from the Front Lines” raised an interesting issue and I wanted to share it here. The article suggests that gluten sensitivity tends to be less severe than celiac disease.

Based on this, it’s suggested that gluten sensitivity might be thought of as “celiac light.”

The article correctly points out that there are people with gluten sensitivity who have very severe symptoms. And in my experience there are many of these people.

However, the fundamental principle of this whole concept is that those with celiac disease are experiencing severe symptoms. This assumption is not based on the facts of celiac disease. The symptoms of those with celiac disease vary just as widely as those with gluten sensitivity. And the data on this topic clearly indicates this. Many celiacs have essentially no symptoms at all. 

The subjective experience of reacting to gluten does not provide any indication about whether or not a person is celiac or experiencing a non -celiac gluten sensitivity. The only true difference is that celiacs have villous atrophy in the small intestine. Therefore it is not accurate to think of gluten sensitivity as celiac light.

Excerpt from Celiac.com:

Should gluten sensitivity be thought of as “celiac light,” as just one of the milder manifestation within the wider spectrum of celiac disease? Some doctors and researchers think so.

Over the past several years, there has been increasing discussion concerning gluten sensitivity as a possible cause of irritable bowel syndrome (IBS) symptoms in patients for whom celiac disease has been excluded. 

This is undoubtedly because gluten sensitivity, like IBS, is a symptom-based condition of diverse pathogenesis. As discussed, some have argued that gluten sensitivity might be best thought of as “celiac light,” representing the milder domains of the celiac disease spectrum.

More information on Celiac disease here.

Image thanks to NIH.gov