How to tell coeliac disease from gluten intolerance

COELIAC UK (coeliac.org.uk) says around one in 100 people in the UK has coeliac disease but only 24% of them have been diagnosed – meaning nearly half a million Britons are unaware they have it.

While coeliac disease affects just 1% of the population, up to 13% are thought to have gluten intolerance. Indeed, a 2015 survey found 10% of households contain someone who believes gluten is bad for them.

“Part of this comes down to a greater awareness of conditions like coeliac disease and gluten intolerance,” says GP Dr Seth Rankin. “It’s important to stress the two conditions are very different.” COELIAC disease is a serious illness where the body’s immune system attacks itself when gluten is eaten, damaging the gut lining.

In gluten intolerance, it’s unclear how the immune system is involved, but Dr Rankin says: “If you’re gluten intolerant, you may experience similar symptoms to someone who has coeliac disease. But importantly, there’s no evidence to suggest this affects the lining of the gut.” coeliac disease, because although she was never diagnosed with it she had very bad digestive problems all her life, and eventually suffered with anaemia and osteoporosis, which are both linked to coeliac disease.

Caroline, who is a Coeliac UK patron, says: “I struggled for years with constant stomach pains, vomiting and total exhaustion.”

It’s not yet known whether gluten intolerance is related to genetics. it’s diagnosed based on the symptoms being experienced, though tests should be carried out to rule out coeliac disease.

A biopsy wouldn’t be useful if a person was only gluten intolerant, as the condition doesn’t damage the gut. THE gut damage caused by coeliac disease means nutrients from food can’t be absorbed properly, and if left untreated, the disease can lead to other conditions, including osteoporosis, infertility and anaemia. It’s linked with a higher risk of certain cancers too. People with gluten intolerance aren’t at higher risk of complications. EVEN the tiniest trace of gluten should be off-limits for people with coeliac disease. Following a strict gluten-free diet should help control symptoms, allowing the damaged gut to heal. Eating any amount of gluten will cause further damage.

People with gluten intolerance can often eat small amounts of gluten without developing symptoms. It’s often a question of discovering what’s comfortable for you, and finding ways to manage symptoms so they don’t cause distress.

“If you have coeliac disease, you need to avoid gluten like the plague,” stresses Dr Rankin, founder of the London Doctors Clinic.

“If you’re gluten intolerant then it is your choice. If you can stand a bit of bloating when eating bread, then it won’t kill you.” However, it’s important to note, coeliac disease and gluten intolerance aside, gluten is not a ‘bad’ food. Dr Rankin adds: “The issue for me is the proliferation of the gluten-free fad and the rise in the belief that gluten is the real enemy of health

– it’s not.”