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Coeliac and Gluten Intolerance: What's The Difference?

Coeliac and Gluten Intolerance: What's The Difference?

We heard both Coeliac and Gluten Intolerance used all the time these days but what exactly is the difference between the two? So many people use the terms to mean the same but they are far from actually being the same.

Added 10th July 2018
Updated 10th November 2020

While we were exhibiting at the Allergy Show over the weekend so many people came and asked us what the difference was between Coeliac and Gluten Intolerance. Some of those people weren't Coeliacs but some were which I found surprising but also made me think that the difference between the two may not be clear to a lot of people.

To a lot of people Coeliac and Gluten Intolerance or Gluten Sensitivity are the same but they really aren't, they are worlds apart.

Please beware I am not a medical professional (nor do I have anything to do with Coeliac UK for that matter), I am a blogger and all this is information I have learnt over the years as a Coeliac myself, but I am still going to try and explain the differences for you and hopefully I can help some of you understand the difference between the two.

Let's start with Coeliac, Coeliac is an AUTO IMMUNE DISEASE, it is not an allergy or an intolerance, this is the vital difference you need to understand. With an autoimmune disease the bodies immune system (the system that fights infections and diseases) mistakenly attacks the bodies healthy tissue and cells because it thinks there is a "foreign invader", in the case of Coeliac, the foreign invader is gluten. When gluten is ingested the body mistakenly thinks it is something bad and attacks itself in an attempt to protect itself.

There are a whole host of autoimmune diseases which cause the body to attack different tissues and cells, for example Type 1 Diabetes attacks the pancreas, Lupus attacks the whole body, Graves Disease attacks the Thyroid gland, in the case of Coeliac the organ primarily affected is the small intestine. When gluten is ingested the immune system attacks the small intestine causing DAMAGE TO THE VILLI. The villi absorb nutrients, so when they become damaged the body can't absorb nutrients in the way that it should.

Coeliac CANNOT BE CURED, the only way to relieve symptoms of Coeliac is to avoid all gluten. It is only once gluten is removed from the diet that the villi can begin healing and absorb nutrients efficiently again. Any other symptoms should reduce too, whether those symptoms are gut related or symptoms such as dermatitis hepformis.

Coeliac can only be diagnosed via blood test and endoscopy a doctor cannot just say "yes it's Coeliac" without tests, for Coeliac to be diagnosed tTG-IgA (transglutaminase antibodies - immunoglobulin A) levels in blood tests should be over 10 and damage should be found via endoscopy and biopsy.

With gluten intolerance there is NO GUT DAMAGE and NO AUTOIMMUNE RESPONSE to the ingestion of gluten but the symptoms are similar to Coeliac. The gut damage is the important difference. If someone intolerant eats a small amount of gluten (say from cross contamination) they may get symptoms such as diarrhea and stomach cramps but the VILLI IS LEFT INTACT. If someone with Coeliac were to eat just one breadcrumb the villi would sustain damage and in the long term can lead to all kinds of other illnesses including cancer.

With gluten intolerance you may not be able to eat a crumb without symptoms but some may be able to eat a certain amount before getting symptoms (same as any other intolerance), whichever way though there is no villi damage. With Coeliac it makes no difference if you are showing outward symptoms or not, the damage will still be happening on the inside, so if you are Coeliac but have no symptoms, be warned you are still causing damage to your body!

Many doctors have questioned if gluten intolerance is real or if removing gluten is just a placebo effect but with so many people intolerant to so many different foods why should it not be real? There are so many people that have issues with gluten but have negative Coeliac results, it is hard to believe it is not real. There is some great websites around that go more in depth about gluten intolerance this article has some great info on gluten intolerance and some references to studies if you want to read some more. If you do have a problem with gluten please make sure you get checked for Coeliac before removing gluten from your diet. Coeliac is a condition that should be taken seriously. Coeliac UK have more info on both Gluten Sensitivity and of course Coeliac Disease.

I hope this blog helps you understand the difference between Coeliac and Gluten Intolerance better.

Your Comments

Hi, I have just read your article as I consider myself to be gluten intolerant and not coeliac. Interestingly I had to look up what dermatitis hepformis was as I have been suffering from what I thought was a reaction to biological washing powder, This has now made me wonder if I should have a coeliac test,
Gina Webb
19th November 2018
I've been asked to provide cakes for a funeral wake and to allow for a couple of Coeliacs in the process. Any suggestions would be gratefully received. Thanks.
will lloyd
14th October 2018
I did know, having been medically diagnosed 21 yrs ago. The more often this message of importance is conveyed, it will eventually register, the old sayings being "If you say it often and loud enough it will stick"- "If in doubt, leave it out"!
Tom Keys
28th September 2018
Thank you, I only knew that gluten was bad but didn't realise the difference. It has now been explained simply.
25th August 2018
Thank you! At last, a short, clear description of the difference between Coeliacs Disease and gluten intolerance.
22nd August 2018
Really fab read! Very interesting and useful. Thank you x
26th July 2018