IF you have digestive problems after eating things like bread, pasta or cereal, there’s a chance you might be intolerant to gluten or have coeliac disease.
But how do you tell the difference?
Both conditions can have similar symptoms, including diarrhoea, nausea, vomiting, fatigue, headaches, mouth ulcers, stomach pain and bloating.
The symptoms appear after consuming gluten, a protein found in wheat, barley and rye, which are used in bread, pasta, sauces and cereals, as well as goodies like cakes, biscuits and pizzas.
The only way to find out whether you’ve got coeliac disease or gluten intolerance is to see a doctor.
Remember, it’s always best to speak to a professional, rather than self-diagnose, as you may need to have tests to rule out other things.
Plus, if you do have coeliac disease, it’s vital you get the right treatment and advice.
But in the meantime, here are some pointers to explain the differences between the two.
Gluten intolerance is much more common
Coeliac UK (www.coeliac.org.uk) says around one person in every 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.
Coeliac disease is an autoimmune disease
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 GP Dr Seth Rankin says: “If you’re gluten intolerant, you may experience similar symptoms to someone who has coeliac disease, but there’s no evidence to suggest this affects the lining of the gut.”
Coeliacs are more likely to have other autoimmune disorders too.
These include conditions such as Type 1 diabetes and autoimmune thyroid disease.
Coeliac UK says the chance of developing other autoimmune disorders may be increased when diagnosis of coeliac disease is delayed.
Coeliac disease is genetic
Having certain genes increases the risk of coeliac disease, so people with immediate family members who have it are more likely to have these genes and are at higher risk themselves.
Actress Caroline Quentin, who was diagnosed with coeliac disease two years ago after suffering for years with symptoms including fatigue, diarrhoea, vomiting and mouth ulcers, has tested positive for genes linked to the disease.
She thinks her late mother had 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.
Coeliac disease can be conclusively diagnosed
Coeliac disease can be diagnosed by blood tests which pick up specific antibodies signalling the condition.
A biopsy of the villi — which line the small intestine (gut) — may also be performed, as gluten consumed by people with coeliac disease prompts the immune system to attack these areas.
The villi absorb nutrients, and the attacking immune system flattens them, so fewer nutrients are absorbed.
There are no reliable blood biomarkers for gluten intolerance, so it’s diagnosed based on the symptoms being experienced.
A biopsy wouldn’t be useful if a person was only gluten intolerant, as the condition doesn’t damage the gut.
Coeliac disease can have serious complications
If left untreated, coeliac 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 these complications.
Coeliacs should never eat gluten
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.
“If you have coeliac disease, you need to avoid gluten like the plague,” stresses Dr Rankin. “If you’re gluten intolerant then it really is your choice.
“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.”
Enjoy the convenience of having The Sunday Post delivered as a digital ePaper straight to your smartphone, tablet or computer.
Subscribe for only £5.49 a month and enjoy all the benefits of the printed paper as a digital replica.
Subscribe