Celiac Disease and Gluten Sensitivity are not the Same
In my last article I talked about the problems that happen in the body when someone has celiac disease. There are serious problems that occur in the digestive system including severe intestinal permeability, which results in vitamin and nutrient deficiencies. There is also damage to the intestinal wall because of the immune response to the protein gliadin found in gluten-containing cereals and other foods. There are also symptoms that occur outside of the digestive tract as well. Celiac disease is often a missed diagnosis or a misdiagnosis for many patients because the symptoms are vague and can be shared by so many other disease processes. Once a doctor suspects celiac disease there are blood tests that are used to measure antibodies in the blood. For those people who have celiac disease they usually have higher levels of anti-endomysium and anti-tissue transglutaminase antibodies. If these tests come back elevated then a biopsy will need to be done to confirm damage to the small intestine and for the patient to be diagnosed with celiac disease. Celiac disease is also known as nontropical sprue, gluten sensitive enteropathy, or celiac sprue. One of the major challenges of diagnosing patients with symptoms that seem consistent with celiac disease is that often the blood tests come back negative for increased levels of antibodies. When this happens I generally tell the patient they probably have a gluten sensitivity. Patients with gluten sensitivities often have digestive symptoms that cause discomfort but are not as debilitating as celiac symptoms. Gluten sensitivity still creates a reaction in the immune system but will not cause the severe intestinal permeability or damage to the intestinal cells. In these cases they still have symptoms but they are not substantiated by the blood test. The lack of a specific diagnosis can be very frustrating to patients and to me. In March, 2011, a study from the University of Maryland Center for Celiac Research Places Gluten Sensitivity on Center Stage of Spectrum of Gluten-Related Disorders stated that gluten sensitivities and celiac disease are two different disease processes and affect the immune system differently. This opens things up for researchers to look for different tests to confirm gluten sensitivity. This is important because the center for Celiac Research estimated that 18 million Americans suffer from gluten sensitivity and will test negative in the antibody test.
Sources http://www.mayoclinic.com/health/celiac-disease/DS00319 http://digestive.niddk.nih.gov/ddiseases/pubs/celiac/ http://somvweb.som.umaryland.edu/absolutenm/templates/?a=1474