Celiac Disease Explained

Introduction

Gluten intolerance (also called non-celiac gluten sensitivity or NCGS) is when your body has trouble digesting gluten, causing uncomfortable symptoms. Gluten is a protein found in wheat, barley, rye, and related grains. When people with gluten intolerance eat foods containing gluten, they feel sick, but unlike celiac disease, it doesn't damage the intestines.

Gluten intolerance affects about 6% of the U.S. population and is more common in women. Some people are born with it, while others develop it later in life. It's different from both celiac disease and wheat allergy, though the symptoms can sometimes look similar.

What is Gluten?

Gluten is a protein that acts like glue, helping foods hold their shape. It's found in grains like wheat, barley, rye, triticale, spelt, and kamut. This means it shows up in common foods like bread, pasta, cereal, baked goods, pizza, and crackers. You'll also find it in beverages like beer and some flavored drinks.

What surprises many people is that gluten hides in unexpected places. Soy sauce, salad dressings, processed meats, soups, candy, vitamins, cosmetics, and even some medications can contain gluten. This is why scanning ingredients becomes so important when managing gluten intolerance.

Gluten Intolerance vs. Celiac Disease vs. Wheat Allergy

These three conditions are often confused, but they're actually quite different.

Gluten intolerance means your body has trouble digesting gluten and causes uncomfortable symptoms, but it doesn't damage your intestines. There are no abnormal genes or antibodies involved, and it's diagnosed mainly by eliminating other conditions.

Celiac disease is an autoimmune disorder where your body actually attacks itself when you eat gluten. This causes intestinal damage over time and is linked to specific genes and antibodies that show up in blood tests. It affects about 1% of the population and requires a strict, lifelong gluten-free diet to prevent serious health complications.

A wheat allergy is different from both. It means your immune system overreacts to wheat proteins and can cause rapid allergic reactions like hives, breathing problems, or even anaphylaxis. People with wheat allergies need to avoid wheat specifically, but they may be able to tolerate other gluten-containing grains like barley or rye.

The key difference to remember: Gluten intolerance makes you feel sick, celiac disease damages your gut, and wheat allergy triggers an immediate immune reaction.

Common Symptoms

Gluten intolerance symptoms usually appear within hours or days after eating gluten. The most common digestive symptoms include:

• Bloating, gas, abdominal pain or cramping

• Diarrhea or constipation

• Nausea

But gluten intolerance doesn't just affect your stomach. Many people experience body-wide symptoms like:

• Fatigue or low energy

• Headaches or migraines

• Brain fog or difficulty concentrating

• Joint or muscle pain

• Numbness or tingling in hands and feet

• Skin issues like rashes or eczema

• Mood changes such as anxiety or depression

• Unintentional weight loss

It's worth noting that many people with gluten intolerance also have irritable bowel syndrome (IBS), which can make symptoms more complex and harder to pinpoint.

What Causes Gluten Intolerance?

Scientists are still studying the exact causes, but current research offers some interesting possibilities.

One theory suggests that some people may actually be sensitive to certain carbohydrates (called FODMAPs) found in wheat and other foods, rather than gluten itself. These carbohydrates don't get absorbed properly and ferment in the gut, causing discomfort.

Another idea is that gluten might affect the intestinal lining in some people. Normally, this lining keeps bacteria from leaking out of your intestines, but in people with gluten intolerance, it might not work as well. This allows bacteria into the bloodstream and causes inflammation.

The truth is, everyone's digestive system is unique, and some bodies simply process gluten differently than others. We don't have all the answers yet, but we know the symptoms are real and manageable.

How Is It Diagnosed?

There's no single test for gluten intolerance, so your healthcare provider will use a process of elimination.

Step 1: First, they'll rule out celiac disease and wheat allergy through:

• Blood tests to check for celiac antibodies

• Allergy tests for wheat

• Sometimes an endoscopy to check for intestinal damage

Step 2: If those tests come back negative, the next step is an elimination diet. You'll remove all gluten from your diet for two to six weeks while carefully tracking your symptoms. If your symptoms improve significantly, gluten intolerance is likely the culprit.

Step 3: The final step is a gluten challenge, where you slowly reintroduce gluten-containing foods and monitor which ones trigger symptoms. This helps confirm the diagnosis and shows you exactly which foods to avoid.

Important note: Don't start a gluten-free diet before getting tested for celiac disease, as it can affect your test results and make diagnosis more difficult.

Managing Gluten Intolerance

The primary treatment for gluten intolerance is following a gluten-free diet. This means embracing naturally gluten-free foods like:

Naturally Gluten-Free Foods

• Fresh fruits and vegetables

• Meat, poultry, fish

• Eggs

• Dairy products

• Beans and legumes

• Nuts and seeds

• Gluten-free grains like rice, quinoa, and corn

Gluten-Free Alternatives

• Gluten-free bread, pasta, and baked goods

• Rice noodles or zucchini noodles

• Corn tortillas instead of flour tortillas

• Gluten-free oats (just check the labels)

Reading Labels Carefully

The key is reading labels carefully, since gluten hides in unexpected places. Look out for ingredients like:

• Wheat, barley, rye

• Malt

• Brewer's yeast

• Modified food starch

• Hydrolyzed vegetable protein

Regular soy sauce contains gluten, but tamari is a great gluten-free alternative.

Pro tip: This is where Inside makes your life easier. Use the barcode scanner to quickly check if packaged foods contain gluten before you buy them.

Additional Support

Your healthcare provider might recommend:

• Probiotics to help with gut health and reduce symptoms

• Digestive enzymes (though research on their effectiveness is still ongoing)

• Nutritional supplements if you're deficient in certain vitamins

• Working with a dietitian to ensure you're getting proper nutrition on a gluten-free diet

Be Especially Cautious With

• Restaurant foods where cross-contamination is common

• Processed meats that may contain fillers

• Sauces and condiments

• Communion wafers

• Lipstick and lip balm

• Medications and supplements

Living Gluten-Free: Important Considerations

While a gluten-free diet relieves symptoms, there are some nutritional concerns to keep in mind. Gluten-free diets are often lower in:

• Fiber

• B vitamins like folate and thiamin

• Iron

• Calcium

• Vitamin D

The solution is to eat a varied diet with plenty of whole, naturally gluten-free foods, and consider supplements if your doctor recommends them.

There are other considerations too. Gluten-free products tend to be more expensive, and some gluten-free processed foods are surprisingly high in sugar and calories. Social situations may require planning ahead, and cross-contamination is a real risk when dining out or eating at friends' houses.

What If You Accidentally Eat Gluten?

Accidents happen, and if you accidentally consume gluten, don't panic. Here's what to do:

• Stay hydrated by drinking plenty of water

• Rest and give your body time to recover

• Eat light and stick to bland, easy-to-digest foods

• Consider taking probiotics to help restore gut balance

• Be patient since symptoms typically resolve in a few days

When to Seek Medical Help

You should seek medical help if you experience:

• Severe diarrhea or vomiting that could lead to dehydration

• Signs of dehydration like dizziness, dark urine, or rapid heartbeat

• Symptoms that last more than a few days

Tips for Success

At Home

• Keep your kitchen organized with separate gluten-free zones to avoid cross-contamination

• Use separate cutting boards and toasters

• Stock your pantry with gluten-free staples

• Try new gluten-free recipes to keep meals interesting and enjoyable

When Dining Out

• Research restaurants beforehand since many now offer gluten-free menus

• Communicate clearly with servers about your needs

• Ask about preparation methods and cross-contamination risks

• When in doubt, stick to simple, whole foods that are naturally gluten-free

On the Go

• Pack gluten-free snacks when traveling

• Use Inside to scan products before buying

• Keep a list of safe foods and brands on your phone

• Join online communities for support and restaurant recommendations

The Bottom Line

Living with gluten intolerance requires some adjustments, but most people find significant relief by following a gluten-free diet. Your symptoms should improve within weeks of eliminating gluten, and many people report feeling better than they have in years.

Remember: Gluten intolerance is a lifelong condition. If you reintroduce gluten, symptoms will likely return. But with the right tools like Inside's scanning features, managing your diet becomes much easier and less stressful.

Questions for Your Doctor

• Do I need testing for celiac disease before starting a gluten-free diet?

• Should I see a dietitian to help plan my meals?

• Do I need any nutritional supplements?

• Are there other conditions I should be tested for?

• How can I ensure I'm getting enough fiber and nutrients?

Need help identifying gluten in products while shopping? Download Inside to scan items instantly and get clear information about gluten content and potential cross-contamination risks. Take the stress out of grocery shopping and feel confident about every purchase.

Disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice. Always consult with your healthcare provider before making significant dietary changes or if you suspect you have any medical conditions.