In the quest for overall health, digestive diseases have been brought to the forefront of many conversations. It’s about time! Gut health has been on the back burner for too long, and we now know that a healthy GI tract is of the utmost importance in achieving and maintaining a healthy, well-balanced life. A few of the most commonly discussed digestive diseases are IBS, IBD, Crohn’s disease, ulcerative colitis, celiac disease, and non-celiac gluten sensitivity (NCGS). Today we’re going to cover the differences between celiac disease and NCGS.
Gluten and Celiac Disease
With the rise in popularity of gluten-free eating, celiac disease and NCGS have become regular topics of conversation. There are many who choose to adopt a gluten-free diet for personal and other health reasons, but there’s a large portion of the population for whom there is no other choice. These are the folks with celiac disease, an autoimmune disorder in which the body literally cannot digest gluten. It’s estimated that one out of every 100 people is diagnosed with this autoimmune disorder. Celiac disease occurs in genetically predisposed people and can occur at any age. Celiac is not something you “catch,” yet it seems to be brought on by a sickness, big life change, or increased life stress.
Gluten is a protein found in grains such as wheat, barley, and rye. When someone with celiac disease ingests gluten, the body sees it as a foreign object and attacks. This cascades into a series of events that lead to the degradation of the villi of the intestines.
The villi are small finger-like projections that line the entirety of the small intestine. They help with the absorption of fluid and nutrients, so the blunting and killing off of these villi makes absorbing nutrients impossible.
For people with celiac, the ingestion of gluten can also increase the permeability of the small intestine, which basically results in the small intestine doing exactly the opposite of what it’s supposed to do!
A diagnosis for celiac comes after a positive blood test and a small intestine biopsy that shows blunting of the villi. For those with celiac disease the only treatment available is strict adherence to a gluten-free diet. Thankfully, sticking to a gluten-free diet has become much easier in recent years due to better food labeling and many, many more gluten-free food options.
Many people have symptoms such as a bloating, diarrhea, foggy mind, achy joints, constipation, fatigue, and headaches after ingesting gluten BUT don’t test positive for celiac disease. If their symptoms improve after removing gluten from their diet, then these individuals are considered to have non-celiac gluten sensitivity (NCGS). There are no tests currently recommended for the
diagnosis of NCGS, but it is estimated that as many as 18 million Americans are affected.
Differences Between Celiac and NCGS
While some of the symptoms are similar between the two conditions, there are two major differences:
- NCGS can cause minor intestinal damage in some people, but celiac disease causes
extensive intestinal damage in all diagnosed patients.
- Permeability of the intestines is not affected in NCGS while in celiac disease there is
NOTE: It’s important to discuss all symptoms with your GI doc and dietitian, as they are vital in identifying, diagnosing, and getting you on the path to excellent health.
Whether it’s celiac disease or NCGS, the treatment is the same: a lifelong adherence to a strict gluten-free diet. A gluten-free diet is one that does not contain wheat, barley, rye, triticale, or wheat varieties like kamut, farro, durum, and semolina.
It can seem like there are quite a bit of exclusions, but in reality there are many grains that are totally okay on a gluten-free plan. Rice, millet, buckwheat, quinoa, corn, and certified gluten-free oats are all safe to have. Many whole foods—fruits, vegetables, nuts, seeds, dairy, meat, beans, tofu, and the above mentioned grains—are naturally gluten free.
The only time these items may pose an issue is when they are processed into a prepackaged or mixed product. For example, an apple is naturally gluten free, but an apple flavored breakfast cereal bar is not, unless noted on the package. Another example: chicken breast is naturally gluten free, but chicken breast that is pre-marinated in a beer-containing BBQ sauce is not gluten free. Be sure to check the allergen statement at the bottom of the nutrition label to help determine if the item is safe. Also, please remember that if a label states the item is wheat-free that DOES NOT ALWAYS mean it’s gluten free! It can still contain other troublesome grains like barley and rye. A good rule of thumb is to purchase whole, unprocessed food items with a minimal list of ingredients.
Now you know the difference between celiac disease and NCGS, as well as how to eat for both conditions. Be sure to check out our Vivante recipe posts. Many are gluten-free. Don’t hesitate to reach out with any questions or concerns. Vivante dietitians are on-call to help members 24/7!