How do I know if I’m gluten intolerant or coeliac?

May is Coeliac Awareness Month, so it seems timely to explore the difference between gluten intolerance and coeliac disease. Sadly, gluten intolerance is becoming more common, with more and more people finding they are in discomfort after eating gluten-heavy foods such as bread and pasta.

A 2020 study carried out by food chemists and biologists found modern wheat varieties contain more immunoreactive proteins than in the past, causing a rise in wheat and gluten sensitivities and allergies.

But how do you know whether your discomfort is caused by gluten intolerance or coeliac disease?

Gluten intolerance

Gluten intolerance can be a painful condition. Sufferers report the following symptoms after consuming gluten-containing foods:

• Abdominal pain
• Bloating
• Diarrhoea
• Constipation
• Skin rashes
• Joint and muscle pain
• Brain fog

These symptoms usually occur within a few hours of eating gluten and should disappear if you follow a gluten-free diet. Whilst gluten intolerance is sometimes misdiagnosed as irritable bowel syndrome (IBS), one important difference is that IBS is not triggered by eating gluten.

Coeliac disease

Coeliac disease, whilst having many of the same symptoms as gluten intolerance, is an autoimmune disease, wherein your immune system reacts to gluten consumption by attacking your body. Symptoms of coeliac disease include:

• Abdominal pain
• Bloating
• Flatulence
• Diarrhoea
• Fatigue
• Weight loss

One major difference between coeliac disease and gluten intolerance is that whilst these symptoms are uncomfortable in gluten intolerant individuals, they do not cause any damage to the body. Coeliac disease causes damage to the lining of the gut.

How can I tell which I have?

As the symptoms are so similar, it can be easy to get confused as to whether you have a gluten intolerance or coeliac disease – in fact, it takes an average of 13 years for patients to get diagnosed with coeliac disease, predominantly because it has been confused with gluten intolerance.

The best way to tell whether you have gluten intolerance or coeliac disease is to undergo a test for coeliac disease – this involves a blood test and, if this comes back positive, a biopsy of your small intestine to confirm the diagnosis. Should the blood test prove negative, then in all likelihood you are gluten intolerant.

In order to improve the time taken to diagnose coeliac disease, Coeliac UK has set up a free online self-assessment. This provides you with a recommendation as to whether you should be tested for coeliac disease, which you can then show to your GP.

Treatment for gluten intolerance and coeliac disease

Unfortunately, there is as yet no medical treatment for either coeliac disease or gluten intolerance, other than following a gluten-free diet. If you are gluten intolerant, you may be able to tolerate small amounts of gluten, but if you have coeliac disease you should avoid gluten entirely.

Foods to avoid include (but may not be limited to):

• Bread
• Pasta
• Pastry
• Cakes
• Biscuits
• Pizza
• Couscous

Fortunately, gluten-free alternatives to most of these foods are now widely available in supermarkets across the UK.

If you are concerned that you may have coeliac disease, you can access the Coeliac UK self-assessment here. Alternatively, or if the result is a recommendation that you be tested for coeliac disease, please contact us to arrange a consultation with one of our GPs.