Gluten sensitivity is a general term covering any sort of adverse reaction to gluten. There are important differences between varieties of sensitivity that are especially important to understand with gluten.
The three types of gluten sensitivity are:
Of the three types of gluten sensitivity listed above, celiac disease is the most significant, although the other types can certainly have a large impact on your life also. What makes celiac disease different is that it is a genetic condition triggered by gluten, making any and all organs in the body susceptible to damage, some of which may never heal.
For example, most people with celiac disease develop a damaged intestine, reducing their ability to absorb food nutrients. This alone has detrimental health effects. Generally speaking, this damage to the villi heals after several months spent on a strict gluten-free diet. Celiacs who continue to consume gluten are at risk of developing bowel cancer, a condition that may not be reversible.
Gluten allergy is not as serious. While many gluten allergy symptoms may be similar to celiac disease symptoms, damage to organs is not a concern, as far as we know so far.
Gluten intolerance is the mildest form of gluten sensitivity, and simply means that it is hard to digest gluten, causing gas, bloating, loose stools or diarrhea, and other symptoms similar to a lactose intolerance.
How Far Should You Go to Avoid Gluten?
A strict gluten free diet is difficult and inconvenient to follow. It is easy to slip up for a variety of reasons, and can be very awkward socially. Is it OK to cheat on your diet occasionally?
If you have celiac disease, then the answer is no. Even quantities of gluten that do not cause you noticeable symptoms could be quietly damaging your organs in the background. You don’t want to end up with cancer, thyroid problems or diabetes due to minor cheating on your gluten free diet. Further, if you were to get one of the many diseases associated with celiac disease, it would be unlikely to be linked to consuming gluten, making it harder to treat.
If you have a gluten allergy, you may well find the symptoms so severe and that they last so long, you will be well motivated to avoid all gluten no matter what. I am in this position. In this case you may as well have celiac disease. If your symptoms are mild, you may feel you can put up with them for special occasions. This is up to you to decide. Ditto for gluten intolerance.
Gluten Intolerance Testing
Testing for gluten intolerance is complicated, but easier to understand if we break them down into the different types.
Celiac disease has the most reliable tests, but even celiac disease testing can produce a false negative (saying you’re not celiac when you are). Still, done properly, it is considered fairly reliable. The catch here is that you must have consumed gluten for at least a month, possibly more, before taking the test, or it will not be accurate.
There are tests for gluten allergy, but like most allergy tests, they are not very accurate and should be thought of as a guide. If you decide to take gluten allergy testing, it is important to understand that whether you get a positive or negative result, it might be wrong. Allergy tests are most useful when you suspect an allergy but have no idea what kind of allergy. Allergy tests help narrow it down.
The only way to know for sure if you have a gluten allergy is to conduct an elimination diet. This will provide results that are accurate to the degree that the symptoms are annoying (the worse the symptoms, the more accurate the test).
What is your experience with gluten sensitivities? Did you get tested? Share your questions and experiences, please leave a comment.