Discover more about their similarities, differences & how to manage your diet
Gluten is a protein that comes from wheat, barley and rye that can be found in lots of foods and drinks such as bread, cakes and beer. While gluten intolerance and coeliac disease are both caused by gluten, they're separate conditions with different causes.
What is coeliac disease?
Coeliac disease is an autoimmune condition where the body’s immune system mistakenly attacks its own tissues when you eat gluten, causing damage to the lining of the small intestine. This results in the body being unable to properly absorb nutrients from food and causes stomach pain.
What are the symptoms of coeliac disease?
Some symptoms are triggered by eating gluten:
• Stomach pain
• Diarrhoea
• Constipation
• Wind and bloating
You may also have more general symptoms:
• An itchy rash called dermatitis herpetiformis – most commonly on your elbows, knees or buttocks
• Fatigue (tiredness)
• Unexplained weight loss
• Tingling in your hands or feet
• Difficulties with co-ordination, speech and balance
• Children with coeliac disease may grow more slowly than expected, and enter puberty later than expected
Coeliac disease is diagnosed by a blood test, followed by a biopsy (where a small sample of tissue is taken from your intestine). If you think you may have coeliac disease, you should see your GP.
How many people have coeliac disease?
It's estimated around one in 100 people in the UK have coeliac disease. However, on average only 30 percent who have the condition have been diagnosed* – coeliac disease can often be mistaken for IBS or an intolerance. You're more likely to develop it if you have:
• Type 1 diabetes
• Autoimmune thyroid disease
• Down syndrome
• Turner syndrome
• A parent, brother, sister or child with coeliac disease
If you're in a higher-risk category, you should see your GP to discuss being tested.
Managing coeliac disease
Coeliac disease is managed by following a gluten free diet. This includes avoiding foods and drinks that contain wheat, gluten, barley, rye and oats. Not everyone with coeliac disease is sensitive to oats, however it is very common.
There are lots of gluten-free alternatives now available in both supermarkets and restaurants, so you won’t have to miss out on your favourite dishes. However, someone with coeliac disease needs to avoid cross-contamination, where food preparation equipment may also have been used for foods containing gluten – even a small amount of gluten to someone with coeliac can be very dangerous. This means, if you’re the only person in your household with coeliac, you may want to get separate bread boards and a separate toaster to avoid cross-contamination of crumbs, and use different butter knives, dishes and jam spoons to prevent breadcrumbs from getting into condiments. Standard washing up liquids or using a dishwasher will remove traces of gluten from other utensils. Someone with a gluten intolerance should avoid cross-contamination where possible, however the risks are lower.
Untreated, coeliac disease can lead to long-term complications, including weakening of the bones (osteoporosis), certain kinds of anaemia, and an increased risk of bowel cancer. You should follow a gluten-free diet even if your symptoms are mild to reduce your risk of these complications.
What is gluten intolerance?
If your GP has confirmed you don't have coeliac disease but you still have symptoms, you may have gluten intolerance.
Having a food intolerance means your body can't properly digest a particular food. This causes symptoms such as bloating, stomach pain, or an itchy skin rash, usually within a few hours of eating.
How is gluten intolerance diagnosed?
There's no specific test for gluten intolerance. Your GP may recommend recording what you eat and the symptoms you experience, or cutting out gluten for a specified period of time and seeing if your symptoms improve.
You can then reintroduce gluten-containing foods and see if your symptoms return. You may find you can tolerate a certain amount of gluten before symptoms are triggered.
Eating a restricted diet can make it harder to get the nutrients you need. Your GP or pharmacist can help you find a registered dietitian who can support you.
NHS guidance is that you should only restrict your child's diet on the advice of your GP or a registered dietician. So if you're worried that your child may have a food intolerance or coeliac disease, you should visit your GP as soon as possible.
If you regularly have symptoms such as diarrhoea, constipation, bloating, stomach pains, or rashes, and you're not sure what the cause is, visit your GP so they can diagnose the issue.
Next steps
• If you have symptoms of coeliac disease, or if you're at higher risk of developing it, you should see your GP
• If you have coeliac disease, you should follow a gluten-free diet even if your symptoms are mild
• If you regularly have symptoms of diarrhoea, constipation, bloating, stomach pains or rashes and you're not sure what the cause is, you should visit your GP for a diagnosis
