Gluten-free diets are more common than ever. For some it is a lifestyle choice, but for many others it is a medical necessity.
Gluten is a glycoprotein found naturally in commonly consumed grains such as wheat, barley, rye or oats. It offers a variety of culinary benefits and is responsible for the soft and elastic texture of many cereal-based foods, mainly bakery products. However, consumption of this component is sometimes somewhat indigestible to the human body. In some people, gluten intake can cause autoimmune, allergic or sensitivity problems. These three reactions have different origins and symptoms, so it is crucial to differentiate them in order to address them properly.
Dr. Rondón Cepeda and Dr. Ferrández Arenas, allergist and digestologist at Paracelso Sagasta respectively, explain the differences between the three most common gluten- and wheat-related conditions: celiac disease, gluten intolerance and wheat allergy.
Celiac disease
Celiac disease is an autoimmune condition characterized by a permanent and chronic intolerance to gluten. It affects the mucosa of the small intestine, resulting in malabsorption of nutrients and all the associated health problems. Although it is one of the most common chronic intestinal pathologies, there is still a high percentage of undiagnosed patients.
The concerned person will notice intestinal and extraintestinal symptoms during the days or weeks following the ingestion of gluten, regardless of the amount ingested. Some of the most common are loss of appetite, vomiting, diarrhea, abdominal pain, bloating, weight loss, fatigue and developmental or growth problems.
Gluten intolerance
Non-celiac gluten intolerance (also known as gluten sensitivity) occurs in genetically predisposed individuals and is characterized by an inability at the intestinal level to assimilate gluten correctly. Unlike celiac disease, the immune system is not involved in this case.
The effects of intolerance vary according to the amount of gluten ingested and appear within hours or days. Symptoms include abdominal pain, headaches, diarrhea, gas, swollen abdomen and tingling in the extremities.
Wheat allergy
It is an immunological reaction to ingested or inhaled wheat that can become severe. It is characterized by the presence of antibodies against the allergens (proteins) contained in wheat.
Unlike celiac disease and gluten intolerance, the reaction of a wheat allergy is sudden and can be triggered by even small amounts of wheat. The affected person will exhibit skin, respiratory, gastrointestinal or (in severe cases) circulatory symptoms within minutes of coming into contact with the substance. The most common symptoms are: itching and hives (urticaria), difficulty breathing, abdominal pain, vomiting, diarrhea, dizziness, low blood pressure and loss of consciousness (anaphylactic shock).
Diagnostic
Celiac disease, gluten intolerance and wheat allergy can all be detected with similar diagnostic tests.
Blood tests are the most common type of test for the diagnosis of gluten-related conditions. In case of a positive result, other complementary tests can also be performed for a more precise diagnosis. For example, endoscopic tests, skin tests (prick test), pulmonary function tests or other blood tests to quantify specific antibodies. It is essential not to follow a gluten-free diet without first consulting a specialist, as the test results could be distorted and false negatives could be obtained.
In any case, if you think you may suffer from any condition related to gluten or wheat, consult a medical professional. At Paracelso Sagasta we provide a wide range of diagnostic tests for the detection of all types of allergies and digestive pathologies. Our Digestology and Allergology Units feature a highly specialized professional team that, along with state-of-the-art technology, will offer you comprehensive and personalized medical care. Make an appointment with one of our experts.
