What's the difference between celiac disease, gluten sensitivity, and gluten intolerance?

Are there different reactions to gluten?

Everyone responds differently to ingesting gluten and wheat. Approximately .04% of the U.S. population react with a full-blown IgE-mediated wheat allergy, displaying classic symptoms of itching, swelling, and difficulty breathing. Others have an autoimmune response known as celiac disease that causes their intestines to be torn down leading to malnutrition (approximately 1% of U.S. population). A recently studied reaction called gluten-sensitivity is characterized by an increased secretion of inflammatory chemicals that disrupt your local and systemic inflammatory balance—but that does not tear down the intestinal lining (approximately 6% of US population).

Even if you have none of the above three, however, far too many people have a gluten-initiated "leaky gut." Gluten—particularly the gliadin peptides—differs from all other foods in that its consumption creates the secretion of zonulin proteins. This can lead to a permeable gut for a short time after eating in all humans and animals. Normally, intestinal cells are bound to one another by tight junctions, which control what is allowed into the intestinal cells and what is not. When the barrier becomes permeable, however, the contents of the intestinal tract, including bacterium and undigested food proteins, are allowed to pass through the intestinal barrier unchecked. This leads to an alert-and- alarm—or inflammatory—response from your local immune cells, and may also contribute to an increase in sensitivities to those food proteins. So in other words, even if you don’t have celiac disease, gluten-sensitivity, or gluten-intolerance, your digestion and overall health may benefit from a gluten-free diet!

References

Non-Celiac Wheat Sensitivity Diagnosed by Double-Blind Placebo-Controlled Challenge: Exploring a New Clinical Entity
Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines.
Spectrum of gluten-related disorders: consensus on new nomenclature and classification

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