Gluten Intolerance

Intolerance to gluten can present itself as celiac disease, wheat allergy or non-celiac gluten sensitivity (NCGS). There is much confusion and misuse of these terms. Presented below are the main features of these three conditions for a better understanding of the differences amongst them.

Celiac disease

• A permanent autoimmune disorder
• Often specific antibodies are present
• Characteristic biopsy changes – intestinal damage noted
• Most well characterized condition and the most common gluten related disorder in India at present
• Strict gluten free diet recommended
• ~1% of the population affected

Read more about celiac disease here

Wheat allergy

• IgE mediated allergy; Usually self limiting and often resolves in a few years
• IgE antibodies to wheat present
• No biopsy changes – No intestinal damage
• Presents like other allergies – rash, hives, respiratory difficulty, profuse vomiting and diarrhea
• Other food allergies could also be present
• Wheat avoidance necessary
• ~0.1% of the population affected

Non celiac gluten sensitivity (NCGS)

• Intestinal and extra-intestinal manifestations
• No antibodies found
• Normal biopsy- No intestinal damage
• Long term or natural history of this condition is not yet clear and lot more research needed to characterize this condition
• Gluten intake reduction adequate for symptom control
• ~2-6% of the population affected ( as per figures from other countries)