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How do I know if I’m gluten intolerant or coeliac?

profile picture of Christina Merryfield
Senior Specialist Dietitian, Cromwell Hospital
22 September 2023
Next review due September 2026

Gluten intolerance is when your body reacts to eating gluten. It can have symptoms similar to coeliac disease and coeliac disease is also a type of gluten sensitivity. Here, I talk about what gluten intolerance is, its symptoms and why it can be mistaken for other conditions. I also talk about what gluten-free foods there are available if you need to avoid eating gluten.

group of people eating pizza

What is gluten?

Gluten is a protein found in foods that contain wheat, barley and rye. Common sources of gluten include:

  • bread
  • pastry
  • cakes
  • pasta
  • pizza bases
  • biscuits

Gluten is also found in breakfast cereals and processed foods such as sausages, soups, sauces, and ready meals. Most beers also contain gluten. Oats may also be contaminated with gluten.

Gluten helps hold foods together. Some people may not be able to eat gluten because they have gluten intolerance or coeliac disease. Gluten free foods are available. But if you don’t have a specific condition or intolerance to gluten, eating gluten is not harmful.

What are symptoms of gluten intolerance?

Gluten intolerance is when your body reacts badly to gluten. It is also called non-coeliac gluten sensitivity. Gluten intolerance symptoms are similar to those of irritable bowel syndrome (IBS) and coeliac disease. If you have gluten intolerance, you may have gastrointestinal symptoms such as:

Signs of gluten intolerance also include non-gastrointestinal symptoms. These include headaches, tiredness, brain fog, joint and muscle pain, and skin rash.

Symptoms usually happen a few hours or days after you have eaten gluten. Gluten intolerance symptoms should go away if you stop eating any more gluten.

What can be mistaken for gluten intolerance?

There is a wide range of reasons for gluten sensitivity. Gluten intolerance is one reason. There is also a condition called coeliac disease. This when your immune system attacks your body when you eat gluten. This is not the same as gluten intolerance, but the symptoms can be similar.

In coeliac disease, there is visible damage to the lining of the gut, this does not happen with gluten intolerance. See our table below for the difference between gluten intolerance and coeliac disease.

Difference between gluten intolerance and coeliac disease

Type

Coeliac disease

Gluten intolerance

Definition

An autoimmune disease where your immune system attacks your body when you eat gluten.

When your body reacts badly to gluten but it is not related to your immune system.

Symptoms

Diarrhoea, tummy cramps, bloating and flatulence (passing excess wind), weight loss, fatigue.

Abdominal pain, bloating, diarrhoea, constipation, fatigue, brain fog, joint and muscle pain, skin rashes.

Diagnosis

Blood test and biopsy of your small intestine.

Other reasons for adverse reaction to gluten are excluded (such as coeliac disease).

Treatment

Following a gluten-free diet.

Following a gluten-free diet to avoid symptoms but small amounts of gluten may be tolerated.

Type

Coeliac disease

Gluten intolerance

Definition

An autoimmune disease where your immune system attacks your body when you eat gluten.

When your body reacts badly to gluten but it is not related to your immune system.

Symptoms

Diarrhoea, tummy cramps, bloating and flatulence (passing excess wind), weight loss, fatigue.

Abdominal pain, bloating, diarrhoea, constipation, fatigue, brain fog, joint and muscle pain, skin rashes.

Diagnosis

Blood test and biopsy of your small intestine.

Other reasons for adverse reaction to gluten are excluded (such as coeliac disease).

Treatment

Following a gluten-free diet.

Following a gluten-free diet to avoid symptoms but small amounts of gluten may be tolerated.

Gluten intolerance may also be mistaken for irritable bowel syndrome (IBS). This is because they have similar symptoms. However, IBS is not specifically triggered by eating gluten, although it can be caused by the fructans in wheat products.

Is there a gluten intolerance test?

There is no specific test for gluten intolerance. You might get diagnosed with gluten intolerance if you are tested for coeliac disease and get a negative result. This means coeliac disease is ruled out. So, when you test negative for coeliac disease, your symptoms may be because of something else.

If you have symptoms and you think it’s because of gluten, speak to a doctor for further advice.

Should I eat a gluten free diet?

A gluten-free diet can benefit you if you have gluten intolerance or other types of gluten sensitivity. If you have coeliac disease, you will need to follow a strictly gluten-free diet.

If you have gluten intolerance, you should also follow a gluten-free diet, although you might be able to tolerate a small amount of gluten. But if you have symptoms after eating gluten, they should get better when you stop eating gluten.

If you don’t have a specific condition, you should still be able to eat gluten. You might have heard claims that eating a gluten free diet is healthier for you. But there is no strong evidence to support this.

If you don’t eat gluten, you could be excluding wholegrain from your diet. Wholegrain foods are good for you as they are a source of fibre.

What are gluten free foods?

Gluten free foods are products which have had their gluten removed. They offer you gluten free alternatives to foods that normally have gluten in such as bread, pasta and beer. You can find gluten free foods in most supermarkets or health food shops. They are sometimes on their own shelf.

You should also check the labels on foods. It should say if the product contains gluten, as well as giving a list of ingredients. Foods labelled ‘gluten-free’, ‘very low gluten’ or have the Crossed Grain Symbol are generally safe for most people with gluten sensitivity.

Foods that are naturally gluten free include rice, potato, eggs, fresh fruit and vegetables, cheese, milk, quinoa, corn, buckwheat, pulses, and eggs.

Check with your doctor if you are unsure about eating gluten. A registered dietician can help you to ensure you eat a well-balanced diet.


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profile picture of Christina Merryfield
Christina Merryfield
Senior Specialist Dietitian, Cromwell Hospital

 

Co-author

Rasheda Begum, Health Content Editor at Bupa UK

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