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Understanding the Differences: Diagnosing Non-Celiac Gluten Sensitivity vs Celiac Disease

Updated: Feb 2

Celiac disease and non-celiac gluten sensitivity (NCGS) are two terms that are often used interchangeably when it comes to reactions to gluten. However, these two conditions are actually quite different. Celiac disease is a well-known autoimmune disorder that affects the small intestine, while non-celiac gluten sensitivity (NCGS) is a less understood condition that can also cause symptoms in response to gluten consumption. In this blog post, we will explore the key differences between celiac disease and gluten sensitivity, helping you understand which one may be causing your symptoms.

Gourds on a table with caption - non-celiac gluten sensitivity versus celiac disease.

The Diagnostic Approach to NCGS and Celiac Disease

So, you suspect that you may have non-celiac gluten sensitivity (NCGS) or celiac disease, but how do you know for sure? Well, diagnosing these conditions can be a bit tricky, but there are some approaches that healthcare professionals use to determine which one you might be dealing with.


When it comes to celiac disease, there is a more established diagnostic process. Your healthcare provider will likely start with blood tests to check for certain antibodies that are typically elevated in individuals with celiac disease. These antibodies include anti-tissue transglutaminase (anti-tTG) and anti-endomysial antibodies (EMA). If these tests come back positive, it suggests that you may have celiac disease, but further confirmation may be needed.

For some, to confirm a celiac disease diagnosis, an intestinal biopsy is usually performed. During this procedure, a small piece of tissue from your small intestine is taken and examined under a microscope. If the biopsy shows damage to the small intestine lining, such as flattened villi, it is a strong indicator of celiac disease. Speak with your specialist to determine whether a intestinal biopsy is necessary.


On the other hand, diagnosing NCGS is a bit trickier. Currently, there is no specific blood test or biopsy that can definitively confirm NCGS. Instead, it is diagnosed clinically. This means that other conditions such as celiac disease and wheat allergy are ruled out, and your symptoms improve when following a gluten-free diet.


Sometimes, a healthcare professional may recommend a gluten challenge as part of the diagnostic process. This involves consuming gluten for a certain period of time and monitoring your symptoms. If your symptoms worsen during the challenge and improve when you eliminate gluten again, it could suggest NCGS.


In summary, the diagnostic approach for NCGS and celiac disease involves blood tests, biopsies, and clinical diagnosis based on symptoms and response to a gluten-free diet. If you suspect you have either condition, it's essential to consult with a healthcare professional who can guide you through the diagnostic process and provide appropriate management options. Remember, accurate diagnosis is key to managing your symptoms and overall health effectively.


Common Symptoms of NCGS Vs. Celiac Disease

When it comes to non-celiac gluten sensitivity (NCGS) and celiac disease, understanding the symptoms is crucial in determining which condition may be causing your discomfort. While both NCGS and celiac disease can produce similar symptoms, there are some differences in the way these symptoms present themselves.


For NCGS, symptoms typically appear shortly after consuming gluten. These can include bloating, gas, changes in bowel movements, nausea, headaches, brain fog, and fatigue. These symptoms can vary in severity, ranging from mild to debilitating, and can last for hours or even days. It's important to note that not everyone with NCGS will experience the same symptoms, and they may differ from person to person.


On the other hand, celiac disease primarily affects the small intestine and can lead to symptoms such as chronic diarrhea, abdominal pain, unintentional weight loss, and malnutrition. Additionally, individuals with celiac disease may develop a skin rash known as dermatitis herpetiformis. There are also those with celiac disease that are asymptomatic, which occurs in approximately 28% celiac disease patients (source).


While both NCGS and celiac disease can cause gastrointestinal issues and fatigue, celiac disease tends to be more severe and can have long-term consequences if left untreated. This is why it's essential to consult with a healthcare professional if you suspect you may have either condition. They can help determine which tests are necessary for a proper diagnosis and guide you towards appropriate management options.


How to Manage NCGS and Celiac Disease

Living with non-celiac gluten sensitivity (NCGS) or celiac disease can be challenging, but with the right management strategies, you can still enjoy a healthy and fulfilling life. Here are some tips to help you manage your condition effectively.


The first step in managing NCGS or celiac disease is to follow a strict gluten-free diet. This means avoiding all sources of gluten, including wheat, barley, and rye, and their derivatives. It's important to read food labels carefully, as gluten can be hidden in many products (read more HERE). Opt for naturally gluten-free foods such as fruits, vegetables, lean proteins, and gluten-free grains like quinoa or rice. Fortunately, there are now many gluten-free alternatives available in grocery stores, making it easier to enjoy your favorite foods without the gluten.


In addition to following a gluten-free diet, it's essential to take care of your gut health. NCGS and celiac disease can cause inflammation and damage to the gut, so it's important to support your digestive system. This can include taking probiotics to promote a healthy balance of gut bacteria and incorporating gut-healing foods such as bone broth, fermented foods, and fiber-rich fruits and vegetables into your diet.


Regular exercise is important for managing NCGS and celiac disease. Physical activity not only helps to reduce inflammation but also supports overall well-being. Find activities that you enjoy, whether it's walking, cycling, swimming, or yoga, and aim for at least 30 minutes of moderate exercise most days of the week.


Stress management is another important aspect of managing NCGS and celiac disease. Stress can exacerbate symptoms and impact your overall health. Explore relaxation techniques such as meditation, deep breathing exercises, or engaging in hobbies that bring you joy. Prioritizing self-care and finding healthy ways to cope with stress can make a significant difference in managing your condition.


Finally, it's crucial to work closely with a healthcare professional or a nutritionist who specializes in celiac disease and NCGS. They can provide personalized guidance, answer any questions you may have, and help ensure that you're getting all the nutrients you need from your diet. To set up a consultation please fill out this health information form.


Remember, managing NCGS or celiac disease may require some trial and error. It's essential to listen to your body, pay attention to how different foods make you feel, and make adjustments as needed. With dedication, support, and a focus on self-care, you can live a healthy and fulfilling life with NCGS or celiac disease.


Consult with our expert nutritionist to get on the path to better health. Fill out a brief health questionnaire and we'll schedule a personalized consultation to address your wellness goals.

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