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Why is it important
to know if you have celiac disease, versus a
wheat allergy or gluten intolerance?
Celiac
disease, wheat allergy and gluten-intolerance
are treated similarly, in that patients with
these conditions must remove wheat from their
diet. It is important to note, however, that
there is a difference between these three
medical problems. Celiac disease is an
autoimmune condition, where the body's immune
system starts attacking normal tissue, such as
intestinal tissue, in response to eating gluten.
Because of this, people with celiac disease are
at risk for malabsorption of food in the GI
tract, causing
nutritional deficiencies. This can lead to
conditions such as iron deficiency anemia and
osteoporosis. Since a person with wheat
allergy or gluten-intolerance usually does not
have severe intestinal damage, he or she is not
at risk for these nutritional deficiencies.
Celiac disease is an autoimmune condition,
putting the patient at risk for other autoimmune
conditions, such as thyroid disease, type I
diabetes, joint diseases and liver diseases.
Since wheat allergy and gluten intolerance are
not autoimmune conditions, people who have food
allergies and intolerances are not at increased
risk to develop an autoimmune condition over the
general
population's risk.
And finally, celiac disease involves the
activation of a particular type of white blood
cell, the T lymphocyte, as well as other parts
of the immune system. Because of this,
patients with celiac disease are at increased
risk to develop GI cancers, in particular
intestinal lymphomas. Because food
allergies and intolerances do not involve this
particular immune system pathway, and do not
cause severe GI tract damage, these patients are
not at increased risk for these cancers.
Thus, while celiac disease, wheat allergy, and gluten-intolerance
may be treated with similar diets, they are not
the same conditions. It is very important
for a person to know which condition they have,
as the person with celiac disease needs to
monitor himself or herself for nutritional
deficiencies, other autoimmune diseases, and GI
cancers. In general,
the symptoms from food allergies and
intolerances resolve when the offending foods
are removed from the diet and do not cause
permanent organ damage.
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