What is the difference between Coeliac Disease and Gluten Intolerance?

It has become increasingly common for both adults and children to be on gluten free diets. For many parents, a gluten free diet will often be trialled after months, if not years, of complaints from their child about gastrointestinal upsets (of varying degrees and severity) while for others, they may have read that a gluten free diet can improve alertness and general behaviour in some children.

Often, parents will find that reducing or avoiding large amounts of wheat breads and pasta will helps to reduce some symptoms of irritable bowel syndrome (IBS), while others report that their child’s attention and general behaviour improve markedly on this exclusion diet.

Unfortunately though, avoidance or significant reduction in gluten in a child (or adult’s) diet, without first consulting with your GP, makes it very difficult to formally diagnose Coeliac Disease.

What is Coeliac Disease?

Coeliac Disease is an autoimmune disease (autoimmune means that your body’s immune system starts to attack your own body, in this case; the lining of the gut, in response to the presence of something your body has seen as foreign or harmful, in this case; gluten).

How is Coeliac Disease diagnosed?

For Coeliac Disease to be diagnosed accurately, gluten must be present in your child’s diet in reasonable quantities (2 slices of bread or equivalent in children aged 4 years or younger, 3 slices of bread of equivalent in children aged 5-8 years and 4 slices of bread or equivalent in children aged  9 years or over) for at least 6 weeks prior to a blood test (Coeliac Serology) which is checking for the presence of antibodies known to be elevated in people with untreated Coeliac Disease. If this blood test indicates that the levels of these antibodies are elevated, your Doctor will refer you to a Paediatric Gastroenterologist who will perform a gastroscopy to confirm a diagnosis.

The ‘cure’ for Coeliac Disease is STRICT life long avoidance of gluten. By following a strict gluten free diet for life, people with Coeliac Disease should lead healthy lives. The lining of their gastrointestinal tract will return to normal, and in children, they should grow to their full height and weight potential.

It is for this reason that it is essential to rule out Coeliac Disease before taking gluten out of a child (or adult’s) diet. If gluten is removed, and the gut has already started to heal, you may receive false negative results to the tests mentioned previously, leaving you at risk of long term complications associated with Coeliac Disease including early onset osteoporosis, infertility and bowel cancer.

If Coeliac Disease has been ruled out, is it OK to avoid or limit gluten in my child’s diet?

Absolutely! For those who find that a reduction or elimination of gluten improves their child’s feeling of wellbeing, any gut symptoms they may be experiencing, or any problems they may be having with concentration or energy, a reduction in gluten is worth trying.

In this case, the occasional indulgence with something containing gluten is not harmful to them (it might make them feel a bit unwell in the short term, but once they recover, they are OK). For people diagnosed with Coeliac Disease however, the occasional indulgence can be both unpleasant and harmful and therefore needs to be avoided.