Coeliac disease vs gluten intolerance? A nutrition expert explains

Do you feel sluggish or bloated after meals? You're not alone. Around 40% of people worldwide experience digestive issues and gluten can often be a contributing factor. But knowing the difference between gluten intolerance and coeliac disease is key to managing your health.

While both can cause similar discomfort, it’s important to understand the distinction. We asked gut health naturopath and nutritionist, Karly Raven, to help unpack the signs and figure out what could be causing that tummy ache.

What is a gluten intolerance?

Gluten intolerance happens when your body has a reaction to gluten, a protein found in wheat, barley and rye. Unlike coeliac disease, it doesn’t cause long-term damage to the small intestine. But it can cause symptoms like bloating, stomach cramps, fatigue, headaches and joint pain.

The tricky part? These symptoms can overlap with other conditions, such as irritable bowel syndrome (IBS), stress, or even perimenopause, which can make it difficult to pinpoint gluten as the main culprit.

There isn’t a specific test for gluten intolerance, so diagnosis usually involves a process where gluten is removed from your diet and then reintroduced with the help of a health professional. “You need someone to help you identify patterns and rule out other causes,” Karly explains. This is crucial, as foods like onions, garlic or wheat fibres (FODMAPs) might be behind the symptoms, rather than gluten itself.

Related: Gluten-free date & banana bread

Coeliac disease

Coeliac disease is an autoimmune condition where the body attacks itself after eating gluten. This damage affects the small intestine and stops it from absorbing nutrients properly.

Symptoms of coeliac disease can include bloating, fatigue, iron deficiency and brain fog. If untreated, it may lead to serious health problems like infertility and osteoporosis.

Around 1 in 70 Australians are diagnosed with coeliac disease, but many don’t’ know they have it. This is a worry, as Karly explains “If someone has coeliac disease and they keep eating gluten, they can end up with really significant health issues.”

Diagnosing coeliac disease typically involves specific blood tests and sometimes an endoscopy to confirm the diagnosis. However, one of the biggest challenges in getting diagnosed is that people remove gluten from their diet before being tested, making it harder to get an accurate result. “People often take gluten out first because they feel better, but that makes the blood tests unreliable.” Karly says. “If coeliac disease is suspected, testing needs to happen before gluten is removed.”

Why self-diagnosis isn’t enough

It’s tempting to try and figure it out yourself, especially since gluten intolerance and coeliac disease share similar symptoms. But here's the catch: self-diagnosis can lead to wrong treatment decisions and missed opportunities for proper care.

“The symptoms of coeliac disease and gluten intolerance can look very similar, which is why testing for coeliac is so important before making any changes to your diet,” says Karly.

Jumping straight into a gluten-free diet without a proper diagnosis may give you temporary relief, but it could delay the right diagnosis. For coeliac disease, removing gluten before getting tested can skew test results, making it harder for healthcare professionals to get an accurate reading.

As Karly explains, “If coeliac disease is suspected, testing needs to happen before gluten is removed.” That’s why, if you’re experiencing digestive discomfort or suspect gluten is behind it, it’s vital to get tested first.

So what should you do if gluten is bothering you?

If gluten is causing you digestive issues, the most important thing you can do is to speak with your trusted healthcare professional to get an accurate diagnosis.

“If something feels off in your gut, it is always worth investigating. But the path forward depends on what is really going on in there. Coeliac disease requires strict lifelong changes, while symptoms of FODMAP or gluten intolerance can vary from person to person,” Karly explains.

Please note: The tips throughout this article serve as broad information and should not replace any advice you have been given by your medical practitioner.