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I was recently diagnosed with celiac disease. Is this an allergy?

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Updated March 20, 2008

Question: I was recently diagnosed with celiac disease. Is this an allergy?
Answer:

No, although some doctors do refer to celiac disease as a gluten allergy. Celiac disease (also known as celiac sprue, gluten-sensitive enteropathy, or nontropical sprue) is an intolerance of gluten, a protein found in wheat, rye and barley. Some patients with celiac disease are also sensitive to avenin, a related protein found in oats. People with celiac disease are often referred to as "celiacs."

Celiac disease is not an allergy but an autoimmune disorder. There are several differences between the way an allergic patient reacts to an allergen and the way a celiac reacts to gluten:

  1. In an allergic reaction, the immune system creates immunoglobulin E (IgE) antibodies. The body creates different types of antibodies -- the most important of them being immunoglobulin A (IgA), anti-tissue transglutaminase (tTGA) -- in celiac disease. Blood tests for celiac disease measure for these antibodies.

  2. In an allergic reaction, the body responds to the allergen by binding directly to the allergen and releasing chemicals that cause allergic symptoms. In contrast, celiacs' bodies respond to the presence of gluten by attacking the body itself. Specifically, celiac symptoms are the result of the body attacking the villi in the small intestine, which are small projections within the intestine that are vital to the absorption of food and nutrients.

  3. Because celiacs' bodies do not produce histamine in response to gluten, antihistamines and other allergy drugs are not effective at relieving symptoms of gluten ingestion in celiacs. There is, at present, no way to relieve intestinal symptoms from celiac disease.

Celiacs are not primarily treated by allergists but by gastroenterologists. You will likely receive regular endoscopies (intestinal biopsies) to ensure that your intestine is in good health and allowing you to absorb nutrients properly. On a day-to-day basis, however, a celiac's life is similar to that of someone who is allergic to wheat, rye, and barley: Both celiac disease and grain allergies are treated by avoiding the problem foods.

Source:

Arentz-Hansen, Helene et al. "The Molecular Basis for Oat Intolerance in Patients with Celiac Disease." PLoS Med. 2004 October; 1(1): e1.

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