Celiac disease (CD) is not an allergy but an autoimmune disease. People with CD have an autoimmune reaction involving IgA antibodies when gluten is ingested. An allergy is different and involves a different branch of the immune system, so the term gluten allergy is not the correct term to use for CD. There are several correct alternative terms for CD:

• • Celiac sprue

• • Gluten sensitive enteropathy

• • Coeliac disease (UK spelling)

However, it is easy to confuse CD with other gluten-related conditions. Below are explanations of the different gluten-related conditions that are often confused with CD:

Dermatitis herpetiformis (DH)

• A different manifestation of celiac disease where the immune system attacks the skin creating an itchy blistering rash when gluten is ingested. It may be present with or without damage to the small intestine.
• DH is diagnosed via skin biopsy by a dermatologist.
• The treatment is a strict gluten-free diet and may also include medications to manage symptoms.

Non-celiac gluten sensitivity (NCGS)

• NCGS is an intolerance to gluten ingestion that may cause an immune response but little to no villi damage; the symptoms may be similar to celiac disease. It is estimated to affect about 6 percent of the population. ²
• There is currently no test to diagnose NCGS. Celiac disease and wheat allergy must be ruled out before a diagnosis of NCGS is made.
• The treatment is a gluten-free diet.

Wheat allergy

• This is an allergic immune reaction (that involves a different branch of immune system than celiac disease) to wheat ingestion. It may include a reaction in skin, mouth, lungs, and/or GI system.
• Wheat allergy should be diagnosed by an allergist.
• The treatment is a wheat-free diet and may include medications to manage symptoms. ¹

You can download an infographic explaining the different gluten-related conditions here:

References:

1. National Celiac Association. Gluten-Free, Off to A Fresh Start. Presentation. May 4, 2018.
2. Igbinedion SO, Ansari J, Vasikaran A, et al. Non-celiac gluten sensitivity: All wheat attack is not celiac. World J Gastroenterol. 2017;23(40):7201–7210.

Reviewed October 20, 2022.