There are a three primary reasons why the human body may not be able to deal with gluten. Celiac disease, intolerance and allergy are three different disorders, the causes of which are quite distinct. We spoke to Dr. Beatrice Salvioli, gastroenterologist at Humanitas, and guest on the Italian Channel RAI 1.


Celiac disease, an autoimmune disease

Celiac disease is an autoimmune disease that only affects genetically predisposed individuals. When these individuals consume gluten, their body produces antibodies that destroy the small intestine. Celiac disease patients are therefore obliged to suspend the intake of gluten for life and it is important to consume products labeled “gluten-free” as they do not tolerate contamination. For example, gluten-free flours that can be consumed by people with celiac disease are: rice starch, corn, millet, soy, tapioca, chestnuts, chickpea and flours from other legumes.


Intolerance and allergies

Intolerance is not related to immunity but is rather a hypersensitivity phenomenon. Intolerance results in break outs. It can be described as a mechanism of accumulation. Meaning that, an excess of gluten generates the onset of symptoms such as diarrhea, bloating, abdominal pain, cramps and weight loss.

An allergy instead is directly involved with the immune system. In particular by the action of immunoglobulin E that causes an allergic reaction. This occurs almost immediately (in minutes or hours), after ingestion of a particular food.


How is it diagnosed?

We should first point out that the diagnosis must be made by a doctor. In the presence of symptoms, speak to your doctor or to a specialist and strictly avoid self-diagnosis and discontinuation of products containing gluten.

First, we must rule out celiac disease. To do this we resort to specific blood tests, duodenal biopsy during a gastroscopy and genetics.

Allergy is diagnosed with specific tests. The prick test, which is carried on the inside of the forearm, and the RAST test (a blood test).