Celiac Disease vs. Wheat Intolerance: What’s the Difference?

Gabi Meltzer, Registered Dietician, June 2025

Do you experience digestive discomfort after eating wheat-based foods like bread or pasta?

You’re not alone! Many people notice bloating, cramps, or fatigue after these meals, and wonder if gluten or wheat could be to blame. But before cutting foods out, it’s important to understand what might actually be causing your symptoms, and what kind of dietary changes are truly necessary.

In this blog post, we’ll break down the difference between coeliac disease and wheat intolerance to help you decide what steps to take to manage your symptoms as well as protect your long-term health.

What Is Celiac Disease?

Celiac disease is an autoimmune condition where the body’s immune system attacks the lining of the small intestine when gluten (a protein found in wheat, rye, and barley) is consumed. This reaction leads to inflammation, gut damage, and poor nutrient absorption.

Common symptoms include:

• Bloating, gas, diarrhoea or constipation

• Fatigue and brain fog

• Iron deficiency or low B12

• Weight loss (or poor growth in children)

• Skin rashes, joint pain, and mouth ulcers

  
  

Diagnosis:

Celiac disease is diagnosed with blood tests and a gut biopsy (via gastroscopy) — but you must be eating gluten for these tests to be accurate.

Treatment:

A strict, lifelong gluten-free diet is the only treatment. Even tiny amounts of gluten can cause damage, even without obvious symptoms.

What Is Wheat Intolerance (or Sensitivity)?

Wheat intolerance is not an autoimmune condition and does not damage the gut lining. It’s often a functional gut issue — where the digestive system isn’t working optimally, but there’s no visible damage like in coeliac disease.

It’s much more common than coeliac disease, and symptoms can be very real and disruptive.

Common symptoms:

• Bloating or gas

• Stomach cramps

• Diarrhoea or constipation

• Fatigue or brain fog

  
  

Diagnosis:

There’s no specific test for wheat intolerance. It’s usually identified through a thorough dietary history and a process of elimination, with the help of a dietician experienced in IBS and gut health.

Why is it confusing?

Many people feel better when they reduce gluten — but it’s often not the gluten (protein) causing their symptoms. The issue is usually fructans, a type of fermentable carbohydrate (FODMAP) found in wheat, rye, and barley.

Fructans are poorly absorbed in the gut and ferment in the large intestine, producing gas and drawing in water. In people with more sensitive guts (such as those with IBS), this can lead to bloating, cramping, and changes in bowel movements.

So… Should You Avoid Gluten or Wheat?

It’s easy to assume gluten is the problem — especially with all the buzz around gluten-free diets. But in many cases, fructans (not gluten) are the true trigger. This makes it incredibly confusing to know what to cut out — and what you actually don’t need to avoid.

That’s why it’s so important to work with a dietitian before making big dietary changes. Cutting out wheat or gluten without proper guidance may:

• Lead to unnecessary food restrictions

• Increase your risk of nutrient deficiencies

• Make your diet less diverse, which may negatively affect your gut health over time

  
  

Fructan-rich foods (like wheat, onion, and garlic) are also high in fibre and act as fuel for the good bacteria in your gut. These foods support a healthy gut microbiome, so removing them entirely could do more harm than good if it’s not needed.

A dietician can help you include these foods in amounts and forms that your body can tolerate, rather than avoiding them altogether.

Quick Comparison

	Coeliac Disease	Wheat Intolerance
Type	Autoimmune	Functional (non-immune)
Gut Damage?	Yes	No
Symptoms	Digestive + systemic	Digestive mostly
Diagnosis	Blood tests + biopsy	By exclusion (no test available)
Management	100% gluten-free diet	Reduce fructans/wheat as needed

If you’re experiencing uncomfortable gut symptoms after eating bread or wheat-based foods, don’t panic — and don’t rush to cut everything out.

Your first step should be to get tested for celiac disease before removing gluten from your diet. Once that’s ruled out, a dietician can help assess your diet and help you to find a balanced, sustainable approach to eating that reduces symptoms without creating fear or restriction. 

If you’re unsure where to start, reach out to a dietician (like me) who can help guide you through this process safely and practically. You deserve to feel good, without unnecessary food rules.

For personalised guidance on finding a more positive relationship with food, exercise, and your body, book a consultation here: https://www.gabimeltzerdietician.com/book-online.