Celiac disease and lactose intolerance are both food-reactive conditions that cause digestive upset such as abdominal pain, bloating, gas and diarrhea. If you have been diagnosed with celiac disease and are following a strict gluten-free diet but symptoms persist, you may need to follow a gluten-free lactose-free diet for a period of time.
Celiac Disease
Celiac disease is an autoimmune disease in which gluten, a protein found in wheat, rye, barley and some oats, causes the body to attack the villi of the small intestine. The villi are finger like projections on the lining of the intestinal wall involved in absorption of nutrients into the body. Ongoing consumption of gluten damages and flattens the villi leading to malabsorption of foods. For most, the gluten-free diet will stop symptoms, and heal the damaged villi. According to the National Institute of Diabetes and Digestive and Kidney Diseases, most people see improvement in a few days. The small intestine will usually heal in three to six months in children, but can take years to completely heal in adults.
Lactose Intolerance
Lactose is a sugar found in milk. The villi of the small intestine contain the enzyme lactase which breaks down lactose into glucose and galactose. Primary lactose intolerance occurs in people who do not produce the lactase enzyme in sufficient amounts. Secondary lactose intolerance occurs in individuals who have experienced intestinal damage, such as that from celiac disease, Crohn's disease or chemotherapy. In either case, lactase deficiency causes undigested lactose to be broken down by bacteria in the large intestine causing bloating, cramping, nausea, gas and diarrhea.
Celiac Disease and Lactose Intolerance Linked
If you have been diagnosed with celiac disease you may have intestinal villi damage that reduces the amount of lactase your body can produce. Low levels of lactase leads to malabsorption of milk sugars, resulting in symptoms similar to those of eating gluten.
Long-Term Diet
While there is no substitute for a gluten-free diet in celiac disease, a lactose-free diet may be eliminated once the villi are repaired and able to produce lactase again. According to Dr. Peter Green, Director of the Celiac Disease Center at Columbia University, about 25 percent of the U.S. population have primary lactose intolerance. If you have primary lactose intolerance, a life-long attention to lactose intake is necessary. However, if you have secondary lactose intolerance, once the villi are healed lactose intolerance usually disappears.
References
- "National institute of diabetes and digestive and kidney diseases": Lactose Intolerance
- "National institute of diabetes and digestive and kidney diseases": Celiac Disease
- 3. "Celiac Disease a Hidden Epidemic"; Peter H.R. Green, M.D.; 2006
