“What's the difference between celiac disease and gluten intolerance?”

Celiac is an immunological reaction in the small bowel to gluten. Gluten intolerance is a vague and ill-defined term. There is no consensus on what intolerance means medically speaking. At most, intolerance means that some type of symptom is experienced after eating a certain food, but in the case of gluten "intolerance", why this happens and how have not been explained fully. In fact, an elegant (comparison, crossover) study done just a couple of years ago showed that most people who self report gluten "intolerance" are actually responding to fructans in wheat, not gluten.
Bottom line: one should not self diagnose as being gluten "intolerant" and should not automatically self impose a life-long gluten free diet.

Gluten intolerance means your son does not have celiac disease, but he is sensitive and cannot tolerate gluten in his diet. The treatment for both celiac disease and gluten intolerance is avoidance of gluten from his diet.

These two conditions can be distinguished by antibody tests and by biopsies taken from the small intestine during upper GI endoscopy. The two conditions have similar symptoms.
I hope your child’s doctor will give you more information as well.

Celiac disease is an actual immune process with antibodies that react to the gluten protein. Gluten intolerance (like lactose intolerance) is not an immune process. The body just does not digest the protein well. Although intolerance causes symptoms from the undigested protein causing problem in the lower bowel, since there is no immune reaction there is no tissue damage or inflammation that occurs.

Mark R. Corkins, M.D., S.P.R., C.N.S.C., F.A.S.P.E.N., A.G.A.F., F.A.A.P.