What is Crohn's Disease?
Is It Crohn's Disease or Celiac Disease?
Thinking of trying a gluten-free diet with Crohn's? There's some overlap between Crohn's and celiac, and eliminating gluten may help with both.
By Elizabeth Shimer Bowers
Medically Reviewed by Justin Laube, MD
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Occasional gastrointestinal upset is normal. But if you’re experiencing abdominal cramps, diarrhea, and other discomfort that persists, you may have a bigger digestive problem, like celiac disease or Crohn’s disease.
Because Crohn’s and celiac disease (sometimes called celiac sprue) are similar in some ways, they may be hard to distinguish from each other at first. Among other features, they share common symptoms, including diarrhea and abdominal pain. It's also possible for one person to have both diseases.
In both Crohn’s and celiac disease, the immune system is reacting to some sort of environmental stimulus. “In celiac disease, we know that stimulus is gluten, but we don’t yet understand what the environmental stimulus is in Crohn’s,” says Karlee Ausk, MD, gastroenterologist with Swedish Gastroenterology at the Swedish Medical Center in Seattle.
Research shows that people with celiac disease also seem to be at an increased risk for inflammatory bowel disorders — specifically Crohn’s disease and ulcerative colitis — compared with people who don't have celiac disease.
In a study published in May 2014 in theWorld Journal of Gastroenterology, researchers found that celiac disease and Crohn’s share some genetic risk factors.
“If you look at the genetic predisposition for Crohn’s and celiac, there are some genes that overlap, which increases the risk of having both conditions,” Dr. Ausk says.
Distinguishing Between Crohn’s and Celiac Disease
If you have symptoms that suggest either Crohn’s disease or celiac disease, the first thing you should do is see your primary care doctor, who may refer you to a gastroenterologist.
Celiac disease is diagnosed after an endoscopic biopsy, which involves inserting a thin tube called an endoscope through the mouth and into the stomach to see inside the GI tract. After this, your doctor will prescribe a gluten-free diet to see if your symptoms improve. A gluten-free diet eliminates certain types of proteins found in wheat, barley, rye, and foods made from these grains.
Diagnosing Crohn’s involves having a colonoscopy to examine the colon, and an upper endoscopy to view the first part of the small intestine.
“While there is a blood test for celiac disease, it has not been shown to be 100 percent accurate in diagnosing the disease,” says Kelly Kennedy, RD, nutritionist for Everyday Health.
The Power of a Gluten-Free Diet
If examination reveals that your gastrointestinal upset is due to Crohn’s disease, treatment will include medication and, in severe cases, surgery. If the diagnosis is celiac disease, treatment involves staying on a gluten-free diet.
“Following a strict gluten-free diet can eliminate all of the gastrointestinal symptoms of celiac disease and allow the lining of the intestines to regenerate, leading to better absorption of the nutrients in food and improved overall health,” Kennedy says.
The same gluten-free diet may also help ease some of the symptoms of Crohn’s disease.
“In my practice I see a lot of people with Crohn’s disease who have worse symptoms when they are eating gluten,” Kennedy says. “I suggest people with Crohn’s try a gluten-free diet, and if it improves some of their symptoms, continue it.”
According to a study published in July 2014 in the journal Inflammatory Bowel Disease, almost 20 percent of inflammatory bowel disease patients have tried a gluten-free diet, and 65 percent of those found a subjective benefit for their GI symptoms.
For both Crohn’s and celiac disease, the guidelines for a gluten-free diet are the same. While you eliminate wheat, barley, and rye from your diet, you can eat these grains and flours:
- Oats (in moderation)
You should also avoid processed lunch meats, as well as the following foods, unless they're labeled “gluten-free” or made with corn, rice, or soy:
- Cereal products
Gluten may also be lurking in some surprising foods, including beer and other alcoholic beverages made from wheat, barley, or rye. For a complete list of foods to eat or avoid, check out the guidelines on the Celiac Disease Foundation website.
Though Crohn’s and celiac disease may be related, having one condition doesn’t mean you’ll develop the other. But no matter which condition you have, a gluten-free diet may make your life a whole lot easier.
Video: Inflammatory Bowel Diseases: Crohn’s Disease | UCLA Digestive Diseases
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