Is it Crohn’s or Celiac Disease?

Crohn’s and celiac disease are often confused with one another. With a common symptoms list that includes abdominal cramps/pain and diarrhea, it is easy to assume you have one or the other before visiting a doctor. That’s not where the similarities end either, and in both, 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 in Crohn’s is,”says Karlee Ausk, MD, a gastroenterologist with Swedish Gastroenterology, part of Swedish Medical Center in Seattle.

Research shows that people with celiac disease seem to be at an increased risk for inflammatory bowel disorders like Crohn’s disease when compared to people who do not have celiac. One study shows the risk of developing inflammatory bowel disease is up to 10 times higher in a person with celiac disease compared to someone without celiac,says Dr. Ausk.

Both diseases share a genetic cause. 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, according to Ausk.

So with both diseases so similar, how are you supposed to know which disease you have? Obviously the first course of action is to see a doctor. Starting with a blood test, they may be able to tell you if you have Crohn’s, celiac disease, or just general gastrointestinal issues. If more diagnostic tests are needed the next step is often endoscopy, biopsy or radiology. Much of diagnosing celiac disease also has to do with switching to a gluten-free diet and seeing how it affects your body. If the removal of gluten is able to keep you healthy with little-to-no gastrointestinal issues, then your diagnosis stops at celiac disease. If you have Crohn’s, treatment will include medication, and in severe cases, surgery.

However, the removal of gluten from the diet may be good for both cases. “In people with celiac disease, the small intestine has been damaged by gluten, and for almost all people, when you remove gluten from their diets, the small intestine heals back to normal,”Ausk says.

The same gluten-free diet may also help ease some of the symptoms of Crohn’s disease. “In the absence of celiac disease genes, gluten products can lead to symptoms resembling gluten sensitivity,”say Razvan Arsenescu, MD, PhD, medical director of the Inflammatory Bowel Disease Center at Ohio State University’s Wexner Medical Center. Therefore, removing gluten helps improve those symptoms.

Ausk agrees. “In my practice I see a lot of people with Crohn’s disease who have worse symptoms when they are eating gluten,”she says. “I suggest people with Crohn’s try a gluten-free diet, and if it improves some of their symptoms, continue it.”

Though the diseases are similar and may be related, having one disease does not mean that you will develop the other. Both are common conditions and there is an overlap between the genetic risk factors that indicates a slight link between the two. But no matter which you have, a gluten-free diet can help your body and make life a lot easier.

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