Crohn’s disease and celiac disease are chronic inflammatory conditions that affect the digestive tract. While they have similar symptoms, their underlying causes, triggers, and treatments vary.
The following article reviews the similarities and differences between the two conditions.
Crohn’s disease and celiac disease are separate conditions that both affect the gastrointestinal (GI) tract. They can cause similar symptoms, making it difficult to tell them apart without diagnostic testing.
In some cases, a person can develop both Crohn’s and celiac. Experts generally believe that celiac disease is more common in people with Crohn’s disease compared with the general population.
What is celiac disease?
Celiac disease is a chronic autoimmune disease. Eating foods containing gluten — a protein in wheat, barley, and rye — causes the immune system to attack and damage the small intestine.
The attacks can cause a person to develop symptoms like cramping and diarrhea. Damage to the small intestine can also disrupt a person’s ability to absorb nutrients.
What is Crohn’s disease?
Crohn’s disease is a chronic inflammatory condition that can affect any part of a person’s digestive or GI tract. Along with ulcerative colitis, it is a type of inflammatory bowel disease (IBD).
Unlike with celiac disease, eating gluten does not cause inflammation in people with Crohn’s. However, depending on the individual, certain foods can worsen symptoms.
An estimated 1 million people in the United States live with the condition.
Both conditions affect a person’s intestines.
They can also cause similar symptoms, including:
- abdominal pain
- nausea or vomiting
- joint or muscle pain
Due to their similarities, a doctor will often order blood tests, an endoscopy, or a biopsy to make a formal diagnosis.
While Crohn’s and celiac can affect the same area of the GI tract, they have some distinct differences.
One of the main differences is the underlying causes.
Experts do not know the exact cause of Crohn’s disease, though they suspect it has to do with an autoimmune response and inherited genes.
One likely cause of celiac is inherited genes. However, it is the presence of gluten that activates the immune response.
A person’s symptoms may also vary from one condition to the other.
Crohn’s can cause various symptoms based on what part of the digestive tract the condition affects.
Some of the common symptoms that may not appear with celiac disease
- eye redness or pain
- loss of appetite
- skin changes, especially red, tender bumps under the skin
Celiac can cause a wide range of digestive and systemic symptoms.
Some common digestive symptoms that may not appear in Crohn’s disease
- chronic diarrhea
- lactose intolerance from damage to the small intestine
- greasy, bulky, loose, or foul-smelling stools
In addition, a person may experience other complications. These may include:
- depression, anxiety, or other mental health conditions
- dermatitis herpetiformis, which is a blistering, itchy rash that often appears on the knees, elbows, buttocks, or scalp
- nervous system symptoms, including balance problems or headaches
- canker sores, dry mouth, or other symptoms in the mouth
- other reproductive issues in females, such as irregular periods
How to tell if a person has Crohn’s or celiac
The difference in symptoms is often not significant enough to tell the difference between the two diseases.
To confirm a diagnosis of either, a doctor will likely order blood tests, a biopsy, endoscopy, and other tests.
A doctor can diagnose either Crohn’s disease or celiac.
They will likely review personal and family medical history, complete a physical examination, and order tests.
To diagnose Crohn’s disease, a doctor
- Lab tests: Lab tests to check for Crohn’s disease will likely include blood tests to check for inflammation and anemia and stool tests to rule out other possible causes.
- Endoscopies: A doctor may perform an enteroscopy by inserting a tube into the throat or a colonoscopy by inserting a tube into the rectum. For both procedures, the doctor uses a camera to check for signs of Crohn’s disease and rule out other conditions. Endoscopies are the most accurate way of diagnosing the condition.
- Imaging tests: A doctor may order what is known as a GI series, which uses a combination of X-ray imaging, fluoroscopy, and a chalky liquid dye called barium. The test shows the radiologist how the fluid moves through the person’s digestive tract. Another imaging test is the CT scan, which also uses a dye to form an image of the digestive tract.
Learn more about diagnosing Crohn’s disease.
To diagnose celiac, a doctor will likely order tests to check for the condition. The tests
- blood tests to look for antibodies consistent with celiac
- biopsy of the intestine or skin
- genetic testing to look for gene variants known as DQ2 and DQ8
Gluten needs to be present in the system for tests to detect celiac. For this reason, a person should not start a gluten-free diet prior to testing.
There are several potential treatment options for Crohn’s disease and complications associated with the condition.
No single treatment
The goal of treatment is to:
- reduce or eliminate symptoms
- retain disease remission
- decrease inflammation in the intestines
There are several medications a doctor may choose from to help manage Crohn’s disease. They include:
- Immunomodulators: Immunomodulators help reduce immune system activity, which helps reduce inflammation in the intestine. They can lead to side effects such as an increased risk of infection.
- Corticosteroids: Corticosteroids help reduce the activity of the immune system and reduce inflammation.
- Aminosalicylates: These medications help reduce inflammation in people with mild Crohn’s colitis.
- Biologics: Biologics are a type of medication made using living cells. They target the immune system to help prevent inflammation.
- Other medications: A doctor may recommend or prescribe additional medications to treat other symptoms or coexisting conditions. These medications may include acetaminophen, antibiotics, or loperamide.
- increasing fluid intake and avoiding carbonated drinks
- eating smaller meals more frequently
- avoiding popcorn, nuts, vegetable skins, and other high fiber foods
In addition, a person may find that keeping a food diary helps them avoid problematic foods. A problematic food is anything that can cause symptoms to flare.
A doctor may also recommend certain diets to help relieve symptoms. Some potential diets a doctor may recommend include:
- low fat, fiber, or salt diet
- high calorie diet
- lactose-free diet
Learn more about foods to eat for Crohn’s.
Bowel rest involves giving the bowels a break by stopping food intake for a few days to several weeks.
A person may need to use intravenous (IV) fluids or a nutrient-rich solution injected directly into the stomach.
Surgery cannot cure Crohn’s disease, but as with other treatments, it may help relieve symptoms or treat complications.
A doctor may recommend surgical options for the treatment of:
- life threatening bleeding
- medication side effects
- intestinal obstructions
- general symptoms
The primary treatment for celiac is following a gluten-free diet.
While a gluten-free diet can stop most symptoms from occurring, some may take more time to go away or improve.
The skin rash — dermatitis herpetiformis — can take anywhere from
A person may also develop malnutrition due to not absorbing enough nutrients. A doctor may prescribe or recommend supplements to help a person get the nutrients they need.
A gluten-free diet involves removing foods that contain gluten. Gluten is a protein present in wheat, barley, and rye.
While cutting out bread, pasta, and other baked goods may be obvious to many, several products, including medications and cosmetics, may include gluten.
A person should avoid all products containing wheat, rye, or barley to help prevent symptoms from returning.
A person may also need to avoid cross-contamination with products containing gluten.
Here are answers to some frequently asked questions about Crohn’s disease and celiac.
Can a gluten-free diet help Crohn’s?
While dietary changes can help with Crohn’s symptoms, a gluten-free diet is not likely to make a difference in symptoms.
However, if a person has both conditions, a doctor will recommend a gluten-free diet to treat celiac.
Does celiac show up on a colonoscopy?
An upper gastrointestinal endoscopy allows a doctor to examine the small intestine and take a biopsy. The examination can reveal damage to the small intestines.
Unlike a colonoscopy, this procedure involves inserting a tube down the throat instead of the rectum.
A biopsy allows a doctor to confirm a diagnosis of Celiac disease.
Crohn’s disease and celiac disease are two chronic inflammatory conditions. They can cause similar symptoms, which can make telling them apart difficult.
While similar in symptoms, they have different causes, triggers, diagnostic criteria, and treatments.
A person should speak with a doctor if they experience symptoms of Crohn’s or celiac.