Celiac Disease, Irritable Bowel Syndrome, Crohn's Disease- What's The Difference?
If you think you have a form of IBS, before the professionals jump to Crohn's Disease or "pass you off" with IBS, ask them to consider Celiac Disease - which is very treatable without "invasive" surgeries.
Here is a bit of background on Celiac Disease. Celiac sprue disease was first noticed in the second century, but it wasn't until research confirmed that children with celiac disease was the same disease as adult non-tropical sprue. When it was translated from Greek to English in 1856, patients became known as "celiacs." The term "celiac disease" is now most commonly used. "Gluten sensitive enteropathy" is another term for the same condition.
In 1888, Dr. Samuel Gee of UK gave accounts of both children and adults with Celiac Disease. Dr.Gee stated that regulating the food intake was essential to treatment. Eating foods made of farina (ex: cream of wheat) should be minimal. If one expected to be cured, diet changes were a must. Dr. Gee was the first to link diet to celiac treatment.
In 1950, a Dutch pediatrician wrote in his doctoral thesis that the disease is caused by the ingestion of wheat proteins. By 1954, a number of his colleagues working in England confirmed the treatment
Celiac Disease - Signs and Symptoms
Each person with Celiac Disease can experience some of the same symptoms or a totally different set of symptoms. Some people have no symptoms (asymptomatic) because their intestines are still able to absorb nutrients, but they may experience bouts of diarrhea. Some of the most common symptoms are:
- Bloating (expelling gas, rolling gas in belly)
- Diarrhea, with alternating Constipation
- Mouth sores (canker sores)
- Protruding belly - intermittent
- Fatigue (Exhaustion, no energy)
- Joint Pain (pre-osteoporosis, thin bones)
- Weight Loss (malabsorption, malnutrition)
- Depression (from mood swings to deep dark depression)
- Menstruation and/or Fertility problems (disrupted or irregular menstrual cycles, infertility or miscarriages)
Diagnosis and Treatment
Because Celiac Disease looks like Irritable Bowel Syndrome, Crohn's Disease, and a host of other mimics, the first order of business is to get certain blood tests performed.
- Total IgA,
If your Total IgA test comes back low, then another test called IgG/IgA-DGP can be requested.
It is extremely important that you continue eating your normal diet - gluten and all, so that your blood tests can detect if there is gluten sensitivity. If so, then a biopsy of lining of small intestine will confirm a diagnosis.
If you are given a diagnosis of Leaky Gut Syndrome, ask your physician to define it better, so you know for sure. Having more intensive laboratory blood studies in addition to the above three blood tests will tell if you have any other markers in your blood.
TREATMENT: The only true treatment, in addition to prescription and over the counter medication and supplements, is a diet that is gluten-free. It is a diet you will have to follow for the rest of your life if you want to remain well.
Keeping a food diary will be very helpful to identify which foods bother you. That means NO wheat, rye or barley. Some people cannot tolerate oats, some can. You'll be surprised all that you can still eat while remaining gluten free.
Which symptom is the hardest for you to deal with?
Irritable Bowel Syndrome (IBS) --Signs, Symptoms & Treatment
Irritable Bowel Syndrome (IBS) is different in that it affects the large intestine but has many of the same symptoms as Celiac Disease and Crohn's Disease with regards to bloating, cramping, both diarrhea and constipation, weight loss, anemia, mucousy or bloody stools, abdominal pain, and gas.
Only your doctor can make this diagnosis. Ask to be tested for lactose intolerance and gluten intolerance in addition to the blood tests listed above under Celiac Disease.
IBS rarely becomes colon cancer. It is treated with revised diet to avoid foods that have been identified as a problem for you. It is best to limit your caffeine, develop an exercise program, take anti-diarrhea medication "as needed", and sparingly use fiber supplements. Many people choose over-the-counter products like Imodium, Maalox and/or Kaopectate for relief of diarrhea. Gas-X and Phazyme are good products to take after each meal to prevent the rolling gas symptom.
Become a label-reader; if the product has magnesium in it, this more than likely will flare your diarrhea symptoms. After you get a diagnosis, your doctor may prescribe an antispasmodic drug (like Bentyl) to help with the abdominal pain. Sometimes doctors prescribe antidepressants for abdominal pain because the properties of those drugs block signals from the brain.
A process of elimination in regard to food triggers is probably the best way to start taking care of yourself.
- Soda (carbonated beverages),
- alcoholic drinks,
- caffeinated foods and
- anything with sorbitol
Sugarless gum and sugarless candies are big gas and diarrhea culprits in today's diet because so many of us are watching our sugar intake or are trying to stick to a diet so we don't eat a lot of sweets. If you have symptoms of IBS, eliminating any foods that say "sugarless" or "sugar free" on the packaging is a big step forward.
Keeping a food diary is essential in getting to the bottom of your food triggers. Many people say they don't understand why all of a sudden they have symptoms. They maintain that they were raised eating the same foods for years, and those same people are now finding themselves having IBS symptoms later in life.
Fried food and foods high in fiber often aggravate IBS symptoms so if these are part of your normal diet, you may have to make some big diet adjustments in order to start feeling better.
We all need fiber in our diets but people with IBS need to limit their fiber intake because they experience bouts of diarrhea and constipation.
Fiber causes gas and bloating; too much fiber at one sitting can make you very uncomfortable. Perhaps spreading your fiber intake out over the course of several days instead of eating a huge helping at one sitting might be more beneficial. Taking simethecone, Gas-X and Phazyme types of over the counter medications help control gas and bloating so you can still get your fiber intake.
Drinking water is also extremely helpful so that it helps move food through your digestive system much easier. Add a teaspoon of concentrated lemon juice or fresh lemon juice if you want to clean out your colon, otherwise lemonade and other citrus drinks will cause you endless hours on the toilet.
Stress is another trigger for IBS. Try to limit your exposure to certain people you find stressful, certain situations that you know are stressful or going to be stressful, and replace the activities with another.
For example, taking a walk, taking a nap, going to the gym, reading a book, or even having another person accompany you when you have to be around people known to be stressful to you or when you are entering into any stressful environment (example: the dentist office!). A second person can often divert conversation and ward off negative influences, steer conversation toward a more congenial topic and help reduce your stress.
If your symptoms continue more than three times a week for up to three months, you have met the first criteria for this diagnosis.
Many restaurants now have gluten free menus. Here are more tips for dining out
It is a good idea to keep a food diary for at least 3 weeks to a month so you can see what foods are an irritant and what foods are safe.
If you are keeping a food diary for eliminating certain foods from your diet, do not eliminate more than one food at a time or you won't be able to tell if that is indeed the culprit of your illness.
Eliminate on food per week. On the second week, don't add that food back into your diet, but choose another food to eliminate. On the third week, don't add either of those foods back into your diet, but eliminate another from your diet. By the third week, you should be able to tell from your symptoms, bouts of diarrhea and/or constipation and your general well being if those foods are problem foods for you.
Food diaries are also kept for other reasons. You can keep a food diary to add foods back into your diet. People who have gluten or lactose intolerance often use food diaries using the same method by adding one food per week. Keep track in your diary and see what, if any, symptoms develop from adding that one food.
Some people need to keep a food diary for as long as 3 months because of the types and preparation of foods they eat, the stress they are dealing with and the types of medications they take. All these things have a bearing on symptoms.
A food diary has been included here so you can print it out to use. Make at least 4 copies and that will do you for four weeks.
Food Triggers And Food Diary
Are you willing to try to keep a food diary to help identify your food triggers?
Symptoms can occur gradually or suddenly. Crohn's Disease can go into remission for long periods or short periods, depending on how well you are managing your disease.
Crohn's disease is considered an autoimmune disease and it is hereditary. It is not unusual for a patient to seek treatment and already have one or more autoimmune diseases in place, because having one autoimmune disease often means they will be contracting another autoimmune disease.
Signs and symptoms are similar to all of the above:
- abdominal cramps and pain,
- blood in stool,
- mouth ulcers,
- intestinal ulcers,
- weight loss, and
- reduced appetite.
Severe Crohn's may also include:
- eye inflammation,
- skin disorders,
- frequent mouth sores,
- arthritis and
- Blood tests,
- stool test for blood,
- either or all of these - CT, Endoscopy, Colonoscopy, Flex-sigmoidoscopy,
- barium enema and images for large intestine, and
- small bowel imaging that cannot be seen on colonoscopy.
TREATMENT: To reduce inflammation, an anti-inflammatory drug is essential. Drugs include Sulfasalazine, Mesalamine, Corticosteroids, drugs to suppress the immune system, anti-diarrhea medications, antibiotics (ex Flagyl, Cipro), pain relievers, laxatives, calcium, Vitamin D, B-12 injections.
Surgery is usually considered a last resort when diet, lifestyle changes, and drug therapy have not put you into remission. Your physician should be more vigilant for colon screenings more frequently than the recommended every 10 years. Colon screenings are not always colonoscopies.
If you have been diagnosed with Crohn's Disease, you might want to ask for "non-invasive" imaging studies instead of an "invasive" colonoscopy. The tablet and liquid preparation for a colonoscopy can send a Crohn's patient into a flare that may not let up for weeks afterward.
There are several non-invasive imaging studies that can be performed without using a harsh preparation that violently cleans out the colon. If you have been on a siege of diarrhea where you are reasonably cleaned out already, ask for an imaging study at that time.
If you are experiencing severe diarrhea and other symptoms where your physician feels you might have something more serious going on in your colon, chances are you are pretty cleaned out already. In that case, what is called a "dirty colonoscopy" or a "dirty sigmoidoscopy" can be performed without taking added preparation tablets and/or preparation fluids.
The bottom line is you want to avoid any type of colon invasion where you can end up with either an intestinal tear, more colon inflammation or a Crohn's flare up that can last quite a while and require hard core medication or even hospitalization to get it under control.
Leaky Gut Disease or Syndrome
Alternative (Complementary) Medicine
Some people do not care for the side effects that often comes with taking prescription medication. In that case, many turn to Alternative Medicine which includes herbal/nutritional supplements, PRObiotics, PREbiotics, fish oil and other vitamin supplementation, and acupuncture. Be sure to consult your physician before you make any changes in your health care or dietary plan.
PRObiotics are not the same as PREbiotics.
Probiotics are good bacteria that you would normally find in your gut, and are used to help with lactose intolerance and with side effects of antibiotics like cramping, gas, and/or diarrhea.
Prebiotics are carbohydrates that can't be digested and what the probiotics need to create healthy bacteria in the colon.
Think of prebiotics as food for the probiotics. You need both to help keep your digestive system healthy.
Examples of Probiotics are yogurt, sourdough bread, and foods that have been fermented.
Examples of Prebiotics are bananas, oatmeal, and legumes.
People with symptoms as described in this hub need to be vigilant to the types of foods they eat, so therefore probiotics and prebiotics should be under the direction of your nutritionist and/or physician.
I hope you have found some of this information helpful on your road to diagnosis and healthier living with colon disorders.
© John De Vettese
Updated November 2013