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Celiac Disease, Irritable Bowel Syndrome, Crohn's Disease- What's The Difference?

Updated on September 13, 2014
The sure way to manage most intestinal disorders, but especially Celiac's Disease, is to maintain a gluten free diet.
The sure way to manage most intestinal disorders, but especially Celiac's Disease, is to maintain a gluten free diet. | Source

Celiac Disease

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.

They are:

  • Total IgA,
  • IgA-tTg,
  • IgA-EMA.

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.

Symptoms

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Moderate to severe abdominal pain can be a symptom of Irritable Bowel Syndrome (IBS)
Moderate to severe abdominal pain can be a symptom of Irritable Bowel Syndrome (IBS) | Source

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.

IBS Irritants:

  • Soda (carbonated beverages),
  • alcoholic drinks,
  • chocolate,
  • 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.

Click here for examples of natural remedies for IBS.

Food Diary

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?

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Daily Food Log
Daily Food Log | Source

Crohn's Disease

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:

  • Diarrhea,
  • 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,
  • fatigue,
  • frequent mouth sores,
  • fever,
  • arthritis and
  • fatigue.

DIAGNOSIS:

  • 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

Leaky Gut Disease (or Syndrome)  is what happens when the balance of bacteria is disturbed
Leaky Gut Disease (or Syndrome) is what happens when the balance of bacteria is disturbed | Source

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

May 2013

Updated November 2013

Comments

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  • shrifulislam profile image

    Md.Sariful Islam 3 years ago from Bangladesh

    This is an amazing article! So much information I had never heard of. Thank you for writing this.

  • here-s johnny profile image
    Author

    John 3 years ago from Philadelphia, PA

    These are serious diseases that affect so many people in this world, but with the diets we have, it will only get worse. I hope if people who are sick read this hub they will start to change their diets so that they can eat more healthy and not have to be sick as much or as badly. shrifulislam - thank you for your comment.

    John

  • MySwanSong profile image

    MySwanSong 3 years ago

    Excellent article and you covered all the bases too. Voted Useful and Interesting. Well done!

  • here-s johnny profile image
    Author

    John 3 years ago from Philadelphia, PA

    MySwanSong - Thank you Marjorie for your compliments and for the follow.

  • profile image

    Rick Archer 3 years ago

    Has anyone ever gone on disability for IBS? I was told I had diverticulitis for twenty plus years. Now they are saying IBS. I still don't think they know. I've been checked for lactose and gluten intolerance--nothing.

    Every year this gets worse and more frequent. I am paying for this with lost work time. I have used up all savings and am moving toward bankruptcy. Trying not to lose my house with a family of four. I am educated with 3 college degrees.

    I work in a public school setting and cannot perform my duties in the line of work I am in right now. Any ideas or helpful suggestions?

    Thanks!

  • here-s johnny profile image
    Author

    John 3 years ago from Philadelphia, PA

    Hello Rich Archer, Sorry about not getting back to you before now. I was at my son's house for the Christmas holiday.

    About your workplace -- You can ask for "reasonable accommodations" in order to be able to perform your job duties. This could be tailor made hours so you can still teach. It can be the school providing you ancillary help in your classroom. It can be a suggestion from you as to what you think you need to get through your work day, within reason. It can be frequent breaks during class, or less classes per day.

    You are entitled to 12 weeks per year of FMLA (Family Medical Leave Act), whether it is due to a family illness or your own. Although this is unpaid time, they cannot fire you while you are out on leave. They also cannot cancel your medical benefits.

    If you were ever in the military, you are eligible for FREE medical care from the Veterans Administration medical services and you simply have to contact your local VA, provide your DD214 (discharge) as proof of service. Here is a link to download their benefits publication. Take a look around the site and see if there are other services you can take advantage of.

    http://www.va.gov/healthbenefits/resources/epublic...

    As for your original question of anyone going on disability for IBS, of course I have no way of knowing the numbers. But if you apply for Social Security Disability and have a doctor who is on board with helping you to get benefits by providing enough paperwork to support and document your diagnosis and who will also SAY you can never work again, that is half the battle.

    Social Security will send you to their doctors who will look over all the supplied paperwork, do a very cursory physical exam (rarely do they order more testing) and they will turn in their opinion to the SS Disability board.

    Be prepared - they almost always turn people down at least once and often more than 3 times. You have to be persistent in application. The good news is your timeline starts the day you apply for Disability.

    For example: if you apply on January 1, 2014, Social Security has two years to grant or deny benefits. IN WRITING, not on the phone. If they finally approve you, say 18 months from filing @ June 2015, you will be back paid from the day of application - in this example, 18 months total from June 2015 back to Jan 1, 2014.

    Besides the medical criteria, you have to have worked at least 40 quarters but it doesn't have to be consecutive time.

    My sister in law applied and was turned down 11 times over the course of 7 years. She never married and had no husband to qualify under Social Security; she had to get it on her own merit. She worked 4 years out of her last 10 and didn't have enough time in to account for 40 quarters. She had to go back to work part time to get enough quarters to qualify and by that time she was in bad shape medically. She just made the qualification timewise, and of course there had been no question she qualified medically with Multiple Sclerosis.

    I see you live in Kansas, and this link may help you understand what is involved with getting accommodations to stay employed as a teacher, but Kansas laws may have more or less resources to help you.

    http://askjan.org/media/educators.html

    - list of accommodations for Educators

    This link is per NY, but there are resources on this page that can help you connect with other agencies.

    http://www.uft.org/committees/capably-disabled/poi...

    Other ADA Resources

    http://www.eeoc.gov/facts/ada17.html

    - the employer’s responsibilities

    http://www.eeoc.gov/facts/ada18.html

    information for employees

    http://www.eeoc.gov/laws/types/disability.cfm

    - definition of disability

    http://www.ada.gov/ - ADA Website

    I hope some of this is helpful to you. Good luck in your efforts to get on SS Disability or to stay employed, if that is your wish.

    John

  • here-s johnny profile image
    Author

    John 3 years ago from Philadelphia, PA

    http://www.aaup.org/file/Accomodating-faculty-with...

    If you get no help from your employer assisting you in keeping your job, you can contact the EEOC in your city to make a formal complaint against them for discrimination of a person with a disability. You have 180 days from the time they turn down your request for accommodation. If possible, get it in writing or keep a tape of it if they leave a message on your phone. You may also want to involve the teacher's union to enlist their aid. It is possible another teacher with IBS/Crohn's/Colon issues needed accommodation in the past and they will be able to advise you in how to proceed. Here is the link for the EEOC:

    http://www.eeoc.gov/policy/guidance.html

  • Susan Trump profile image

    Susan Trump 2 years ago from San Diego, California

    Thanks for writing. Loads of information. I write about it too but it is not something people hear of as mainstream. Important just the same. Thanks.

  • here-s johnny profile image
    Author

    John 2 years ago from Philadelphia, PA

    People are searching for the information and we need more outlets for them to find it.

    Thank you Susan Trump for leaving a comment.

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