Digestive Distress: The Difference Between Celiac, Crohn’s, and IBS

Digestive discomfort is one of those universally unpleasant experiences that can range from a minor inconvenience to a daily battle. For many, understanding the root cause of these issues is a complex puzzle, especially when conditions like Celiac disease, Crohn's disease, and Irritable Bowel Syndrome (IBS) are in play. These gastrointestinal disorders not only share some symptomatic overlap but also require different approaches to treatment and management.

Let's explore how these gut health concerns are different from each other, and what you need to know if you suspect you're dealing with Crohn's, Celiac disease, or IBS.

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Three Culprits: Celiac, Crohn’s, & IBS

The trio of Celiac disease, Crohn's disease, and IBS are often mentioned in the same breath due to their association with gluten sensitivity, inflammation of the digestive tract, and comparable symptoms like chronic diarrhea, abdominal pain, and bloating. However, their specifics differ significantly and understanding these nuances is the first step in managing your health effectively.

Celiac Disease

Celiac disease is an autoimmune condition triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. When people with Celiac disease eat gluten, their immune system responds in a big way that ultimately leads to damage in the small intestine's lining. Over time, this can prevent the absorption of nutrients.

Common symptoms include digestive issues, fatigue, and weight loss, but Celiac disease can also lead to other systemic symptoms like skin rashes, anemia, and depression. Symptoms of Celiac disease aren't limited to just the digestive tract, but they are generally alleviated if patients stop eating gluten and adopt a gluten-free diet.

Related: Going Gluten-Free to Manage ADHD Symptoms

Crohn’s Disease

Crohn's disease is one of two types of inflammatory bowel disease (IBD), the other being ulcerative colitis. Crohn's can affect any part of the GI tract, from the mouth to the anus, but it most commonly affects the small intestine and the beginning of the large intestine.

Studies show that people who are genetically susceptible to Crohn's disease likely have an overactivity of the gut immune response against otherwise beneficial flora that reside in the gastrointestinal tract (1). Crohn's and Celiac disease are both considered autoimmune disorders.

Symptoms of Crohn's disease can include severe diarrhea, abdominal pain, weight loss, and ulcers, along with potential complications such as bowel obstructions and fistulas.

Irritable bowel syndrome (IBS)

IBS, on the other hand, is a functional gastrointestinal disorder where the gut's functionality and structure appear normal, despite the gastrointestinal symptoms experienced by the individual.

Symptoms of IBS can include chronic or intermittent diarrhea and/or constipation, along with abdominal pain and bloating. The exact cause of IBS is unknown, but it's thought to involve a combination of genetic, environmental, and psychosocial factors that influence the gut-brain axis (2).

Read: You Must Address Anxiety to Heal IBS, Studies Say

Comparing the Symptoms

Distinguishing between the three conditions can be complex, as they share similar symptoms.

Common Threads

All three disorders can present with gastrointestinal distress, such as abdominal pain, nausea, changes in bowel habits, and discomfort or pain related to bowel movements.

The Cornerstone of Celiac Disease

Unique to Celiac disease are symptoms such as dermatitis herpetiformis (a chronic itchy skin rash), anemia, osteoporosis, and issues affecting the nervous system. It is also characterized by a rise in immunoglobulin A (IgA) antibodies in the blood (3). 

Shop: At-Home Food Sensitivity Test

Crohn's Distinction

Studies looking at antibodies present in patients with Crohn's disease found that the most sensitive and specific test showed positive anti-Saccharomyces cerevisiae antibodies (4). The identification of these markers can help differentiate Crohn’s disease from other digestive problems like ulcerative colitis. 

Crohn's can lead to severe inflammation, deepening ulcers, and connective tissue infiltrating the bowel wall, potentially causing complications such as strictures, fistulas, abscesses, and malnutrition.

IBS Symptoms May Come & Go

IBS is characterized by chronic, relapsing symptoms which can include diarrhea, constipation, or alternating bouts of both, often accompanied by other functional symptoms such as bloating and discomfort. IBS is usually diagnosed once other potential conditions like Celiac or Crohn’s disease have been ruled out (5).

Related: 5 Signs SIBO is Behind Your IBS Symptoms

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Navigating Diagnosis

Receiving an accurate diagnosis of the specific GI condition at hand involves an integrative approach, including traditional and functional medicine, and a deep understanding of each illness. 

How do I know if I have a food intolerance?

Traditional Diagnostic Paths

Blood tests are common for diagnosing Celiac disease, as they can identify the presence of certain antibody types. Endoscopy and biopsy of the small intestine are often used to confirm and assess the extent of the damage.

For Crohn’s, tests might include blood and stool samples, endoscopic procedures, and imaging tests like CT scans.

IBS, on the other hand, is diagnosed based on a set of symptom criteria and by ruling out other disorders through similar diagnostic tests.

Functional and Integrative Medicine’s Role

The use of functional medicine can be instrumental in distinguishing between these conditions, as well as during treatment. This holistic approach dives into the patient’s complete health history, lifestyle, and environmental factors, as well as utilizing specialized tests that can identify imbalances and determine truly effective individualized treatment plans.

Lifestyle and Dietary Management

Beyond diagnosis, managing these conditions often hinges on tweaking one’s lifestyle and dietary habits, under the guidance of an experienced functional healthcare professional.

The Gluten-free Life with Celiac Disease

The only effective treatment for Celiac disease is a strict gluten-free diet. This means avoiding not just obvious sources of gluten, but also hidden sources like cross-contamination in food preparation.

Other foods, such as oats, also contain a similar protein to gluten and can cause issues for some individuals with Celiac disease (6).

Read: Should Your Child Be on a Grain-Free Diet? A Holistic Pediatrician Explains

Overcoming Crohn’s

Dietary changes may help alleviate symptoms in Crohn’s disease, such as reducing fiber intake during flare-ups and avoiding trigger foods like dairy, spicy foods, and caffeine. Those with Crohn’s often face malabsorption issues, so maintaining a nutrient-dense diet is crucial.

In some cases, medication, including anti-inflammatory drugs and immunosuppressants, may also be part of the treatment regimen, depending on the extent and severity of the disease.

Relief from IBS

Lifestyle changes can also help manage symptoms in patients with IBS. This includes stress management techniques, regular exercise, and a balanced diet that avoids trigger foods such as caffeine, alcohol, and artificial sweeteners.

IBS symptoms can come and go, depending on a person’s situation and circumstances, which necessitates a personalized approach to dietary and lifestyle management.

The Importance of Early Diagnosis and Management

Understanding the differences between Celiac, Crohn’s, and IBS is not just about categorization. Early diagnosis and management can significantly improve health outcomes and quality of life and minimize the risks of long-term, serious complications.

Fewer Complications

Collapsing the time to diagnosis and treatment reduces the impact of lasting damage on the body and improves overall wellness.

We Are What We Digest

The health of your digestive system underpins your overall well-being. For your body to function well in the long-term, a healthy gut is required to absorb essential vitamins, minerals, proteins, fatty acids, and more.

Next Steps in Your Digestive Health Journey

Your investigation into Celiac, Crohn’s, or IBS is just the beginning of a path toward understanding and managing these serious digestive disorders. Take the first steps to be informed, seek professional advice, and advocate for your own health.

Seeking Professional Guidance

Our integrative team of experienced, compassionate providers who are well-versed in the holistic treatment of digestive disorders will take a comprehensive view of your whole health and work with you to address all potential contributing factors to your symptoms.

What to Remember

Crohn’s disease, Celiac, and IBS are distinct conditions but that often share similar symptoms. Early diagnosis, understanding the root causes, and implementing an individualized treatment plan can significantly impact your overall health and well-being in the long-term.

Take charge of your digestive health journey today.  So remember, no matter what digestive disorder you may be facing, there is hope for improved symptoms and a healthier future.


digestive health, gut health, Holistic Medicine, ibs

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These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any diseases.
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