Celiac vs. IBS: What You Need to Know About Each

Celiac vs. IBS: What You Need to Know About Each

Both celiac disease and irritable bowel syndrome (IBS) can cause many of the same symptoms, leading to uncertainty of which you may have.

Digestive issues are extremely common and extremely frustrating. As common as digestive issues like bloating, gas and abdominal cramping are, many people who suffer from them face the additional challenge of trying to determine their cause.

Celiac disease, irritable bowel syndrome, and several other digestive disorders have a similar set of symptoms, which makes diagnosis tricky. Celiac disease affects roughly 1% of the population, while irritable bowel syndrome (IBS) is thought to affect up to 15% of the population. What’s more, anywhere from 5% to 15% of celiac disease sufferers were originally diagnosed with IBS. These statistics highlight the fact that not only are both celiac disease and IBS very common, but it is important to know the similarities and differences between the two if you hope to achieve an accurate diagnosis and an effective treatment plan.

In this article, we’ll explore these two conditions in greater depth to help you gain a better understanding of your own symptoms so you can have a constructive conversation with your doctor to diagnose your condition.

Similarities and Differences in Symptoms

Occasional digestive upset is completely normal and can be triggered by anything from spicy food to stress. When symptoms such as diarrhea, constipation, gas, and/or bloating become a near-everyday occurrences, however, it is typically a sign that something more is going on.

Celiac disease is an autoimmune disorder that damages the small intestine. It is a reaction to gluten, one of the primary proteins in wheat, barley, and rye, that causes the immune system to mistakenly attack the cells lining the wall of the small intestine. This damage prevents the body from properly digesting and utilizing nutrients which, in addition to certain digestive symptoms, can lead to a whole host of other symptoms such as chronic fatigue, joint pain, and headaches.

Irritable bowel syndrome is a digestive disorder that affects the large intestine or colon. It typically causes stomach pain and bloating, but may also cause constipation or diarrhea in some patients. Much like celiac disease, symptoms may flare up after eating, especially after eating certain foods. The primary difference between celiac disease and IBS, when it comes to symptoms, is that IBS is characterized by an irritation of the digestive tract while celiac disease is a full-on immune reaction.

What is the Underlying Cause?

Doctors and researchers are not completely sure what causes either celiac disease or irritable bowel syndrome. Celiac disease is an autoimmune disease that causes the immune system to launch an attack against gluten molecules and, in doing so, mistakenly attacks healthy tissue in the small intestine as well. As is true for most autoimmune conditions, doctors are not sure what triggers this reaction, though there is a genetic component to the disease itself.

Irritable bowel syndrome is similar to celiac disease in that there is no known cause, but there are several factors that seem to play a role. Some research suggests that the strength of the muscles in the digestive tract may affect the speed at which food passes through the system – slow food passage can cause gas, bloating, and diarrhea. Abnormalities in the nerves in the digestive system can trigger symptoms, as can inflammation, infection, and changes to the microflora in the digestive tract. Symptoms of IBS can also be triggered by certain foods, stress, and hormonal fluctuations.

Because both IBS and celiac disease have such a diverse array of symptoms, it can sometimes be tricky to make an accurate diagnosis. IBS is typically diagnosed by exclusion. There is no specific test for IBS, so the only option is to rule out other conditions first then take a closer look at your symptoms to see if they meet the diagnostic criteria for the IBS.  The only way to properly diagnose celiac disease, is doing an intestinal biopsy to examine the tissues in the small intestine. However, a blood test can be done to be a strong indicator.  

How Are Celiac Disease and IBS Treated?

If your doctor suspects that your digestive issues might be related to celiac disease, there are two blood tests that can help support that diagnosis. Genetic testing for human leukocyte antigens can rule out a diagnosis of celiac disease while blood tests looking for elevated levels of certain antibody proteins can support the diagnosis. If you test positive for either of these, your doctor may order an endoscopy to check the lining of the small intestine for damage that could indicate celiac disease.

Irritable bowel syndrome is typically diagnosed by first ruling out other conditions. After doing so, your doctor may take a closer look at your symptoms to see if they line up with the diagnostic criteria for IBS. The severity and frequency of certain symptoms like abdominal pain or changes in stool can be used to support a diagnosis. By taking a closer look at your symptoms, your doctor will also be able to identify which of three types of IBS you have – constipation-predominant, diarrhea-predominant, or mixed.

Because both celiac disease and IBS are digestive disorders, some of the most effective treatments are diet-related. For IBS, it is best to avoid foods that trigger your symptoms and to increase the fiber and fluid content of your diet. You may also want to remove gluten, FODMAPs, and certain raw foods from your diet as well. For celiac disease, the only treatment is a gluten free diet. In either case, additional treatments like fiber supplements, antidiarrheals, and OTC pain medications may help.

If you’ve been diagnosed with either celiac disease or IBS, making changes to your diet should help resolve symptoms. If you find that your symptoms do not improve after a few weeks, talk to your doctor about the possibility of a secondary condition. People with celiac disease are four times more likely to also have IBS than the general population, so talk with your doctor to find out if it could be a possibility for you.

Where Do You Go from Here?

Digestive symptoms like bloating, abdominal pain, and diarrhea are inconvenient at best and difficult to live with at worst. If you find that you experience these and other digestive issues more frequently than you think is normal, don’t hesitate to talk to your doctor. You are the strongest advocate for your own health and wellbeing, so be proactive about seeking medical help and take what you’ve learned here to develop and present your doctor with a fully formed picture of your symptoms from which to make an accurate diagnosis and to recommend a course of treatment.

Celiac disease and irritable bowel syndrome produce some pretty unpleasant symptoms, but they are both treatable diseases. The best thing you can do is pay attention to your symptoms so you can give your doctor all the information needed to make an accurate diagnosis. From there, simply follow the prescribed treatment plan, and you should be on your way to recovery.