FacebookSimilarities in symptoms
Coeliac disease is an autoimmune disorder in which ingestion of gluten leads to damage in the small intestine. IBS is digestive disorder that causes pain and discomfort. IBS symptoms may come and go, but in coeliac disease there is damage to the lining of the gut every time the person eats gluten. The two conditions are very different, but they have similar symptoms that flare up after eating certain types of food.
The symptoms of coeliac disease vary, but may include stomach cramping, bloating, diarrhoea, constipation, nausea, or chronic fatigue, as well as unexplained neurological symptoms. Common IBS symptoms also include stomach cramping, bloating, diarrhoea, and constipation. Flare-ups last a few days or weeks depends on the person and may be different from one episode to the next.
Differences between IBS and coeliac disease
Coeliac disease is an autoimmune disorder triggered by gluten ingestion, which is a protein present in wheat, barley and rye. In people with celiac disease, gluten causes the immune system to attack the cells lining the wall of the small intestine. This damage prevents the body from properly digesting and absorbing nutrients from food, which in addition to gut symptoms, can lead to a whole host of other health complications, including anaemia, osteoporosis, and poor growth in children.
IBS is a functional bowel disorder, meaning it is a problem with how your gut works. IBS problems occur in the middle and lower intestinal tract and typically include uncomfortable gas, bloating, and abdominal pain.
The underlying causes
Scientists are not sure what causes coeliac disease or IBS. There may be a hereditary component to both conditions which interacts with environmental factors to trigger disease onset.
Around 99% of people with coeliac disease have specific variants in their HLA genes - which help the immune system distinguish between proteins that belong in our body and those made by foreign invaders. But just having one of these variants does not mean a person will develop coeliac disease. In fact, around 30% of the population have at-risk genes, but a small proportion of them will develop coeliac disease.
IBS also seems to run in families, but in some cases, this is not the case. Some research suggests that the strength of the muscles in the digestive tract may affect the speed at which food passes through the system – either too slowly or too quickly. Abnormalities in the nerves in the digestive system can trigger symptoms, as can inflammation, infection, and changes to the microflora in the gut. Symptoms of IBS may also be triggered by certain foods, stress, and hormonal fluctuations.
What about non-coeliac gluten intolerance or sensitivity?
Gluten intolerance, or non-coeliac gluten sensitivity, is when individuals cannot tolerate gluten and experience symptoms similar to those who have coeliac disease. However, these people do not carry the gene for coeliac disease and are not at risk of associated long-term health complications. Again, the key is diagnosis. If gluten seems to be triggering symptoms, it is important to have a test for coeliac disease and keep gluten in your diet to make sure the test result is accurate. If this is negative, it may be that you have non-coeliac gluten sensitivity, which is also treated with a gluten-free diet.
How are coeliac disease and IBS treated?
Coeliac disease has a specific and effective treatment; a strict gluten free diet. If gluten is avoided, the damaging autoimmune reaction does not occur and symptoms subside.
IBS treatment is more complex and individualised. There is no cure for IBS, but there are diet and lifestyle changes that may reduce symptoms. A doctor may also prescribe medications to help alleviate certain symptoms, such as diarrhoea or constipation.
The vast majority of people with IBS say that certain foods trigger their symptoms. Common ‘trigger’ foods include dairy products, garlic, onions, alcohol, and some fruits, like apples. FODMAPs are short-chain carbohydrates that are poorly absorbed in the small intestine and have been linked to gut symptoms. If you have IBS, speak to a doctor and/or dietitian about identifying which foods may be triggering or worsening your symptoms.
Getting the right diagnosis
For coeliac disease diagnosis, a simple blood test can indicate the presence of the antibodies associated with the condition. Usually, a biopsy taken from the small intestine will be analysed as well to confirm the diagnosis. First-degree relatives of individuals with celiac disease should be screened for the condition as they have 1 in 10 chance of developing the condition.
There is no specific test for IBS, so diagnosis is based on symptom-related criteria. It is important to keep track of your symptoms and work with your doctor to address each one of them appropriately.
It is important to speak with a doctor if you have any of the symptoms associated with IBS or coeliac. Family history may be relevant and keeping track of food intake and can also be helpful. Both conditions can be difficult to manage, but both have treatments that can help you live life to the fullest.
