Crohn’s vs. Celiac: What’s the Difference?

Crohn's disease and celiac disease are both autoimmune diseases that involve inflammation in the gastrointestinal (GI) tract. Both conditions can cause a wide range of symptoms, including abdominal pain, cramps, bloody stool, diarrhea, and/or weight loss.

Though Crohn's and celiac disease produce similar GI symptoms, their causes and how they're treated are significantly different. Celiac disease is specifically triggered by the wheat protein gluten. When it comes to Crohn's, doctors still don't clearly understand what causes the immune system to attack the GI tract.

This article will review the similarities and differences between these two conditions as well as the diagnostic process and treatment options for Crohn's and celiac disease.

What Is Crohn’s Disease?

Crohn's disease is a form of inflammatory bowel disease (IBD) characterized by inflammation in the gastrointestinal tract. It is considered an autoimmune condition.

In people without Crohn's, harmless bacteria live in the GI tract and don't trigger a response from the immune system. In those with Crohn's, the immune system thinks these bacteria are a threat and launches an immune response. The resulting attack causes inflammation and damage to the intestinal wall. It can also cause ulceration (open sores) and thickening of the intestinal wall.

Men and women are equally likely to have the disease. The condition can run in families, and those with a first-degree relative with Crohn's have an increased chance of also developing the disease.

Symptoms of Crohn's

Crohn's disease can impact any part of the gastrointestinal tract from the mouth to the anus. Each person with Crohn's may experience different symptoms.

Crohn's is a chronic condition. The majority of people with the disease will experience periods of remission when symptoms aren't as noticeable. They'll also experience periods called flares when their symptoms are active.

Common symptoms include:

• Bleeding from the rectum
• Persistent diarrhea
• Increased urgency with bowel movements
• Pain in the abdomen
• Cramps in the abdomen
• Constipation
• Feeling that a bowel movement is incomplete

Those with Crohn's disease may also experience complications due to their condition. These include:

• Fatigue
• Poor appetite
• Weight loss
• In children, delayed growth or development

What Is Celiac Disease?

Celiac disease is an autoimmune disorder in which the immune system overreacts to the protein gluten. When a person with celiac disease consumes food that contains gluten (found in wheat, rye, and barley), the immune system attacks the lining of the small intestine.

Celiac disease can run in families. Those with a first-degree relative with celiac disease have a one in 10 chance of also developing celiac disease.

The condition can occur at any age. If left untreated, celiac disease can lead to other autoimmune disorders such as type I diabetes and multiple sclerosis or serious health complications such as dermatitis herpetiformis (a skin rash), anemia, osteoporosis, infertility, migraines, and even cancer.

Symptoms of Celiac Disease

People with celiac disease may experience different symptoms. There are more than 200 possible symptoms of celiac disease.

The symptoms of celiac disease vary between adults and children.

Symptoms in children may include:

• Chronic diarrhea
• Abdominal pain
• Bloating
• Weight loss
• Irritability
• Behavioral issues
• Short stature
• Vomiting
• Constipation
• Fatigue
• Attention deficit hyperactivity disorder (ADHD)
• Defects to dental enamel
• Pale stool
• Foul-smelling stool
• Anemia

Symptoms in adults may include:

• Joint pain
• Bone pain
• Fatigue
• Unexplained anemia
• Depression
• Anxiety
• Liver disorders
• Osteoporosis or osteopenia
• Migraine
• Canker sores inside the mouth
• Skin rashes
• Numbness, tingling, or pain in the feet and hands
  

Crohn’s vs. Celiac

While Crohn's disease and celiac disease are different conditions, there is a connection between them that goes beyond overlapping symptoms.

Research shows that people with celiac disease are significantly more likely than the general population to also have Crohn's disease. To a lesser extent, those with Crohn's are also more likely to have or develop celiac.

Similarities

Both Crohn's disease and celiac disease involve inflammation in the gastrointestinal tract that's caused by an attack from the immune system. This results in the two conditions causing similar symptoms:

• Diarrhea
• Anemia
• Abdominal pain
• Malnutrition
  

Differences

While celiac disease and Crohn's disease have many similarities, the conditions also have key differences. In particular, the conditions have two distinctly different triggers, which means they need to be treated differently.

There's no single treatment for Crohn's disease. Treatment options may include:

• Medications
• Surgery
• Management of diet and nutrition

For those with celiac disease, the only treatment option available is a lifelong adherence to a gluten-free diet.

Typically, celiac disease symptoms disappear entirely within a few months if you completely avoid gluten.

For those with Crohn's disease, symptoms may flare up at different times, even with treatment.

Diagnosis

Both Crohn's and celiac disease have symptoms that may be similar to other conditions. If either condition is suspected, your healthcare provider will order some tests to rule out other conditions and reach a correct diagnosis.

Diagnosing Crohn's

There's no single test that can be used to diagnose Crohn's disease. A healthcare provider will take a medical history and use the results of medical tests to make a diagnosis.

Possible tests include:

• Physical exam
• Blood tests
• Stool tests
• X-rays
• Endoscopy, a procedure in which a long, thin tube equipped with a camera is inserted down the throat
• Colonoscopy, an examination of the colon in which a long, thin tube with a camera is inserted into the anus

Diagnosing Celiac Disease

To test for celiac disease, your healthcare provider may order a blood test. People who have celiac disease and also eat gluten have high levels of specific antibodies in their blood. The immune system produces these antibodies in response to gluten, which it views as a threat.

For a celiac disease blood test to be accurate, the person being tested must be on a diet that contains gluten. The antibodies test will be positive in roughly 98% of people with celiac disease who are eating a diet containing gluten.

If the results of the blood test come back positive, your healthcare provider may also suggest a biopsy of your intestine to confirm the diagnosis and assess the damage in your small intestines.

An endoscopic tube and camera enter the digestive tract, allowing your healthcare provider to see inside the small intestine and take a tissue sample to be studied under a microscope.

Summary

Crohn's and celiac disease are two different autoimmune conditions that attack the gastrointestinal tract. While both conditions present with similar symptoms, including digestive issues, fatigue, and growth problems, they have distinctly different causes and treatments.

Doctors don't understand exactly what causes the immune system to overreact in Crohn's, and it may take a multifaceted approach to treat and manage the condition. In celiac disease, the immune system attack is only triggered by gluten, so adopting a gluten-free diet is considered the best course of treatment.

A Word From Verywell

Crohn's disease and celiac disease are both autoimmune diseases that affect the digestive system. These conditions can lead to serious health complications if left untreated, so it's important to get an accurate diagnosis and start treating the conditions as soon as possible. If you're concerned that you or a loved one may have celiac disease or Crohn's disease, make an appointment to speak with your healthcare provider. There are ways to manage both diseases before they cause severe problems.