Coeliac Disease and IBD: What’s the connection?

As I type this, Coeliac Awareness Week is in full swing here in the UK; whilst American folks get the whole of May dedicated to raising awareness of the illness. But what’s that got to do with IBD? Of course, both diseases are digestive in their nature, but actually, the connection runs much deeper. Let’s take a moment to discuss coeliac disease and why it might be more closely related to IBD than you’d think.

What is coeliac disease?

Like Crohn’s Disease, Coeliac Disease is an autoimmune disease (and not an allergy). However, with coeliac disease; the trigger is known: the small intestines overreact to gluten particles; causing the villi (which we absorb nutrients through) to flatten, and a whole host of symptoms such as malnutrition, diarrhoea, stomach pain and anaemia. Coeliac disease has a ‘cure’: patients who eliminate gluten from their diet usually return to normal and their small intestine repairs itself.

What’s that got to do with IBD?

Unfortunately, those of us with IBD are automatically more likely to be at risk of a second autoimmune disease (fun!) and since coeliac disease is one of the commoner ones, it makes sense there would be an increased chance. A 2015 study managed to put a statistical finding to the connection, by estimating that the ‘prevalence of IBD in coeliac patients is reported up to ten times higher than the general population;’ concluding that it was reasonable for those with IBD to be tested for the disease if certain symptoms remained prevalent-e.g. iron deficiency anaemia. Another study noted that as well being both autoimmune disease, IBD and Coeliac Disease shared a ‘partially common genetic background.’

What does this mean for IBD Patients?

The most important thing is that IBD patients are made aware of the symptoms of coeliac disease. Unfortunately, these are very similar to IBD but it might explain the ongoing nature of symptoms when patients are in clinical remission; especially when patients aren’t responding to treatments for Iron Deficiency Anaemia. (source)

Most people think coeliac disease would show up on a colonoscopy, but it doesn’t! The damages happens higher up and is therefore found via an endoscopy (which is not a very common procedure for those of us with IBD) or a specific blood test. So if you haven’t had it ruled out, definitely chat to your doctor!

Should patients with IBD stop eating gluten?

The answer to this is a resounding no! If you suspect you might have coeliac disease, it’s incredibly important to keep eating gluten so it stays in your system for testing. If you’ve already had coeliac disease ruled out, keeping a food diary might be beneficial when considering if gluten could be an issue for you. It’s important you don’t make any drastic diet changes without consulting a doctor or dietician

Some people with IBD do find removing gluten from their diet helpful (a patient study found the majority of those with IBD had some form of improvement in gastrointestinal symptoms) and may suffer from Non Coeliac Gluten Senstivity if Coeliac Disease is ruled out. However, given that may patients have complex nutritional needs, it’s always best to make diet changes with the support of a qualified professional.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The InflammatoryBowelDisease.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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