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Home , Irritable bowel syndrome

September 2017 | Members Spotlight on Health

Celiac Disease and IBS

Do you often feel bloated, have stomach pain, or get after you eat? Celiac disease and irritable bowel syndrome (IBS) are both common causes of these complaints. Although these conditions have similar symptoms, the causes and treatments are different. So, diagnosing the correct condition is important for getting the right treatment. This newsletter will discuss the similarities and differences between celiac disease and a type of IBS that causes similar symptoms. It will also discuss how your healthcare provider can help you figure out if you have one of these conditions, and how to relieve your symptoms. Celiac Disease vs IBS-D What is Celiac Disease? Celiac disease and IBS-D have similar symptoms but different 1 Celiac disease may affect over 3 million Americans. Symptoms of celiac disease causes and treatments. include , stomach pain, and diarrhea. People with celiac disease have an immune response to , a protein found in wheat and other grains. It is Celiac Disease common in many food products. When people with celiac disease eat food that • Symptoms: Bloating, stomach contains gluten, their small intestines become inflamed. In addition to discomfort, pain, diarrhea the damage caused by inflammation can keep you from absorbing important nutrients. Removing gluten from the diet can help relieve symptoms for people • Cause: Consuming gluten with celiac disease and for others who are sensitive to gluten. • Diagnosis: Laboratory testing Celiac disease is related to a person’s genes. People with certain genes are more for antibodies and genes to likely than others to have the disease. However, just because a person has a gene assess likelihood; using an that is linked to celiac disease does not mean they will get the disease. endoscope and a to look for tissue damage What is IBS? • Treatment: Gluten-free diet IBS affects up to 35 million Americans.2 Similar to celiac disease, IBS symptoms IBS-D include bloating, stomach pain, and diarrhea. But people with IBS may also • Symptoms: Bloating, stomach experience or other irregular bowel functions. The causes of IBS are pain, diarrhea not known; however, some theories include having abnormal contractions of the colon, and , and . A bacterial infection in your body can • Cause: Unknown or infection be caused by eating contaminated food. IBS symptoms after an infection can • Diagnosis: Laboratory testing sometimes last from months to years. Doctors think anywhere from 4% to 36% of for infection people with IBS symptoms may have this type of post-infectious IBS.3 • Treatment: Certain medications Not all IBS is the same; different subtypes of IBS include:

• IBS-D: IBS with diarrhea • IBS-C: IBS with constipation • IBS-M: IBS with a mix of diarrhea and constipation at different times

How Celiac Disease and IBS-D are Different Celiac disease and IBS-D have similar symptoms of bloating, stomach pain, and diarrhea—but their treatments are very different.4 Treating celiac disease

1 means being on a gluten-free diet, whereas treating IBS-D means taking certain medications. Medications may include antibiotics and bowel relaxants. The References correct diagnosis can help you get the right treatment. 1. Celiac disease: fast facts. Beyond Celiac website. beyondceliac.org/ How Your Healthcare Provider Can Help celiac-disease/facts-and-figures/. Fortunately, your healthcare provider can use a number of tools to find out if you Accessed July 25, 2017. have celiac disease or IBS-D.4 Medical guidelines suggest that people suspected 2. IBS 101: What is irritable of having IBS-D should be tested for celiac disease.6 So your healthcare provider bowel syndrome? American Gastroenterological Association may test you for both conditions. website. gastro.org/info_for_patients/ Your healthcare provider can help to determine if you have celiac disease or IBS-D irritable-bowel-syndrome-ibs-101- in the following ways: what-is-irritable-bowel-syndrome. Accessed July 25, 2017. • Asking questions about your 3. Klem F, Wadhwa A, Prokop LJ, et al. Prevalence, risk factors, • Asking about your family history and outcomes of irritable bowel • Asking about your eating habits syndrome after infectious : a systematic review and meta-analysis. • Ordering blood tests to help determine your condition . 2017;152:1042-1054 e1041. • Looking at your intestines with a camera (called an endoscope) to see if there is visible tissue damage 4. Borghini R, Donato G, Alvaro D, et al. New insights in IBS-like disorders: • Taking a sample of tissue (called a biopsy) from your intestines during an Pandora’s box has been opened; a to look for tissue damage under a microscope review. Gastroenterol Hepatol Bed Bench. 2017;10:79-89. How the Laboratory Can Help 5. Pimentel M, Morales W, Rezaie A, et al. Development and validation of a Quest Diagnostics offers celiac disease tests that look for markers of biomarker for diarrhea-predominant inflammation, such as antibodies for gluten sensitivity. Quest also offers tests for irritable bowel syndrome in human celiac disease that look at specific genes that increase the likelihood of having the subjects. PLoS One. 2015;10:e0126438. disease. In addition, Quest offers blood tests that can help support a diagnosis of 6. American College of Gastroenterology IBS-D.5 These tests look for markers of IBS-D after a gastrointestinal infection. Task Force on IBS. An evidence- based position statement on the management of irritable bowel Additional Information syndrome. Am J Gastroenterol. 2009;104 (suppl 1):S1-S35. For more information, visit CeliacAnswers.com at celiacanswers.com/ and questdiagnostics.com/home/patients/tests-a-z/ibs/what-is-ibs, or any of these helpful websites:

• Genetics Home Reference: ghr.nlm.nih.gov/condition/celiac-disease • Celiac Disease Foundation: celiac.org/ • Medline Plus: medlineplus.gov/irritablebowelsyndrome.html • FamilyDoctor.org: familydoctor.org/condition/irritable-bowel-syndrome- ibs/#resources

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