It’s safe to say just about everyone experiences tummy upset and digestive problems from time to time. But if you’re having persistent pain, feeling constantly bloated, or find yourself frequently having to run to the bathroom – there may be more going on.
A growing number of people are suffering from a group of conditions collectively known as inflammatory bowel syndromes. Today we’re going to explore three of the most common – and commonly confused – inflammatory bowel conditions:
- Crohn’s Disease
- Ulcerative Colitis
- Celiac Disease
We’ll dive into their similarities, how they differ, and most importantly, the steps you can take to manage and heal if you’re struggling with any of these conditions. Let’s dig in!
Diseases of the Digestive Tract With Different Causes
Your digestive tract must maintain a delicate balance. One that allows you to absorb nutrients from the outside world while simultaneously defending you against harmful microbes that sneak in alongside those nutrients.
To balance these two divergent needs, the thin lining that makes up the innermost part of your digestive tract is heavily guarded with lymphoid tissue and immune cells. This is meant to protect you, but in inflammatory bowel conditions, the immune cells and tissue lining your gut become unnecessarily activated – creating inflammation without infection.
Pinpointing the exact cause of this inflammation can sometimes be tricky considering that Crohn’s disease, ulcerative colitis, and celiac disease can all have nearly identical symptoms. Let’s explore exactly what these symptoms can be.1
May Have Similar Symptoms
Because all three of these inflammatory bowel diseases involve inflammation of your digestive tract, Crohn’s disease symptoms, ulcerative colitis symptoms, and celiac disease symptoms have a significant amount of overlap and include:2,3
- Diarrhea and/or constipation
- Bloating and flatulence
- Pain, discomfort, and/or cramping in the abdomen
- Anemia (low levels of red blood cells)
- Weight loss and poor appetite
- Canker sores in the mouth
- Joint pain
- Skin rashes
While these inflammatory bowel conditions may be hard to differentiate at first glance, there are actually some important and distinct differences between them.
Digestive System Parts: A Brief Anatomy Overview
Before we dive into the specifics of comparing Crohn’s disease, ulcerative colitis, and celiac disease, let’s briefly review the anatomy of your digestive tract. Your digestive tract extends from your lips to your anus. A bite of food's journey through your digestive tract looks something like this.4
- Food enters your mouth, or oral cavity, where your teeth, tongue, and saliva begin breaking it down.
- Once you swallow, it travels down your throat, through your esophagus, and is delivered to your stomach.
- Once in your stomach, your food is further churned with gastric secretions to break down particles into digestible form.
- From there, it’s ushered into your small intestine which consists of three distinct parts – the duodenum, the jejunum, and the ileum. Your small intestine is lined with millions of tiny finger-like projections known as villi. These villi help absorb nutrients – allowing them to pass from your GI tract to your bloodstream.
- Up next, the partially digested food enters your large intestine, which is made up of the cecum, the ascending colon, the transverse colon, the descending colon, and finally, the sigmoid colon. The primary responsibility of your large intestine is to absorb water and electrolytes while storing undigested matter (feces) until it’s ready to be excreted.
- The sigmoid colon connects to your rectum which terminates at the anus. In its final leg of the journey through your digestive tract, the undigested materials that make up your fecal matter are moved through your rectum and anus – expelling them via a bowel movement.
Now that we got that out of the way, let’s take a deeper look at each of these conditions of the digestive tract.
What Is Crohn’s Disease?
Crohn’s disease is an inflammatory bowel condition that causes patchy lesions or ulcers that can extend deep into the layers of affected tissue – sometimes creating fistulas that tunnel all the way through the wall of your gut.
Crohn’s disease lesions can develop in any part of your digestive tract – from your lips all the way to the rectum. These lesions typically have a “patchy” appearance, with areas of healthy and normal tissue found between alternating ulcerated areas. In some cases, these inflammatory lesions can even begin growing in areas outside of your digestive tract – like in your liver and bile ducts, or even in your eyes, skin, or joints.5
So how exactly is Crohn’s disease different from other inflammatory bowel conditions? And what causes Crohn’s disease?
Crohn’s Disease Causes
While researchers are still working to fully understand Crohn’s disease, we do know that there’s a genetic component that makes certain individuals more susceptible to developing this condition. It’s thought that these genes can predispose you to Crohn’s disease by:6
- Altering the permeability of the lining of your gut, therefore inappropriately exposing your mucosa to the normal bacteria that reside in your gut.
- Exposure to the antigens – a specific type of protein found on the surface of these gut bacteria – causes an exaggerated immune response.
- This exaggerated immune response triggers an influx of inflammatory cells – particularly two types of white blood cells known as T-cells and macrophages.
- As these white blood cells migrate to gut tissue, so do pro-inflammatory cytokines, harmful free radicals, and degrading enzymes.
This series of events causes the widespread and deep penetrating inflammation that triggers the symptoms of Crohn’s disease. Now that you have an understanding of Crohn’s disease, let's compare Crohn’s disease versus ulcerative colitis.
What Is Ulcerative Colitis?
Unlike Crohn’s disease, ulcerative colitis is restricted to the colon. The inflammatory lesions seen in ulcerative colitis typically begin in the rectum and slowly work their way up the colon as the disease progresses. The inflammatory ulcers seen in ulcerative colitis are restricted to the mucosa of your digestive tract but tend to spread continuously and evenly – with no healthy tissue found between ulcerated areas.
So what causes the continuous inflammation seen in ulcerative colitis?
Ulcerative Colitis Causes
Just like Crohn’s disease, more research and time are needed to have a deeper understanding of the exact mechanisms that cause ulcerative colitis. But scientists and doctors speculate that ulcerative colitis may be an organ-specific autoimmune disease. This means that for some reason, your body mistakenly launches an immune attack against the cells that make up the lining in your colon – flooding these tissues with white blood cells known as neutrophils.
This response may be triggered when your immune system misinterprets the “friendly” bacteria that make up your gut flora as harmful invaders. When this happens your immune system flags them as intruders that must be destroyed. Or in other cases, there may in fact have been a legitimate viral or bacterial infection that triggered an immune response, but for one reason or another, your body was unable to “turn off” the immune response – leading to excessive and long-term inflammation.7
While we touched on the fact that both Crohn’s disease and ulcerative colitis can be triggered by an alteration in the microbes in your gut, let’s take a little deeper look at exactly how these microorganisms can contribute to inflammation in your gut.
Infectious Triggers to Inflammatory Bowel Conditions
There are a few distinct ways that a shift in your gut microbiome can contribute to the widespread inflammation seen in both Crohn’s disease and ulcerative colitis. These include:
- Dysbiosis: This occurs when there is a modification in the composition of microbes that reside in your gut – with an imbalance between between beneficial and harmful bacteria
- Excessive bacterial translocation: This is caused by a disruption in the function of your intestinal barrier – allowing gut bacteria to mistakenly migrate through the gut wall and inflame surrounding tissues.
- Persistence of a pathogen: Invading bacteria and viruses can adhere to epithelial cells where they survive and proliferate while using your own cells as protection against your immune system. These persistent pathogens induce inflammation and disrupt the function of your intestinal lining that acts as a selective barrier.
Oftentimes, the inflammation seen in Crohn’s and ulcerative colitis can be caused by a combination of these 3 underlying infectious triggers – creating a vicious cycle of inflammation.
Now let’s explore our final inflammatory bowel condition – celiac disease.
What Is Celiac Disease?
Celiac disease, sometimes also referred to as gluten-sensitive enteropathy or celiac sprue, is by far the most well-understood among these three inflammatory bowel conditions. Celiac disease is an excessive immune response to the ingestion of a protein known as gluten.
Gluten is a protein naturally found in certain grains like wheat, rye, and barley. It’s also often added to countless processed foods and even products like supplements or lip balm. Most people can ingest gluten without any issues. But if you have celiac disease, consuming gluten can trigger a massive immune response.
As your immune system fights to neutralize and eliminate the gluten in your digestive tract, your own tissues can accidentally end up in the line of fire. This can lead to massive inflammation and damage to the lining of your upper small intestines (particularly your duodenum and jejunum).8
So what exactly causes the immune system to go haywire over gluten in celiac disease?
Celiac Disease Causes
The underlying cause of celiac disease is a genetic predisposition – meaning your genes are coded in a specific way that makes your body more likely to have an exaggerated immune reaction to gluten. But not everyone that has these specific gene sequences develops celiac disease.
The development of celiac disease can be triggered by lifestyle factors that essentially “activate” these genes. And if these genes are activated and you do in fact develop celiac disease, the introduction of gluten into your body is what sets off the cascade of inflammation seen in this condition.9
To learn more about the underlying cause of celiac disease, head over and read my article Celiac Disease and Your Genes: A Look At the Fascinating Link.
Different Diet and Treatment Options
When it comes to treating these inflammatory bowel conditions, it requires a big-picture approach. Treatment options may include medications but also require some lifestyle tweaks. Let’s take a little deeper look at these.
In some cases, particularly upon initial diagnosis or during acute flare-ups, medications can be helpful in managing and reversing some of the inflammation seen in these inflammatory bowel conditions. Some medications commonly and effectively used in treatment include:10
- Crohn’s Disease: Corticosteroids, azathioprine, TNF alpha blockers
- Ulcerative Colitis: Corticosteroids, azathioprine, aminosalicylates
- Celiac Disease: Gluten free diet
While medications can be useful, by far the biggest factor when it comes to healing is your diet.
It makes sense that celiac disease treatment includes following a strict gluten-free diet. But it can also be hugely beneficial to follow a gluten-free diet in Crohn's disease treatment and ulcerative colitis treatment. That’s because when treating these inflammatory bowel conditions, it’s crucial to follow an anti-inflammatory diet to help minimize and heal the inflammation in your digestive tract.
Following an anti-inflammatory diet means eliminating foods that promote inflammation like:
- Processed dairy (some people may do ok with raw high-quality dairy products, but many times, dairy can trigger inflammation)
- Refined sugar
- Processed foods
- Processed oils (like canola and vegetable oils)
- Corn and soy can also be inflammatory for some people
You’ll also want to incorporate lots of anti-inflammatory foods like:
- Fresh fruits and vegetables
- High-quality protein sources (like organic grass-fed, pasture-raised, or wild-caught meat)
- Healthy fats (like those found in nuts, avocados, and olive oil)
- Plenty of high-quality purified water
While simply following a well-rounded anti-inflammatory diet can be a good place to start, sometimes you may need to follow a more specialized diet to manage the inflammation seen in Crohn’s and ulcerative colitis.
Specialized Diets to Manage Crohn’s and Ulcerative Colitis
In some cases, following a strict and specific diet protocol can do wonders for managing and reversing the massive inflammation seen in these inflammatory bowel conditions. In particular, two specific diets that have been found to be especially effective components of treatment are:
The Specific Carbohydrate Diet (SCD):
This diet restricts specific carbohydrates that encourage the overgrowth of harmful bacteria in the gut. These harmful bacteria and their byproducts trigger and amplify inflammation in your gut. The SCD diet eliminates carbohydrates that contain two or more linked sugar molecules such as:
- All grains including wheat, rice, corn, millet, quinoa, etc.
- Any processed meats or meats containing additives
- Dairy (with the exception of occasional cheese, butter or homemade yogurt that has been fermented for a minimum of 24 hours)
- Most legumes
- Processed sugar, artificial sweeteners and sugar alcohols
- All processed foods
Eliminating complex carbs can yield impressive and significant results in many Crohn’s and ulcerative colitis patients.
The Elemental Diet:
This diet allows your digestive tract to take a break without sacrificing your nutritional intake by consuming nutritionally complete liquids that are “pre-digested”. These premade formulas contain all of the carbs, fat, proteins, and nutrients your body needs in a super digestible form that doesn’t require your digestive tract to break them down – essentially allowing your gut to focus entirely on healing and repairing inflammation.
While it’s possible to complete a “home-made” elemental diet, this protocol is usually completed by consuming prescription or commercial formulas under the direct supervision of a healthcare provider.
Your diet is hands-down one of the most pivotal components when it comes to the management of these inflammatory bowel conditions.
Supplements can help fill in any nutritional gaps while speeding up healing and ramping down inflammation. The supplements that’ll give you the most bang for your buck include:
- Collagen will bolster and strengthen the integrity of your gut lining.
- Probiotics to populate your gut with plenty of beneficial bacteria.
- Digestive enzymes to help your gut break down and absorb nutrients.
- Glutathione and Vitamin C to boost your antioxidant levels and combat inflammation.
- Gut Immune to give your gut a concentrated dose of immune-boosting immunoglobulins.
You can find all of these supplements and more at my online store. And you can even get 10% off your first order by clicking right here.
In addition to diet and supplements, there are a few other lifestyle factors that can have a remarkable impact on managing the inflammation associated with these conditions. These include:
- Managing stress: Stress and inflammation go together like two peas in a pod – with psychological and emotional stress feeding inflammation. So taking steps to minimize stress can significantly help lower inflammation. Whether it’s through meditation, going for a walk, or simply connecting with a loved one, these small acts can make a significant difference.
- Getting plenty of rest: Sleep deprivation is a surefire way to ramp up inflammation and put a damper on your immune system. So make sure you’re logging plenty of high-quality sleep each night. Learn how you can start sleeping better by clicking right here.
- Minimizing your toxic burden: An accumulation of toxins from your environment can skyrocket inflammation and overwhelm your immune system. Taking steps to minimize your toxic burden is a powerful way to lower inflammation and keep your immune system in tip-top shape.
These simple lifestyle tweaks pack a powerful punch when it comes to fighting inflammation.
Breakdown of Crohn’s, Ulcerative Colitis, and Celiac Disease
|Altered gut permeability that triggers excessive immune reaction and influx of T-cells, macrophages, and inflammatory compounds in response to antigens of normal gut bacteria.
|Organ-specific autoimmune disease in which the immune system attacks the cells lining the colon. Affected areas are flooded with neutrophils and inflammatory cytokines.
|Genetic alteration triggers an excessive immune response to the ingestion of a protein known as gluten found in wheat, rye, and barley.
|Patchy ulcerations can develop anywhere along the GI tract. Lesions can even develop outside the GI tract.
|Restricted to the colon. Continuous ulcerations typically begin in the rectum and slowly work their way up the colon as the disease progresses.
|Upper small intestines – particularly your duodenum and jejunum.
|Corticosteroids,azathioprine, antibody to TNFa
|Corticosteroids, azathioprine, aminosalicylates
Are You Struggling With Crohn's Disease, Ulcerative Colitis, or Celiac Disease?
Are you or a loved one struggling with an inflammatory bowel condition? If so, the good news is, you're not at the mercy of your diagnosis. While we may not be able to cure these conditions, you have so much power over your own health. I can’t overemphasize the importance and influence your diet, supplements, and lifestyle factors can have on your inflammation levels and symptoms.
So if you’re ready to take your power and health back from one of these inflammatory bowel conditions, I recommend starting with the steps outlined in this article and seeking out the guidance of an experienced Integrative and Functional Medicine Practitioner. They’ll help you identify the root cause of your condition and come up with a personalized plan of action to begin healing.
And if you’re hungry for more practical and research-backed tips on optimizing your health, you can head over to my blog and catch up on hundreds of articles that simplify healthy living. You can also sign up for my weekly newsletter by entering your name and email address in the form below.
Now it’s time to hear from you. Were you surprised to learn about the similarities and differences between Crohn’s disease, ulcerative colitis, and celiac disease? What steps are you taking to keep your gut happy and healthy? Leave your questions and thoughts in the comments below!
- [PDF] Immunity, Inflammation, and Allergy in the Gut | Semantic Scholar
- Inflammatory bowel disease and celiac disease: Overlaps and differences (nih.gov)
- Crohn's vs Celiac: What's the Difference Between the Two Diseases (webmd.com)
- Human digestive system – Anatomy | Britannica
- The Difference Between Crohn’s Disease, Ulcerative Colitis, and Celiac Disease — Colorectal Clinic of Tampa Bay (tampacolorectal.com)
- [PDF] Immunity, Inflammation, and Allergy in the Gut | Semantic Scholar
- Ulcerative colitis – Causes – NHS (www.nhs.uk)
- What is Celiac Disease? | Celiac Disease Foundation
- Symptoms & Causes of Celiac Disease | NIDDK (nih.gov)
- [PDF] Immunity, Inflammation, and Allergy in the Gut | Semantic Scholar
* These statements have not been evaluated by the Food and Drug Administration. The product mentioned in this article are not intended to diagnose, treat, cure, or prevent any disease. The information in this article is not intended to replace any recommendations or relationship with your physician. Please review references sited at end of article for scientific support of any claims made.