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Crohn's Disease And Gluten-Free Diets


munchkinette

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munchkinette Collaborator

I'm currently training for my first triathlon in order to raise money for the Crohn's and Colitis Foundation of America. I picked this one because I know that some of their research does overlap other GI immune conditions. I'm not totally sure how though. I've found some research about shared genes. I want to make sure I'm telling people the right things, since many of them have experience with celiac only.

My main question now is how many people with Crohn's and/or colitis follow a gluten free diet? Is it the same or different from the celiac diet in any ways? I've met one person who said she couldn't eat many other gluten free replacement grains. Is that something that varies by person?

Also, how does a doctor distinguish between celiac disease and Crohn's when it affects the small intestine?


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trents Grand Master

I cannot address a lot of your questions but I believe the differential dx between Crohns and Celiac disease would be that with Celiac disease there will be villi blunting.

mushroom Proficient

I believe Crohn's is usually diagnosed by barium swallow x-rays of the GI tract, both upper and lower, as it affects the whole intestine.

GFinDC Veteran

Some people with Crohn's follow the GFCFSF diet also. Others don't. If it helps an individual seems to vary. Some people have both Crohn's and celiac too.

There isn't any clear cut answer to why Crohn's affects the whole intestine and celiac only the small intestine. They are both auto-immune diseases/conditions and are both serious. However with Crohn's a diet that helps everyone is not a known thing, like it is with celiac. Of course then you look a little further and find that many people with celiac have additional food intolerances beyond GFCFSF. People with Crohn's often have antibodies to baker's yeast also.

Crohn's patients generally use a combination of diet and immuno-suppressants to manage their symptoms. Some don't make any diet changes and use drugs to control their symptoms.

They are both auto-immmune diseases/conditions of the digestive tract and probably have more in common than different. But celiac is the only auto-immune disease that doctors understand the trigger for right now. Crohn's is still a mystery.

kareng Grand Master

There isn't any clear cut answer to why Crohn's affects the whole intestine and celiac only the small intestine. They are both auto-immune diseases/conditions and are both serious. However with Crohn's a diet that helps everyone is not a known thing, like it is with celiac. Of course then you look a little further and find that many people with celiac have additional food intolerances beyond GFCFSF. People with Crohn's often have antibodies to baker's yeast also.

Crohn's patients generally use a combination of diet and immuno-suppressants to manage their symptoms. Some don't make any diet changes and use drugs to control their symptoms.

They are both auto-immmune diseases/conditions of the digestive tract and probably have more in common than different. But celiac is the only auto-immune disease that doctors understand the trigger for right now. Crohn's is still a mystery.

Might be because docs don't tell them to change their diet. I know people with Crohn's, one had huge chunks of her large intestine removed, who were never told about diet. They just take pills. :o

sa1937 Community Regular

I know someone with Crohn's, too, and I asked her if she'd ever been tested for celiac. She hasn't but knows we share a lot of the same symptoms. She also knows both are autoimmune. She'd rather just take her pills, which she's been doing for many years. So I don't know if she was ever told about the gluten-free diet or if she'd just miss the spontaniety of eating out a lot. So I've dropped the subject.

mushroom Proficient

Before I was aware of celiac I knew someone with Crohn's who literally lived on pasta, and no, it was not Tinkyada :o And I did sonehow know at that time that was not the right thing to do because I said to my MIL "But she has Crohn's!!" It makes you wonder why doctors insist on NO SALT and NO FAT but they can't say the words NO GLUTEN!!


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munchkinette Collaborator

Thanks for the responses. It's interesting. The one girl I talked to at the meetings said she went into remission on a Gluten-free Casein-free low sugar diet, and some doctors supported her while others didn't. It sounded very similar to my own experience with negative tests, a variety of responses from doctors, but major health improvements on a different diet.

sb2178 Enthusiast

Crohn's disease affects several layers of the intestines, unlike celiac, which just affects the top layers, and there is often narrowing/scarring/ulcers. It shows up in biopsies in the affected area, and I believe the pattern of immune cells in the mucosa is different. Typically, the symptoms are slightly different as well but there can be a lot of overlap. (I really really did not want Crohn's disease to be diagnosed last year.)

A really common diet recommendation for Crohn's is no whole grains and no beans. Digesting fiber ahd phytic actid tends to be hard. That's probably why she said she can't eat some (whole) gluten-free grains.

Some research points to infection with MAP (Mycobacterium paratuberculosis) as the trigger for Crohn's but it's not well accepted.

GlutenFreeManna Rising Star

This thread is interesting to read. The only person I have ever known with crohns told me there was no way to help the symptoms with dietary changes and they would not even entertain the idea. So I never really looked into it or anything. This person was on very strong medicines and still in pain most of the time. I wish they would have at least looked into some dietary changes to see if it helped (although I understand it's not the same as celiac and diet may not help everyone, it's hard to watch someone so desperate for symptom relief yet refuse to at least try a change of food). This person also ate mostly pasta and breads however and I really do wonder now if they were addicted to the gluten and just making their pain worse by eating it so much.

Reid B. Kimball Newbie

Hi everyone,

Interesting to read the responses from the Celiac community. I have Crohn's disease, am working on a documentary film about treating digestive conditions such as IBS, Celiac, Crohn's & ulcerative colitis using alternative treatments when drugs and surgery no longer work.

Several of you are correct that there is no specific, doctor recommended dietary plan for treating Crohn's disease. Unless you talk to a Naturopathic doctor, but even then, it's still a mixed bag of responses. No standards at all.

I use primarily diet and supplementation to control my D and pain. I haven't been on medication since 2007. Gastroenterologists absolutely do not believe food plays a role and tell patients that the best course of treatment is medication and sometimes surgery. This is why some of you have run into opposition when trying to talk to your friends about diet treatments for Crohn's. They are told it doesn't work and they believe their doctors.

It is my hope with my documentary that I will prove that it can work! There are many people who are discovering this everyday and defying their doctor's requests to take immunosupressive drugs, which can have horrible side effects. It ain't easy, especially because we can't tolerate any grains at all (those of us who use special diets) and instead we make our breads with nut flours like almond and pecan. The most popular diet for us is called the Specific Carbohydrate Diet (SCD). If anyone with Celiac still has trouble on gluten free, I recommend SCD.

  • 4 weeks later...
Mother of a Celiac Rookie

Hi everyone,

Interesting to read the responses from the Celiac community. I have Crohn's disease, am working on a documentary film about treating digestive conditions such as IBS, Celiac, Crohn's & ulcerative colitis using alternative treatments when drugs and surgery no longer work.

Several of you are correct that there is no specific, doctor recommended dietary plan for treating Crohn's disease. Unless you talk to a Naturopathic doctor, but even then, it's still a mixed bag of responses. No standards at all.

I use primarily diet and supplementation to control my D and pain. I haven't been on medication since 2007. Gastroenterologists absolutely do not believe food plays a role and tell patients that the best course of treatment is medication and sometimes surgery. This is why some of you have run into opposition when trying to talk to your friends about diet treatments for Crohn's. They are told it doesn't work and they believe their doctors.

It is my hope with my documentary that I will prove that it can work! There are many people who are discovering this everyday and defying their doctor's requests to take immunosupressive drugs, which can have horrible side effects. It ain't easy, especially because we can't tolerate any grains at all (those of us who use special diets) and instead we make our breads with nut flours like almond and pecan. The most popular diet for us is called the Specific Carbohydrate Diet (SCD). If anyone with Celiac still has trouble on gluten free, I recommend SCD.

Thank you so much for this post. I just finished messaging another advanced member about my daughter's recent symptoms. She is 7 yrs old and was diagnosed a year and a half ago w/Celiac. She was doing great on the gluten-free diet for almost exactly a year to the date and then she started getting horrible stomach pains and bad headaches. Her GI suggested taking her off of lactose to see if it would help. It didn't. I started reading about the SCD diet and Dr. Haas' research and decided to take her off of ALL grains and also dairy which almost immediately seemed to work. Her symptoms went away. I tried to reintroduce rice and rice pasta a few weeks later and after 4 days of one serving a day, her symptoms returned. I also tried separately to reintroduce casein and the stomachaches returned as well. I am baffled that she could be doing so well and now she is so restricted on what she can eat. She also cannot tolerate corn so she is basically now following the Paleo diet: protein, vegetables, fruit, no grains...also, no starches, no corn, no dairy....VERY hard for a 7 yr old.

Over the past couple weeks a stomach bug has been going around our house where we feel pretty good until we eat something and then we get abdominal gurgling, loose stools, mild stomach pain, and loss of appetite. Most of us are recovered and pretty much back to normal, except for our daugher who is still having a lot of stomach pain and just doesn't feel good in general. I'm scared that her symptoms are now returning again since it is taking her so long to get over it. Have you found that following the SCD diet can possibly be temporary and then you are able to return to a "normal" gluten-free diet or is this a permanent solution? Dr. Haas talked about doing it for a number of years and then being able to return to normal foods. Thanks for any advice you can give!

  • 1 year later...
Aly's mom Newbie

I would love to see your documentary. Did you complete it?

My daughter was suffering with many symptoms for several months. She had a colonoscopy and the results came back "consistent with Crohns". Her gastroenterologist stated that current medical thinking is that diet is not the answer. He said that there were very effective drugs available now and put her on Asacol. She wound up in the emergency room twice in one day with palpitations. Even though the doctor claimed that there was no connection he pulled her off the medication. Wonder of wonder, no more palpitations. I have taken her to 2 different gastroenterologists, a holistic doctor, a nutritionist and the list is growing...meanwhile she has gone gluten free and is doing very well. I wonder if she had Crohn's at all.

gstewart88 Newbie

I was diagnosed with Crohns disease last year after colonoscopy with biopsies. I only have a mild case and the medication does help, but I still have alot of other symptoms and I am convinced that changing my diet is the answer.

I can't handle whole grains, corn, popcorn, too much milk, caffeine and a variety of other foods. I still get daily nausea and stomach pain. I know alot of other people who suffer from Crohns disease have very restricted diets but it is mostly trial and error to avoid things that set them off, not just a simple Dr recommended diet.

Incidently, I have just had an endoscopy to test for concurrent coeliacs but I haven't got the biopsy results back yet.

I also plan to visit a dietitian who specialises in IBD/coeliac type diseases so hopefully I will get some results.

  • 3 months later...
Riverand Newbie

My main question now is how many people with Crohn's and/or colitis follow a gluten free diet? Is it the same or different from the celiac diet in any ways? I've met one person who said she couldn't eat many other gluten free replacement grains. Is that something that varies by person?

Also, how does a doctor distinguish between celiac disease and Crohn's when it affects the small intestine?

My mother had Crohn's disease, so I can't say I was totally surprised in 2008 when I was diagnosed with it as well after a colonoscopy. We never heard of celiac, or gluten back then. I lived on pasta, cereal and sandwiches. I was given medication to treat the disease.

In 2010, after a stint of antibiotic-associated colitis, I had developed the greatest food fear of my life because I had gotten so sick from everything I consumed. I went to a nutritionist.

She said I was gluten and dairy intolerant. I thought she was nuts, but in my desperation, I followed a gluten-free DF diet for one month before returning to her. In that time I was convinced - I had lost five pounds and symptoms overall were decreasing.

I have been gluten-free and DF ever since. In 2011, when I had my follow up colonoscopy, my doctor said the evidence of early stages Crohn's was gone. He would not credit the diet, but admitted that there was no way the medication could have reversed the effects.

I don't know if I have celiac and I was misdiagnosed. What's worse, is that I will never know if this diet could have helped my mother in all her years of suffering (she passed away in 2006).

GFinDC Veteran

My mother had Crohn's disease, so I can't say I was totally surprised in 2008 when I was diagnosed with it as well after a colonoscopy. We never heard of celiac, or gluten back then. I lived on pasta, cereal and sandwiches. I was given medication to treat the disease.

In 2010, after a stint of antibiotic-associated colitis, I had developed the greatest food fear of my life because I had gotten so sick from everything I consumed. I went to a nutritionist.

She said I was gluten and dairy intolerant. I thought she was nuts, but in my desperation, I followed a gluten-free DF diet for one month before returning to her. In that time I was convinced - I had lost five pounds and symptoms overall were decreasing.

I have been gluten-free and DF ever since. In 2011, when I had my follow up colonoscopy, my doctor said the evidence of early stages Crohn's was gone. He would not credit the diet, but admitted that there was no way the medication could have reversed the effects.

I don't know if I have celiac and I was misdiagnosed. What's worse, is that I will never know if this diet could have helped my mother in all her years of suffering (she passed away in 2006).

It's good to hear the gluten-free diet is helping you Riverand. You might want to look at going soy-free also. Soy is one of the top 8 food allergens and is a problem for some celiacs. Isn't it great they put it in baby formula?

Open Original Shared Link

Research Studies Effects Of Soy Baby Formula On Intestinal Development

Dec. 27, 2004 — URBANA, Ill. -- Two studies by University of Illinois food science and human nutrition professor Sharon Donovan show that the soy isoflavone genistein, in amounts present in commercial soy infant formulas, may inhibit intestinal cell growth in babies. So what are we to think about soy in a baby's diet?

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    • trents
      So, essentially all of the nutrition in the food we eat is absorbed through the villous lining of the small bowel. This is the section of the intestinal track that is damaged by celiac disease. This villous lining is composed of billions of finger-like projections that create a huge amount of surface area for absorbing nutrients. For the celiac person, when gluten is consumed, it triggers an autoimmune reaction in this area which, of course, generates inflammation. The antibodies connected with this inflammation is what the celiac blood tests are designed to detect but this inflammation, over time, wears down the finger-like projections of the villous lining. Of course, when this proceeds for an extended period of time, greatly reduces the absorption efficiency of the villous lining and often results in many and various nutrient deficiency-related health issues. Classic examples would be osteoporosis and iron deficiency. But there are many more. Low D3 levels is a well-known celiac-caused nutritional deficiency. So is low B12. All the B vitamins in fact. Magnesium, zinc, etc.  Celiac disease can also cause liver inflammation. You mention elevated ALP levels. Elevated liver enzymes over a period of 13 years was what led to my celiac diagnosis. Within three months of going gluten free my liver enzymes normalized. I had elevated AST and ALT. The development of sensitivities to other food proteins is very common in the celiac population. Most common cross reactive foods are dairy and oats but eggs, soy and corn are also relatively common offenders. Lactose intolerance is also common in the celiac population because of damage to the SB lining.  Eggs when they are scrambled or fried give me a gut ache. But when I poach them, they do not. The steam and heat of poaching causes a hydrolysis process that alters the protein in the egg. They don't bother me in baked goods either so I assume the same process is at work. I bought a plastic poacher on Amazon to make poaching very easy. All this to say that many of the issues you describe could be caused by celiac disease. 
    • catnapt
      thank you so much for your detailed and extremely helpful reply!! I can say with absolute certainty that the less gluten containing products I've eaten over the past several years, the better I've felt.   I wasn't avoiding gluten, I was avoiding refined grains (and most processed foods) as well as anything that made me feel bad when I ate it. It's the same reason I gave up dairy and eggs- they make me feel ill.  I do have a bit of a sugar addiction lol so a lot of times I wasn't sure if it was the refined grains that I was eating - or the sugar. So from time to time I might have a cookie or something but I've learned how to make wonderful cookies and golden brownies with BEANS!! and no refined sugar - I use date paste instead. Pizza made me so ill- but I thought it was probably the cheese. I gave up pizza and haven't missed it. the one time I tried a slice I felt so bad I knew I'd never touch it again. I stopped eating wheat pasta at least 3 yrs ago- just didn't feel well after eating it. I tried chick pea pasta and a few others and discovered I like the brown rice pasta. I still don't eat a lot of pasta but it's nice for a change when I want something easy. TBH over the years I've wondered sometimes if I might be gluten intolerant but really believed it was not possible for me to have celiac disease. NOW I need to know for sure- because I'm in the middle of a long process of trying to find out why I have a high parathyroid level (NOT the thyroid- but rather the 4 glands that control the calcium balance in your body) I have had a hard time getting my vit D level up, my serum calcium has run on the low side of normal for many years... and now I am losing calcium from my bones and excreting it in my urine (some sort of renal calcium leak) Also have a high ALP since 2014. And now rapidly worsening bone density.  I still do not have a firm diagnosis. Could be secondary HPT (but secondary to what? we need to know) It could be early primary HPT. I am spilling calcium in my urine but is that caused by the high parathyroid hormone or is it the reason my PTH is high>? there are multiple feedback loops for this condition.    so I will keep eating the bread and some wheat germ that does not seem to bother me too much (it hasn't got enough gluten to use just wheat germ)    but I'm curious- if you don't have a strong reaction to a product- like me and wheat germ- does that mean it's ok to eat or is it still causing harm even if you don't have any obvious symptoms? I guess what you are saying about silent celiac makes it likely that you can have no symptoms and still have the harm... but geez! you'd think they'd come up with a way to test for this that didn't require you to consume something that makes you sick! I worry about the complications I've been reading about- different kinds of cancers etc. also wondering- are there degrees of celiac disease?  is there any correlation between symptoms and the amnt of damage to your intestines? I also need a firm diagnosis because I have an identical twin sister ... so if I have celiac, she has it too- or at least the genetic make up for having it. I did have a VERY major stress to my body in 2014-2016 time frame .. lost 50lbs in a short period of time and had severe symptoms from acute protracted withdrawal off an SSRI drug (that I'd been given an unethically high dose of, by a dr who has since lost his license)  Going off the drug was a good thing and in many ways my health improved dramatically- just losing 50lbs was helpful but I also went  off almost a dozen different medications, totally changed my diet and have been doing pretty well except for the past 3-4 yrs when the symptoms related to the parathyroid issue cropped up. It is likely that I had low vit D for some time and that caused me a lot of symptoms. The endo now tells me that low vit D can be caused by celiac disease so I need to know for sure! thank you for all that great and useful information!!! 
    • trents
      Welcome, @catnapt! The most recent guidelines are the daily consumption of a minimum of 10g of gluten (about the amount found in 4-6 slices of wheat bread) for a minimum of two weeks. But if possible stretching that out even more would enhance the chances of getting valid test results. These guidelines are for those who have been eating gluten free for a significant amount of time. It's called the "gluten challenge".  Yes, you can develop celiac disease at any stage of life. There is a genetic component but also a stress trigger that is needed to activate the celiac genes. About 30-40% of the general population possesses the genetic potential to develop celiac disease but only about 1% of the general population actually develop celiac disease. For most with the potential, the triggering stress event doesn't happen. It can be many things but often it is a viral infection. Having said that, it is also the case that many, many people who eventually are diagnosed with celiac disease probably experienced the actual onset years before. Many celiacs are of the "silent" type, meaning that symptoms are largely missing or very minor and get overlooked until damage to the small bowel lining becomes advanced or they develop iron deficiency anemia or some other medical problem associated with celiac disease. Many, many are never diagnosed or are diagnosed later in life because they did not experience classic symptoms. And many physicians are only looking for classic symptoms. We now know that there are over 200 symptoms/medical problems associated with celiac disease but many docs are only looking for things like boating, gas, diarrhea. I certainly understand your concerns about not wanting to damage your body by taking on a gluten challenge. Your other option is to totally commit to gluten free eating and see if your symptoms improve. It can take two years or more for complete healing of the small bowel lining once going gluten free but usually people experience significant improvement well before then. If their is significant improvement in your symptoms when going seriously gluten free, then you likely have your answer. You would either have celiac disease or NCGS (Non Celiac Gluten Sensitivity).
    • catnapt
      after several years of issues with a para-gland issue, my endo has decided it's a good idea for me to be tested for celiac disease. I am 70 yrs old and stunned to learn that you can get celiac this late in life. I have just gradually stopped eating most foods that contain gluten over the past several years- they just make me feel ill- although I attributed it to other things like bread spiking blood sugar- or to the things I ate *with* the bread or crackers etc   I went to a party in Nov and ate a LOT of a vegan roast made with vital wheat gluten- as well as stuffing, rolls and pie crust... and OMG I was so sick! the pain, the bloating, the gas, the nausea... I didn't think it would ever end (but it did) and I was ready to go the ER but it finally subsided.   I mentioned this to my endo and now she wants me to be tested for celiac after 2 weeks of being on gluten foods. She has kind of flip flopped on how much gluten I should eat, telling me that if the symptoms are severe I can stop. I am eating 2-3 thin slices of bread per day (or english muffins) and wow- it does make me feel awful. But not as bad as when I ate that massive amnt of vital wheat gluten. so I will continue on if I have to... but what bothers me is - if it IS celiac, it seems stupid for lack of a better word, to intentionally cause more damage to my body... but I am also worried, on the other hand, that this is not a long enough challenge to make the blood work results valid.   can you give me any insight into this please?   thank you
    • trents
      The biopsy looks for damage to the mucosal lining of the small bowel from the inflammation caused by celiac disease when gluten is ingested. Once you remove gluten from the diet, inflammation subsides and the mucosal lining begins to heal. 
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