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Byrne's Blog

What's the Difference Between Celiac Disease and Ileitis, Colitis, Crohn's Disease and Irritable Bowel Syndrome?

As the spouse of someone who was diagnosed with celiac disease more than 35 years ago, I will admit that becoming more educated about the subject is a continuing process. This educational process has, at times, caused confusion for me.

One area that has caused confusion is understanding the difference between celiac disease and other diseases and conditions that also affect the gastrointestinal tract. Are these diseases and conditions similar to celiac disease, and are they related? These other diseases and conditions are: ileitis, colitis, Crohn’s disease, and irritable bowel syndrome.

To learn more about these, I searched for the websites of any national groups, organizations, or foundations for these diseases. As mentioned in a previous blog, I am not a medical practitioner of any kind, so if you have questions or need specific information on any of these diseases and conditions, please consult your physician.

As you already know, celiac disease is an autoimmune disorder caused by an intolerance to the gluten found in wheat, barley, and rye. I’m assuming you are also aware of and have already visited the website for the Celiac Disease Foundation. If not, you should. It contains a wealth of information about living with celiac disease.

As it turns out, there is also a national foundation for both Crohn’s disease and colitis called the Crohn’s & Colitis Foundation of America (CCFA). There is also a wealth of information on this site, but I’m only including the information that helped me better understand these diseases and clear up any confusion on my part. I highly recommend you go to the site and read all the information provided.

About Crohn’s disease, it says: “Crohn’s disease belongs to a group of conditions known as Inflammatory Bowel Diseases (IBD). Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract... It is important to know that Crohn’s disease is not the same thing as ulcerative colitis, another type of IBD. The symptoms of these two illnesses are quite similar, but the areas affected in the gastrointestinal tract (GI tract) are different. Crohn’s most commonly affects the end of the small bowel (the ileum) and the beginning of the colon, but it may affect any part of the gastrointestinal (GI) tract, from the mouth to the anus...Ulcerative colitis is limited to the colon, also called the large intestine.”
About colitis, also known as ulcerative colitis, it says: “Ulcerative colitis is a chronic disease of the large intestine, also known as the colon, in which the lining of the colon becomes inflamed and develops tiny open sores, or ulcers.”

In addition, the CCFA site says: “While both ulcerative colitis and Crohn’s disease are types of Inflammatory Bowel Diseases (IBD), they should not be confused with Irritable Bowel Syndrome (IBS), a disorder that affects the muscle contractions of the colon. IBS is not characterized by intestinal inflammation.”

I then decided to search for the term “’irritable bowel syndrome” on Google. I found no national foundation or website, but there was some interesting information on a National Institutes of Health website called National Digestive Diseases Information Clearing House. It helped clarify several misconceptions I had. It says: ”Irritable bowel syndrome is a functional gastrointestinal (GI) disorder, meaning symptoms are caused by changes in how the GI tract works. People with a functional GI disorder have frequent symptoms; however, the GI tract does not become damaged. IBS is a group of symptoms that occur together, not a disease. In the past, IBS was called colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel. The name was changed to reflect the understanding that the disorder has both physical and mental causes and is not a product of a person’s imagination.”

Further, since I didn’t see any information on the CCFA site about ileitis, I also searched for that term on Google. I couldn’t find a national foundation or website specifically for ileitis, but did learn that ileitis refers to inflammation of the ileum, or small intestine, as described on the CCFA site, and can be caused by Crohn’s Disease affecting the ileum. Another National Institutes of Health website says there can also be ileitis not caused by Crohn’s disease but by a variety of other diseases. Please refer to this website for information on those types of ileitis.

By now you may be asking what any of this has to do with celiac disease, or why I was confused in the first place. Since reading more information about ileitis, colitis, and irritable bowel syndrome, I have learned that:

- Except for irritable bowel syndrome (IBS), the other diseases and conditions I was wondering about all involve inflammation in the GI tract, including celiac disease.

- IBS should not be confused with irritable bowel disease (IBD). The two are different. IBS involves muscle contraction while IBD involves inflammation.

- Crohn’s disease and ulcerative colitis are both IBDs. Crohn’s disease can occur anywhere along the GI tract from the mouth to the anus, while ulcerative colitis only affects the colon (large intestine).

- Ileitis is a type of Crohn’s disease that usually affects the ileum, which is the end of the small intestine, and also the beginning of the colon; however, there are also other forms of ileitis caused by other diseases.

- Several symptoms are common to celiac disease, Crohn’s disease, and ulcerative colitis: abdominal pain, diarrhea, weight loss, fatigue.

- Celiac disease is not classified as an IBD or IBS.

- Celiac disease is caused only by an intolerance to gluten. An intolerance to gluten is not the cause of Crohn’s disease (and ileitis), ulcerative colitis, or IBS.

I hope this will be helpful to you as well in your continuing education on celiac disease.

"What Am I Going to Eat?"

Living gluten-free has never been particularly easy. But it’s getting easier; note, I did not say easy, but easier.

You have to keep in mind how important food and diet is or has become to the person with celiac disease. While eating is most likely second nature to you and me and to most other people, that is simply not the case for the person with a gluten intolerance. Food and diet have become a way of life.

If you live with or around someone with celiac disease, I’m sure you’re familiar with their very real and ongoing question, “What am I going to eat?” It’s what they have to think about every time they shop at a grocery store, go out to a restaurant, accept an invitation where food will be served, and while traveling or on vacation.

You already know it takes planning, and usually a lot of planning ahead, to ensure the availability of a wholesome, nutritious, well-rounded, as well as gluten-free, meal and diet.

As I said previously, it is getting easier. It may help to realize that things are now 1000 percent better than they used to be just a few years ago. Back then (and I’m talking as late as the 1990s), almost no one had ever heard of gluten and certainly not celiac disease, even some physicians. There was almost no information available, and, if you read my last blog, food labeling was abysmal.

Now, almost everyone has at least heard of gluten even if they’re not sure what it is. You’ve probably also noticed more and more grocery chains and restaurants carrying gluten-free items on their shelves and menus. Fantastic.

And with websites, such as glutenfreeweek.com, and others, planning and planning ahead is easier than ever. You now have access to great recipes that are easy to prepare, and as the name implies, you can plan gluten-free meals ahead on a weekly basis.

So to the question, “What am I going to eat?” just click on http://www.glutenfreeweek.com/ !

Sometimes Reading the Label Isn't Enough

As much as I try to stay informed and do whatever I can to support someone living on a gluten-free diet, I was surprised to learn about some of the ingredients on food labels in our kitchen.

Let me be the first to applaud the gigantic steps that have been made on behalf of consumers by making food manufacturers in the US add the ingredients of their products to all food labels. In the last 20 years or so, we have come out of the dark ages of labeling when the requirements were either lax or worse, non-existent.

What’s more, in the US, fairly recent legislation mandated eight common allergenic foods be added to labels--wheat being one of the eight--so that the label must now read “contains wheat.” Although the US Food & Drug Administration has not mandated “gluten free” be added to food labels, manufacturers may do so voluntarily, but they are then accountable for the product being gluten free.

I know to look for wheat, barley, and rye on food labels and avoid those foods. But even with all this information, it doesn’t mean the average person like me can simply read ingredients and know if the product is gluten free or not unless, of course, the product is labeled (or certified) gluten free.

I didn’t have to look very far to find the following ingredients on labels of a couple of what I consider to be typical kitchen-variety products (no brand names). Even though the ingredient was listed on the product, since I really didn’t know what it was, I didn’t know whether it was gluten free.

Malt Extract, an ingredient I now know is derived from malted barley, was listed on a box of CORN FLAKES.

Dehydrated Soy Sauce (soybeans, wheat, salt, maltodextrin), which fortunately also listed the word wheat, was listed on a bottle of BARBECUE SAUCE; (in the US maltodextrin has been declared gluten free; however, another listed ingredient, natural smoke flavoring, is problematic because it may contain barley malt as the carrier for the smoke flavor).

What makes this so disconcerting is that you may not necessarily stop to think about whether malt extract and soy sauce, dehydrated or otherwise, contain gluten--but corn flakes and barbecue sauce?

When you’re on a gluten-free diet, you have to educate yourself and question everything. Sometimes reading the label isn’t enough.

Just FYI--a useful resource I ran across while researching this was the website Labelwatch (labelwatch.com) that compares “ingredients in over 25,000 brand name products,” plus it also gives you information about some ingredients, especially the more unfamiliar ones.

What Exactly Is Gluten?

To follow up on my last blog about supporting those who must eat gluten free, I thought I would continue with another basic topic--what exactly is gluten?

Think of this as your “elevator” speech, a relatively concise answer in under a couple of minutes you can use if and when someone asks you about gluten.

So you know, and as a caveat, I am not a nutritionist or a medical practitioner of any sort. Rather, I am a lay person who, like you, eats and happens to be living with or around someone with celiac disease. This information was synthesized from several sites found easily by search engine on the internet. If you are unsure about the accuracy of any of this information, by all means, consult your own physician or nutritionist.

Without going into too much scientific detail on gluten, which is not the intent, simply, gluten is the proteins found only in the mature seeds (or grain) of wheat, barley, and rye grasses and of wheat’s relatives: einkorn, farro, kamut, spelt, and triticale. It is the gluten proteins in these grains that give dough its elasticity and end up in the food we eat (or drink) made from these grains.

It’s important to note that gluten is only found in the grains mentioned above and not others, such as rice and oats. However, be aware that rice and especially oats can be exposed to gluten through cross-contamination during processing.

To add to that simple definition, proteins are large biological molecules made up of organic compounds of carbon, hydrogen, oxygen, and nitrogen residues called amino acids. Among other things, proteins are important in the human diet to obtain essential amino acids through digestion for metabolism, the chemical reactions that occur in organisms and, to make a long story short, give us energy.

To put this in context, and a topic for further exploration, it is the adverse reaction one has to gluten that calls for a gluten-free diet.

So if anyone should ask, now you know what gluten is.

Seven Ways to Be Supportive of Someone with Celiac Disease

Welcome to my first blog on GlutenFreeWeek! It’s about living with or around someone you
know who has celiac disease.

It’s an important topic, so from time to time when I discover a new tip or trick to make life easier,
I’ll blog about it. I also welcome any comments or information you would like to share.
You yourself may not have celiac disease; maybe you’re a family member, like me, or a
companion, or just a friend who cares about someone and wants to help. As such, you probably
don’t really understand how difficult it is for someone with celiac, but you know it’s not easy.
In this first blog, I wanted to start with the most important things first since living gluten free is a
marathon and not a sprint. So, the number one most important thing you can do is to be
supportive.

That said, here are seven ways you can be supportive:

1) Listen to how celiac disease has had, and will always have, an impact on his or her life.

2) Learn as much as you can about gluten and celiac disease and share that knowledge.

3) Understand that eating gluten free is imperative to the health and well being of the person.

4) Learn what foods are and are not gluten free.

5) Don’t complain about extra effort in finding and preparing gluten-free
food or seeking gluten-free restaurants and establishments.

6) Be flexible and open in trying out new methods, recipes, and tastes.

7) Be empathetic and never ever say, “you’re lucky it can be treated with diet."

Living with celiac disease is a challenge for everyone, so get with the program.