Sunday, October 7, 2012

Is there a relation between IBD and Celiac's Disease?


Inflammatory Bowel Disease (IBD ) is caused by an inflammatory response to host microflora, and is usually characterized by two prevalent diseases: Crohn’s Disease (CD) and Ulcerative Colitis (UC).  Celiac’s disease also affects the digestive tract- it is an inflammatory response to gluten when it is digested. Both are caused by inflammatory responses; however in IBD it is still unclear what exactly triggers the response. There have been a few studies trying to answer questions regarding a possible relationship between these two diseases.

In one study, patients with IBD and patients with celiac’s were studied and compared with a normal healthy group. The researchers measured total IgA levels, tissue transglutaminase antibody, and antigliadins in IBD patients, and if positive for antibodies they were offered a duodenal biopsy. In celiac patients colonoscopies and biopsies were used. The results showed a10-fold greater prevalence of IBD in those who had celiac’s disease compared with the controls, and the same prevalence of celiac’s in those who had IBD and the controls. http://www.ncbi.nlm.nih.gov/pubmed/17918008 “Is there an association between coeliac disease and inflammatory bowel disease?” 

Another study also analyzed IBD patients and their susceptibility for celiac’s disease. They measured their anti-endomysial antibodies and tissue transglutaminase antibodies, and if positive performed an endoscopy with duodenal biopsy. Results showed that 9 out of the 1711 IBD patients had celiac’s disease and of these, 6 had UC and 3 had Crohn’s. In summary, their results indicate a lower risk of celiac’s disease in those with IBD than in the general population. http://www.ncbi.nlm.nih.gov/pubmed/19786375 “Prevalence of Celiac disease in inflammatory bowel disease”

The results of these two studies are very interesting, because it seems like they are pointing towards a relation where those who have celiac’s are more likely to develop IBD than non-celiac patients, but IBD patients are less likely to develop celiac’s than the general population. 

This leads to the questions, how can an immune response to gluten lead to a general immune response in the digestive tract? Why isn’t someone with IBD more susceptible to celiac’s disease than a normal person? Are there other tests that can be used to study these two inflammatory responses better?

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3 comments:

  1. The question of whether or not celiac disease could be related to IBD is a relevant question. They both pertain to the digestive tract. Celiac disease is the allergy to gluten. The relationship is probably due to the fact that it Celiac disease is the immune response to gluten while the IBD is the physical response to said allergy.
    Because of these studies conducted and the conclusions made, can we say that other diseases/food allergies/and intolerances (such as lactose intolerance) cause IBD as well?
    People with lactose intolerance also have an immune response to dairy products and lactose containing products. Patients exhibit certain bowel issues similar to IBD when they ingest lactose. Can we say that this sort of reaction can also lead to IBD?
    Can we also say that certain deprivation of certain foods can also cause IBD?

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  2. @ElizabethN495, lactose intolerance is not really an immunological disease. Lactose intolerance is actually due to the inability to produce lactase, a lactose enzyme. Thus, the digestion of lactose is left to bacteria in the intestines, causing the bloating, gas, digestive upset, etc.

    Actually, milk consumption is more or less associated with the incidence of irritable bowel syndrome (IBS), not IBD. IBS is associated with diseases that have a known irritant (i.e. milk). IBD is not associated with an irritant.

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  3. I think this is really interesting to think about! Especially the part where you said, "The results of these two studies are very interesting, because it seems like they are pointing towards a relation where those who have celiac’s are more likely to develop IBD than non-celiac patients, but IBD patients are less likely to develop celiac’s than the general population. "

    In Celiac Disease, I learned that the body has an allergy to gluten, but the immune system can also cross react with the lining of the intestines to cause damage. I was thinking that maybe the reason that people with celiac disease are more prone to IBD may be because their immune systems aren't working normally. IBD also has autoimmune undertones, so maybe those who have one type of autoimmunity (like celiac disease) may be more likely to have another autoimmune disorder because their immune system is working differently than a normal person's immune system. That said, I wonder why a person with IBD would not be prone to get celiac disease? The only reason why I can think of would be that celiac disease is associated with an allergy to gluten. If IBD patients don't already have that allergy, then they won't get celiac disease. Those are just my brainstorms!

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