Irritable bowel syndrome (IBS) and celiac disease are conditions that affect the digestive system. However, while IBS is a group of symptoms that affect digestive function, celiac disease is an autoimmune disorder.

People with celiac disease react specifically to gluten, which can cause severe symptoms and potentially damage the intestines over time.

IBS can also disrupt people’s lives to a significant degree, but the underlying cause is often less clear. Some people have specific triggers, but they can vary between individuals, as can the treatments that help.

This article compares IBS and celiac disease, covering their causes, triggers, and treatments.

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IBS and celiac disease are conditions that affect the digestive system. They share some overlapping symptoms, such as abdominal discomfort and altered bowel movements. However, they are fundamentally different in their nature and how they affect the body.

IBS is a chronic conditionTrusted Source that affects how the digestive system functions. It causes recurring abdominal pain and bowel habit changes, such as diarrhea, constipation, or a mix.

Various factors contribute to IBS, including stress, hormonal changes, and sensitivity to certain foods, but evidence does not link it to a specific genetic component or autoimmune reaction.

In contrast, celiac disease is an autoimmune conditionTrusted Source in which the ingestion of gluten triggers an immune response that affects the small intestine’s lining. This response leads to inflammation and damage to the villi, tiny fingerlike projections that absorb nutrients.

Celiac disease is genetic, meaning it tends to run in families and is more likely to occur in individuals with specific genes, such as HLA-DQ2 or HLA-DQ8. Managing celiac disease requires a strict, lifelong gluten-free diet to prevent further intestinal damage.

It is possible to have both celiac disease and IBS at the same time. A 2022 study found that half of participants diagnosed with celiac disease had IBS-like symptoms even after following a gluten-free diet for at least 1 year.

Learn more about the genetic links to celiac disease.

It is not always possible for a layperson to tell the difference between IBS and celiac disease.

Some people who find their symptoms only occur when they eat gluten-containing foods may think their symptoms are due to celiac disease. But there are other reasons this could occur.

For example, people can have nonceliac gluten sensitivity or an allergy to wheat. These are distinct conditions that may appear similar to celiac disease.

As a result, a doctor needs to evaluate a person to determine the cause of their digestive symptoms.

Diagnosing IBS vs. celiac disease

To diagnose IBS or celiac disease, a doctor will ask a person about their symptoms, medical history, and family history. They may also perform a physical examination of the abdomen and recommend diagnostic tests.

Celiac disease diagnosis often reliesTrusted Source on blood tests that detect specific antibodies, such as tissue transglutaminase and endomysial antibodies.

If these tests suggest an immune response to gluten, the next step traditionally is for surgeons to perform a small intestine biopsy to confirm the diagnosis. However, some guidelines say this is unnecessary if a person has positive antibody tests.

Sometimes, especially if a person has been on a gluten-free diet, a gluten challenge — where the person reintroduces gluten into their diet for a specified period — may help ensure accurate results.

There is no specific, widely available test for IBS, so doctors make this diagnosis after ruling out other possibilities.

Learn more about tests and IBS.

Another distinction between IBS and celiac disease is their symptoms. IBS flare-ups cause primarily digestive symptoms, includingTrusted Source:

  • abdominal cramping
  • bloating
  • excess gas
  • diarrhea
  • constipation

In celiac disease, the immune reaction gluten causes can trigger similar digestive symptoms, as well as nausea or vomiting.

However, unlike IBS, the symptoms of celiac disease often extend beyond the digestive tract and may also causeTrusted Source:

A person with IBS could also potentially develop fatigue, anemia, or weight loss as a complication of frequent diarrhea or dietary restrictions, but this is not a core feature of the condition.

Celiac disease occurs due to an immune reactionTrusted Source to gluten. It has strong links to HLA-DQ2 or HLA-DQ8 genes, which most people with celiac disease have.

Environmental factors may also play a role, such as early exposure to gluten or certain gastrointestinal infections that could activate the immune response.

In contrast, IBS has no single known cause. Instead, experts believe it results from a combination of factors. These may includeTrusted Source:

  • abnormalities in the way the muscles in the intestine contract
  • heightened sensitivity to pain from gut distension
  • changes in the gut microbiota
  • food intolerances
  • psychological factors such as stress or anxiety
  • hormonal changes
  • genetics

Gluten is the primary and most critical trigger for celiac disease. Foods containing wheat, barley, or rye can cause immediate and severe reactions, even in trace amounts.

However, triggers for flare-ups can vary much more widely in IBS. Some people with IBS also have difficulty digesting wheat, barley, or rye, but this may not necessarily be due to gluten.

Other potential triggers can includeTrusted Source:

Stress and anxiety are also potential triggers, as are hormonal changes, such as those related to the menstrual cycle.

However, it is important to note that not everyone will react to all these triggers. Part of managing IBS involves a person identifying the triggers in order to reduce symptoms.

Learn more about the causes and triggers of IBS.

Managing IBS involves a combinationTrusted Source of dietary changes, medications, and lifestyle adjustments.

Dietary changes such as a low FODMAP diet may help alleviate symptoms. FODMAPs are carbohydrates that trigger IBS symptoms in some people.

Medications may include antispasmodics to reduce cramping, laxatives for constipation, or antidiarrheal drugs. Stress management techniques or treatment for coexisting mental health conditions may also benefit some people.

Managing celiac disease requires strict, lifelong adherence to a gluten-free dietTrusted Source to avoid triggering symptoms and further damage to the intestines.

It involves avoiding all foods and products containing wheat, barley, and rye. If a person’s intestine has received significant damage or nutrient absorption is impaired, they may require supplements such as iron, calcium, and vitamin D.

Despite sharing some overlapping symptoms, IBS and celiac disease are fundamentally different in their causes, triggers, and treatments.

IBS is a functional disorder that requires a personalized approach to managing symptoms. In contrast, celiac disease is an autoimmune condition that necessitates a strict gluten-free diet to prevent further harm.

Distinguishing between these conditions is crucial for effective treatment and improving the quality of life for those affected.

IBS resources

Visit our dedicated hub for more research-backed information and in-depth resources on irritable bowel syndrome (IBS).