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Original Question:  "....when she (my niece) was younger she was
diagnosed with Crohn's Disease and a blockage was removed in her colon.
I believe she had to have part of her colon and small intestine removed.
I know sometimes Celiac disease is sometimes misdiagnosed as Crohn's.
What is your experience on this?  I know I don't have a lot of
information but I was wondering if anyone else knew anything about the
relationship between colon blockages and Celiac, if there is any.  If
there are any good websites that talk about this that I could point her
to, that would be helpful."


RESPONSES:

We do know that 1/4 of all celiacs react to gluten with constipation.
That could easily impact and cause a bowel blockage.

* * * * * * * * * * *

My daughter has Crohn's disease (age 12) and is also gluten intolerant
and follows a GF diet (she is anti-gliadin IgG positive, IgA negative,
never biopsied, extremely sensitive to gluten).

Here's my take on your questions, based on my own research since I've
been dealing with Crohn's for 4 yrs now.

Crohn's is an autoimmune disease that causes  swelling and inflamation
of part of the GI tract - most often the small intestine but it can be
anywhere from mouth to anus and often has a skipped appearance (some
bowel is fine, some is affected).  It is mostly inherited but is
believed to require an environmental trigger.

Celiac is also autoimmune and inherited.  As I'm sure you know, gluten
causes reversible damage to the villi.

Both celiac and Crohn's cause a characteristic appearance to the
intestine.  The changes to villi in Celiac Disease are usually only seen
by microscope (since villi are very small).  The damage of Crohn's
causes swelling and inflammation (red, swollen) to the full thickness of
the intestinal wall when moderate to severe.

Some people will have Crohn's in a single area which causes obstruction
(due to swelling); if this is removed surgically (as in your niece's
case) and the disease does not re-occur.  This is the exception -not the
rule.  Most folks with Crohn's have it their whole life; even if they
have surgery to remove severely damaged intestine (has a hole or is so
swollen that food

cannot pass thru) - the disease reoccurs in months.  Most Crohn's
sufferers are on powerful drugs for life (Prednisone, Imuran, 6MP).

My daughter's GI doc thought she may have become sensitive to wheat
because her intestine was so inflamed (with oozing sores) that gluten
was able to cross into her blood stream. Her body recognized it as a
'foreign protein' and formed antibodies.  She has attention deficit
disorder (ADD) and gluten sensitivity is much more common in these kids
- so maybe she just has a gene for  gluten sensitivity also - who knows!

I have never heard of colon blockages from celiac disease - except for
constipation, of course - but that does not require surgery.

I don't think there is that much chance of misdiagnosis in your niece's
case (if all the docs were competent and honest with her family) - since
they did surgery, they were able to visualize the intestine very well
and I'm sure sent tissue samples for pathology.  The slides should have
been pretty clear cut.  Of course, there are exceptions - but I'm just
sharing the usual course of things.

The website for the Crohn's & Colitis Foundation is www.ccfa.org.
There is some info there; I ordered a couple of books from their site
about kids & Crohn's disease - that's where I got most of my info.

* * * * * * * * * * *

I have Celiac Disease and in the past, oh...about 12 years I have had 3
bowel blockages. The first required surgery to straighten things out but
no bowel was removed. Since then I have had 2 other lengthy
hospitalizations for blockages but no surgery was required.

After my first bout, my gastroenterologist told me that celiacs can
develop something called a volvulus (or something like that) which means
the bowels can get kinked and double back and into other sections of the
bowel (not a very scientific description, I'm afraid). After I had the
surgery I discovered that I was celiac (the surgery caused the condition
to flair up) and I went on the GF diet. Apparently the diet has not
caused my tendency toward blockages to go away, but at least I can tell
when one is coming on and head to the emergency room.

I know many, many celiacs and none of them have had blockages...I guess
some of us are just lucky, huh?

* * * * * * * * * * * * * *

I had five small intestional obstructions one an intusseption that
Nearly ended my life and almost three ft were removed but when i finally
Got a diagnoses of celiac i haven't had any obstructions and i do feel
the DRs are saying people have Chrons when it's probably celiac and
that's so sad. Because my Diagnosis was so late i can't eat or drink and
i live on tpn

* * * * * * * * * * *

Most "blockages" are growths or tumors in the small or large intestine.
In someone who has had previous surgery(ies) then the problem is often
adhesions or scar tissue that grows to the extent that it "blocks" the
portion of the intestine above the blocked area.

Blockage from adhesion-type tissue can also result from severe Crohn's
which was not treated or which didn't respond to treatment -- would
expect this to be less likely in children who don't have years of damage
from Crohns dis. (or other diseases) to result in extensive "scarring".

These are the most common causes of blockages in intestines but there
are other causes which are more rare (like following an abdominal
injury.

If they did total or partial resection (removal) of colon or small
intestine, it's because total blockage of colon or intestine is
life-threatening - a very serious emergency needing immediate surgery.
Also they may have feared the blockage was pre-cancerous.

I believe Crohn's and Celiac are 2 separate GI disorders but it is
possible to be Celiac and have Crohn's at the same time.  Often Celiac
and Crohn's are mistaken for each other but biopsies, if carefully done,
should distinguish between the two.  IBS is a third GI disorder and it
is an overused diagnosis which too often is mistakenly given when Celiac
or Crohn's is the actual diagnosis.  Microscopic colitis is another GI
disorder and is believed to be carried on the HLA-DQ2 gene ( I have 2
copies of this gene and the information I gave here is mainly from Dr.
Fine's research and theory.  I got partial relief from eliminating
gluten -- but also had to eliminate all dairy, not just lactose but
casein and whey and other milk-proteins also to get relief.)   Fine's
website is www.finerhealth.com I think -- haven't checked it in awhile
but probably is the same.