What is the Difference Between Celiac Disease and Cystic Fibrosis

Celiac disease and cystic fibrosis are connected conditions. An estimate suggests that in Norway, 1 out of every 83 people with cystic fibrosis has celiac disease, and an estimate that in Poland, 1 out of every 50 people with cystic fibrosis has celiac disease. These reports suggest a connection between celiac disease and cystic fibrosis. People with cystic fibrosis often have celiac disease. Moreover, both conditions have overlapping symptoms, including lack of energy, weight loss, constipation, poor weight gain, and lack of growth.

The key difference between celiac disease and cystic fibrosis is the organs affected. Celiac disease affects the intestine of the gastrointestinal tract, while cystic fibrosis affects the lungs of the respiratory system, digestive system, and other organs of the body.

CONTENTS

1. Overview and Key Difference
2. What is Celiac Disease
3. What is Cystic Fibrosis
4. Similarities – Celiac Disease and Cystic Fibrosis
5. Celiac Disease vs Cystic Fibrosis in Tabular Form
6. Summary – Celiac Disease vs Cystic Fibrosis
7. FAQ – Celiac Disease and Cystic Fibrosis

What is Celiac Disease?

Celiac disease is a condition that triggers the intestine to have an immune reaction to gluten protein in food. Gluten can be found in foods like wheat, oats, barley, and rye. Celiac disease damages the small intestine over time. The typical symptoms of celiac disease include malnutrition, diarrhoea, fatigue, bloating, anemia, weight loss, constipation, abdominal pain, and loss of bone density. Celiac disease occurs in people who have normal gene variants such as DQ2 and DQ8, people who have a higher number of infections in early life, and certain digestive tract infections.

Figure 01: Celiac Disease

Celiac disease can be diagnosed through physical examination, serology testing, genetic testing, endoscopy, and capsule endoscopy. Furthermore, treatment options for celiac disease include following a strict, lifelong gluten-free diet, taking vitamin and mineral supplements, medications to control inflammations such as steroids, other drugs like azathioprine or budesonide, and dapsone for dermatitis herpetiformis.

What is Cystic Fibrosis?

Cystic fibrosis is a condition that causes serious damage to the lungs, digestive system, and other parts of the body. Cystic fibrosis affects the glands that produce mucus, sweat, and digestive juices. The mutated gene in this condition causes secretions to become sticky and thick. Therefore, these secretions plug up tubes, ducts, and passageways, mainly in the lungs and pancreas. Cystic fibrosis occurs due to a mutation in the transmembrane conductance regulator (CFTR) gene. Moreover, symptoms of this condition are persistent cough, wheezing, exercise intolerance, repeated lung infection, inflamed nasal passages, recurrent sinusitis, foul smelling, greasy stool, poor weight gain and growth, intestinal blockage, and chronic and severe constipation.

Figure 02: Cystic Fibrosis

Cystic fibrosis can be diagnosed through physical examination, blood test, and genetic test. Furthermore, treatment options for cystic fibrosis are medications such as antibiotics, anti-inflammatory drugs,  mucus-thinning drugs (hypertonic saline), oral pancreatic enzymes, stool softeners, acid-reducing drugs,  cystic fibrosis transmembrane conductance regulator (CFTR) modulators (elexacaftor, ivacaftor, and tezacaftor), airway clearance technique chest physical therapy (CPT), pulmonary rehabilitation, nasal and sinus surgery, oxygen therapy, non-invasive ventilation, feeding tube, bowel surgery, and lung transplantation.

Similarities Between Celiac Disease and Cystic Fibrosis

1. Celiac disease and cystic fibrosis are two associated medical conditions.
2. Both these conditions predominantly affect children.
3. They show overlapping symptoms such as lack of energy, weight loss, constipation, poor weight gain, and lack of growth.
4. Both these conditions can be diagnosed through physical examination and imaging testing
5. They can be treated through specific medications.

Difference Between Celiac Disease and Cystic Fibrosis

Definition

1. Celiac disease is a condition due to the immune system attacking its own tissues when people eat gluten-containing food.
2. Cystic fibrosis is a condition due to impairing of the normal clearance of mucus from the lungs, pancreas and other organs of the body.

Causes

1. Causes include normal gene variants such as DQ2 and DQ8, people who have a higher number of infections in early life and certain digestive tract infections.
2. The main cause is the gene mutation in the CFTR gene.

Symptoms

1. Diarrhoea, stomach aches, bloating, indigestion, constipation, tiredness, unintentional weight loss, problems getting pregnant, nerve damage, an itchy rash, ataxia, delayed growth, and puberty are the symptoms of Celiac disease.
2. Frequent lung infections, loose or oily poop, trouble breathing, frequent wheezing, frequent sinus infections, a nagging cough, slow growth, and failure to thrive are the symptoms of cystic fibrosis.

Diagnosis

1. Diagnosis can be made through physical examination, blood test, biopsy, and genetic test.
2. Physical symptoms evaluation, sweat test, genetic test, pulmonary function test, sputum test, pancreatic biopsy, nasal potential difference (NPD) and intestinal current measurement (ICM) are the diagnosis methods of Celiac disease.

Treatment

1. Celiac disease is treated by gluten-free diet, vaccination, vitamin and mineral supplements, dapsone for skin rash, steroid medicine such as prednisolone, or immunosuppressant medicine.
2. Cystic fibrosis is treated by airway clearance technique, taking CFTR modulators, antibiotics, anti-inflammatory drugs, pancreatic enzymes, stool softeners, nasal and sinus surgery, oxygen therapy, non-invasive ventilation, feeding tube, bowel surgery, and lung transplantation.

The following table summarizes the difference between celiac disease and cystic fibrosis.

Summary – Celiac Disease vs Cystic Fibrosis

Celiac disease and cystic fibrosis are two connected diseases that show overlapping symptoms, such as lack of energy, weight loss, constipation, poor weight gain, and lack of growth. However, celiac disease occurs when the immune system attacks the body’s own tissues in response to consuming gluten-containing foods like wheat, oats, barley, and rye. In contrast, cystic fibrosis is characterized by the impaired clearance of mucus from the lungs, pancreas, and other organs of the body. This is the basic difference between celiac disease and cystic fibrosis.

FAQ: Celiac Disease and Cystic Fibrosis

1. Which is the main cause of celiac disease?

• Celiac disease is caused mainly by having normal gene variants such as DQ2 and DQ8. The other risk factors include having more infections in early life and some digestive tract infections. All these trigger immune system to overreact when people consume foods contacting gluten protein.

2. What foods should celiac patients avoid?

• People with celiac disease should avoid mainly wheat, oats, barley and rye. The other products they should avoid include triticale, which a cross between wheat and rye, graham flour, farina, semolina, and any other type of flour, including self-rising and durum, not labeled gluten-free.

3. What is the main cause of cystic fibrosis?

• Cystic fibrosis is an autosomal recessively inherited disease caused by mutations in the CFTR (cystic fibrosis transmembrane conductance regulator). This gene gives instructions for the CFTR protein. Generally, those who inherit two copies of a mutated CFTR gene will have symptoms of cystic fibrosis.

4. What are 5 symptoms of cystic fibrosis?

• The main symptoms of cystic fibrosis may include recurring chest infections, difficulty putting on weight, frequent, wet-sounding coughs, diarrhea, occasional wheezing and shortness of breath.

5. What is the life expectancy for cystic fibrosis?

• The average life expectancy of a person with cystic fibrosis currently would be 50 years, and some patients with cystic fibrosis live into their 80s with proper disease management.

Reference:

1. “Celiac Disease.” NHS Choices, NHS.
2. “What Is Cystic Fibrosis?” Cleveland Clinic.

Image Courtesy:

1. “Celiac disease – high mag” By Nephron – Own work (CC BY-SA 3.0) via Commons Wikimedia
2. “Cystic fibrosis associated bronchiectasis. (52096764294)” By Atlas of Pulmonary Pathology from USA – Cystic fibrosis associated bronchiectasis. (CC BY-SA 2.0) via Commons Wikimedia

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