Crohn’s Disease vs. Lactose Intolerance : Differences Worth Knowing

Crohn’s disease and lactose intolerance are known to cause very similar types of digestive symptoms. These may include abdominal pain and diarrhea, amongst others. However, even though the symptoms may be similar, this does not mean that the causes of both these conditions and the treatment options are also the same. The causes and treatment of Crohn’s disease and lactose intolerance are very much different and doctors carry out a thorough comparison of the causes, risk factors, symptoms, diagnosis, and treatment options for both these conditions. Today we take a look at the similarities and differences between Crohn’s disease versus lactose intolerance and how to tell them apart.

Both of these conditions, Crohn’s disease and lactose intolerance, share many of the same symptoms and it is possible for a person to assume that they are suffering from one condition, while they might actually be suffering from the other. What complicates matters further is that people who have Crohn’s disease are likelier to suffer from lactose intolerance as well as compared to the general population.

So in order to understand both the conditions better, it is necessary to understand the similarities and differences between the two.

Crohn’s disease is a type of chronic inflammatory bowel disease (IBD) that is typically characterized by intestinal inflammation. If Crohn’s disease is not treated, then it can lead to serious disability or more illnesses. Crohn’s disease is a long-term condition and affects the digestive tract.

Lactose intolerance is a less serious condition than Crohn’s disease, but it is also a more common condition. Lactose intolerance occurs when a person is unable to digest a certain type of sugar known as lactose. Lactose is typically found in milk and a majority of dairy products. When individuals consume dairy products that contain lactose, they end up experiencing symptoms that are similar to Crohn’s disease.

Lactose intolerance is also known as lactase deficiency and it is known to cause severe digestive discomfort when people who are sensitive to the sugar lactose.

The exact cause of Crohn’s disease is not yet clear, but it is believed to be an autoimmune condition, meaning that the immune system starts attacking the healthy tissues in the body. Genetics and factors such as smoking or previous infection are also believed to be responsible for the development of Crohn’s disease.

Crohn’s disease can occur anywhere in the digestive tract, though it is known to most commonly impact the beginning of the colon or the small intestine. The inflammation that accompanies this condition is known to impact several parts of the digestive tract at the same time, and there are many types of varying symptoms.

Lactose intolerance is caused when a person’s body loses the ability to produce sufficient levels of the enzyme lactase. Lactase is found in the small intestine and is responsible for digesting the sugar lactose. As mentioned above, lactose is a sugar that is commonly found in dairy products such as milk.

Both of these conditions are known to impact the digestive system and there is quite an overlap in their symptoms. Both Crohn’s disease and lactose intolerance cause the following similar symptoms:

• Nausea
• Abdominal cramping and pain
• Diarrhea

Now let’s look at the symptoms that are specific to each condition.

Symptoms that are specific o only Crohn’s disease are:

• Anemia
• Loss of appetite
• Diarrhea, usually quite severe
• Mouth sores
• Malnutrition
• Rectal pain or tenesmus
• Unintentional weight loss
• Fatigue
• Fever
• Skin and eye irritation
• Redness of the skin and eyes
• Soreness and pain in the joints
• Bloody stool in some rare cases

If you do not receive proper and timely treatment for Crohn’s disease, then some additional symptoms may also occur. These include:

• Delayed puberty or stunted growth in children
• Inflammation around the eyes and skin
• Inflammation of the joints
• Inflammation in the bile ducts and the liver

Symptoms that are specific to lactose intolerance are:

• Vomiting
• Growling sound from the stomach
• Excessive gas or flatulence
• Bloating

These symptoms of lactose intolerance occur due to the fermentation process, which happens due to the bacteria present in the colon that works to break down the lactose. When the bacteria starts acting on the lactose sugar, it changes into an acid, which is what produces excessive gas.

Apart from the above-mentioned symptoms, the acid that is created in the colon can also cause a symptom of anal burning.

The symptoms of Crohn’s disease are likely to go into a period of remission, sometimes for a couple of weeks to even months, during which a person will experience very few or almost no symptoms of the disease.

On the other hand, a person suffering from lactose intolerance are likely to experience the symptoms of the condition each and every time they consume dairy products.

There are several risk factors associated with Crohn’s disease. These include:

• Having a family history of Crohn’s disease
• Smoking cigarettes
• Age – Crohn’s disease is likely to affect people under 30 years old, though it can happen at any age
• Ethnicity – This condition is more likely to occur in Jewish people of Eastern European descent. Caucasians are more likely to have Crohn’s than black people.
• Consuming a high-fat diet or a diet high in processed foods.
• Excessive use of antibiotics
• Infections of the digestive tract
• Taking oral contraceptives
• Appendix removal

The risk factors of lactose intolerance include:

Premature birth

A family history of lactose intolerance

Infections or conditions that are likely to cause injury to the small intestine, such as celiac disease and inflammatory bowel disease

Studies have observed that lactose intolerance occurs in nearly all people of Native American and Asian descent. It is also commonly occurring in people who have African, Ashkenazi Jewish, and South Indian ancestry.

Age is also a risk factor for lactose intolerance as with age, some people start to lose some parts of the lactase enzymes, making them less capable of easily digesting foods that contain lactose.

Apart from these risk factors, it has also been observed that lactose intolerance is more common in those who have Crohn’s disease, as compared to those who do not have Crohn’s. In spite of the findings, though, there is no guarantee that a diagnosis of Crohn’s disease means you will definitely develop lactose intolerance.

Lactose intolerance is not the same as having a food allergy, and it is not even a harmful situation, even for those who already have Crohn’s disease. However, lactose intolerance can add to an individual’s overall level of discomfort.

For most people who have lactose intolerance, it is possible for them to digest some amount of lactose. Though, just how much they can digest depends on the levels of lactase that is present in their body. For example, in some people the enzyme lactase might be inducible, meaning that if a person exceeds the lactose amount they can tolerate on a regular basis, then their body may respond to this situation by increasing the production of the lactase enzyme.

There is no specific test that a doctor uses to diagnose Crohn’s disease. When you go to the doctor, a variety of tests will be performed in order to rule out the potential causes of the symptoms. Some tests that are used to diagnose Crohn’s disease include:

Blood tests for ruling out anemia and underlying infections.

CT Scan for viewing the small intestine

Fecal occult blood test to check for the presence of hidden blood in the stool

MRI to look for fistulas, or any opening, in the small intestine

Colonoscopy to look for inflammatory cells that are known as granulomas. This can take place with or without a biopsy.

Esophagogastroduodenoscopy to look at the stomach, the food pipe, and the small intestine, through a small camera. Similar to a colonoscopy, it can be done with or without a biopsy.

Balloon-assisted enteroscopy to look deeper into the small intestine. This is usually the test that confirms the diagnosis of Crohn’s disease.

One of the easiest ways to diagnose lactose intolerance is to observe if your symptoms go away by avoiding dairy products such as cheese, milk, ice cream, yogurt, etc. If after one week you again consume some dairy product and you observe that the abdominal cramps and diarrhea has returned, then it is highly likely that you are lactose intolerant.

If you want to get a confirmed diagnosis of lactose intolerance, then you can always request your doctor to prescribe a lactose breath test. Lactose metabolizes in the colon instead of the small intestine, as it should under normal circumstances. When this happens, the bacteria release hydrogen into your blood. It is possible to measure this hydrogen in the breath. Therefore, people who are lactose intolerant tend to have a higher level of hydrogen in their breath.

The treatment for Crohn’s disease focusses on lowering the inflammation of the digestive tract and getting rid of the complications that may crop up over a period of time. There is presently no cure for Crohn’s disease and thus treatment centers on management of the symptoms, though there is a possibility of long-term remission.

Furthermore, the effectiveness of the treatments for Crohn’s varies from person to person. Some of the treatment options for Crohn’s disease include:

Antibiotics

Anti-diarrheals

Anti-inflammatory drugs

Immune system suppressors

A customized diet that is administered through a feeding tube, a process known as parenteral nutrition or nutrition therapy

Surgery in severe cases

In the severe cases of Crohn’s disease, doctors recommend surgery. Surgery will help in treating the complications that can prove to be fatal, such as intestinal blockages or internal bleeding.

Your doctor may also prescribe other medications for treating the specific symptoms of Crohn’s disease, such as:

loperamide for getting relief from diarrhea

acetaminophen for treating mild pain

Antibiotics for treating any underlying infections of the digestive tract

It is also recommended that a person suffering from Crohn’s disease carries out certain positive lifestyle changes that can have an impact on your life and also increase the effectiveness of the medical treatment. Stop smoking cigarettes in you smoke or if you use some other form of tobacco or nicotine. Also identify the food triggers that cause a flare-up of your symptoms, such as fiber or dairy products.

Crohn’s patients are also likely to experience many of the symptoms of lactose intolerance if they consume high-fat dairy products. Consuming low-fat dairy products may not cause a flare-up of symptoms. When you experiment with having different types of foods, it becomes easier to identify the specific food triggers.

At present, there are only two ways of treating lactose intolerance. One is by completely avoiding dairy products or, the second treatment is that you consume lactase enzymes in the form of a supplement available over-the-counter, such as Lactaid. If you decide to completely give up dairy products then it is necessary to supplement your diet with calcium and vitamin D tablets or supplement your diet with some non-dairy sources of calcium and vitamin D.

Vitamin D is primarily acquired from sun exposure and there are very few foods that contain vitamin D. These include:

• Egg yolks
• Liver
• Fatty fish such as salmon, mackerel, and tuna
• Foods that are fortified with vitamin D such as orange juice, soy milk, and some breakfast cereals

Meanwhile, some of the non-dairy sources of calcium include:

• Almonds
• Lentils
• Seeds such as chia and poppy seeds
• Sardines
• Beans
• Dark, leafy green vegetables such as kale and spinach

Both Crohn’s disease and lactose intolerance are health conditions that affect the digestive system and both conditions can cause similar symptoms. However, ultimately, the causes, risk factors, diagnostic processes, and treatment of both the conditions are different for each condition. Both of these are generally known to be lifelong conditions, though it is easier to manage lactose intolerance as compared to Crohn’s disease.

It is important to identify which condition you suffer from so that the correct treatment can begin. Without treatment, Crohn’s disease can prove to be a serious condition and over a period of time, it can become dangerous. Your doctor is the best person to help you determine which condition you are suffering from and then decide the correct course of treatment to manage your symptoms.