Which statement correctly distinguishes celiac disease and inflammatory bowel disease?

• A. Celiac disease is gluten-sensitive enteropathy with anti-TTG IgA; IBD is autoimmune intestinal inflammation; diagnosed via serologies and intestinal biopsy with colonoscopy.
• B. IBD is gluten-sensitive enteropathy with anti-TTG IgA; celiac disease is diagnosed by colonoscopy alone.
• C. Both diseases are diagnosed by symptoms only.
• D. Gluten-free diet is used to manage IBD, not celiac disease.

Answer: (A)

Distinguishing these two conditions rests on their cause, typical diagnostic tests, and treatment focus. Celiac disease is a gluten-triggered autoimmune enteropathy. The immune reaction targets gluten, with anti-TTG IgA antibodies commonly used in screening and small-bowel biopsy showing villous atrophy and crypt hyperplasia to confirm the diagnosis. The mainstay of treatment is a strict lifelong gluten-free diet to allow mucosal healing.

Inflammatory bowel disease, including Crohn disease and ulcerative colitis, is a chronic inflammatory disorder of the GI tract driven by immune dysregulation. It is not defined by a gluten sensitivity. Diagnosis relies primarily on endoscopic evaluation with mucosal biopsies to characterize the pattern and extent of inflammation and distinguish Crohn’s from ulcerative colitis; serologies can be supportive but are not definitive. Treatment centers on anti-inflammatory and immunomodulatory therapies, with diet playing a supportive role rather than being the primary driver of disease control.

So, the statement correctly reflects that celiac disease involves gluten-triggered autoimmunity with anti-TTG IgA, that IBD is an autoimmune-like inflammatory condition of the gut, and that their diagnostic approaches involve serology and biopsy with colonoscopy for the inflammatory disease, while confirming celiac disease involves small-bowel biopsy.