A celiac rash by another name?

Picture of an arm with a dermatitis herpetiformis rash

There are many things that can cause a rash. A gluten intolerance can cause a rash like the one above.
© Can Stock Photo

Dermatitis herpetiformis is a VERY itchy rash (more on that below), but it can also be an important clue to solving your IBS puzzle.

If you have IBS symptoms and an itchy, burning rash, you may have celiac sprue disease or some other gluten intolerance. Dermatitis herpetiformis is a rash that is closely tied with gluten intolerance and… Gluten intolerance can cause IBS symptoms.

You see where I’m going with this?

What is dermatitis herpetiformis?

Dermatitis herpetiformis starts out as a burning sensation on the skin. Then itchy little blisters appear. These blisters often burst or get scratched open because the skin is so irritated and itchy. Be careful, this can lead to infection. While the blisters and scabs heal, new ones usually show up, and the cycle continues.

Dermatitis herpetiformis usually appears on:

  • Elbows
  • Back
  • Buttocks
  • Knees
  • Back of the head

But it can show up in other places (such as hands). Often people that have this will get an instant diagnosis of excema.

What causes dermatitis herpetiformis?

One very common cause of dermatitis herpetiformis is a problem digesting gluten, which is a protein found in many grains.

In fact dermatitis herpetiformis is often called other names like celiac rash, or gluten rash. One reason I keep using the technical name is because gluten or celiac sprue are not ALWAYS the cause.

If you have IBS symptoms like cramping, chronic diarrhea, chronic constipation and also have the skin rash described above, there’s a good chance you have gluten intolerance or celiac sprue disease.

What is Gluten Intolerance?

Intestines and Words of Celiac Condition Sketched on a Blacboard

Celiac can be a complicated issue. Only your doctor can tell for sure if you have it!
© Can Bigstock.com

Whew! That’s a huge topic. Here is the short answer:

Gluten is a protein found in wheat, rye, and barley. That means it’s in bread, flour, muffins, etc., most beer, the list seems endless. It’s not in fruits, vegetables or meat (unless it’s added).

When a person has a gluten intolerance that person’s body can’t digest the protein (gluten). Instead, the person’s body attacks the protein (an immune system response). Because the protein is stuck to parts of the intestinal tract, the person’s bowels can be irritated, inflamed and damaged by eating gluten. This can lead to all kinds of IBS symptoms. It can also cause anemia and other vitamin deficiencies because the damaged bowels don’t absorb food properly.

IMPORTANT: Don’t stop eating gluten right away unless your doctor tells you to. There is a test for gluten intolerance. The doctor can run tests for certain antibodies (part of the immune system). If you stop eating gluten for a while, then get tested, the test will say you don’t have the antibody.

Many people don’t have these gluten antibodies, but still have problems with gluten! AFTER your gluten antibody tests, you can try a food elimination diet or food challenge diet. In other words you can try completely avoiding gluten for a little while and see what happens. Some people’s symptoms clear right up, other people continue to have problems.

Sorry, I guess that answer wasn’t very short after all. Take heart, it could have been MUCH longer :).

What can you do about dermatitis herpetiformis?

Skin with a dermatitis herpetiformis rash

ITCH ITCH ITCH! Is it a gluten allergy? Is it Celiac Sprue?
© Can Stock Photo

If you try a gluten challenge diet (eliminating gluten for a while) and the rash goes away; then try some food that contains gluten and the rash comes back… Well that’s probably your answer. The gluten is the problem. If that happens you’ll probably have to permanently avoid gluten containing foods. It’s probably a good idea to work with a dietitian so you get enough vitamins and minerals, etc.

If gluten was causing your IBS symptoms, and those go away too, so much the better (I haven’t eaten gluten for years!).

Otherwise… There are other kinds of food intolerance that can cause a dermatitis herpetiformis rash or something that looks similar. These foods may also be causing you stomach or bowel upset. Your best resource to figure all this out is your doctor. If your current doctor “writes off” your symptoms, you may need to find another one.

There are also medications, and antibiotics that your doctor can prescribe to help this agony. That’s why it’s important to find a doctor who takes celiac sprue or gluten intolerance seriously.

Dermatitis Herpetiformis Statistics in the United States:

In the U.S. it is estimated that:

  • 1 in 10,000 have dermatitis herpetiformis
  • Men get it twice as often as women
  • White (caucasion) people are much more likely to get dermatitis herpetiformis than Black or Asian people.