Inflammatory Bowel Disease

Gluten and IBD. Does it matter?

April 23, 2023

To be gluten free or not is a common question for patients with inflammatory bowel disease. Here’s the scoop!

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These are lifestyle changes. Not a diet. Not a pill. But the recipe to longevity.

As a gastroenterologist, I can tell you that there is some evidence to suggest that a gluten-free diet may have some benefits for people with inflammatory bowel disease (IBD).

Here are a few key points to consider:

Reduced inflammation:

Some studies have suggested that a gluten-free diet can help to reduce inflammation in the gut, which is a key factor in IBD. By eliminating gluten, which is a protein found in wheat, barley, and rye, some people may experience less inflammation and therefore, fewer symptoms.

Improved gut health:

Another potential benefit of a gluten-free diet for IBD is that it may help to improve the health of the gut microbiome. This is the collection of bacteria and other microorganisms that live in the gut and play a critical role in digestion and immune function. Some research has suggested that a gluten-free diet can help to promote a more diverse and healthy microbiome, which could in turn reduce inflammation and improve overall gut health.

Symptom relief:

Finally, some people with IBD may simply feel better on a gluten-free diet. While this is not true for everyone, some report that symptoms improve when they eliminate gluten from their diet. This may be due to a reduction in inflammation, improved gut health, or other factors.

Now, it’s important to note that a gluten-free diet is not a cure for IBD, and not all people with IBD will benefit from this approach. You may find that you are sensitive to gluten that is often found in processed foods. And in certain autoimmune conditions like Crohn’s and ulcerative colitis, being gluten free has been found to be helpful in managing symptoms, health, and possibly in managing overall inflammation.  So, if you have found that gluten containing products might be triggering symptoms, one thing to keep in mind and consider is, is it the gluten you are really sensitive to or the other ingredients in the processed foods you are eating? As you can see its not totally clear cut here, but gluten is certainly not the evil ingredient it has been made out to be. 

It’s also important to work with a registered dietitian to ensure that you are getting all of the nutrients you need if you decide to go gluten-free. With that said, if you’re interested in exploring this option further, I would recommend discussing it with your physician.

As for references, here are a few studies that may be of interest:

  1. Fasano A. et al. “Gluten, gut microbiota, and inflammatory bowel disease: a triple threat?” Cell Host Microbe. 2015; 17(3): 281-283.
  2. Eswaran SL, et al. “A randomized controlled trial comparing the low FODMAP diet vs. modified NICE guidelines in US adults with IBS-D.” Am J Gastroenterol. 2021; 116(2): 397-406.
  3. Ruemmele FM, et al. “Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease.” J Crohns Colitis. 2014; 8(10): 1179-1207.

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