Gluten‐Free Diet in IBD: Time for a Recommendation?

Patients and providers alike are highly interested in identifying potentially useful dietary interventions in the management of inflammatory bowel diseases (IBD). This review examines the clinical associations of celiac disease (CeD), non‐celiac gluten sensitivity (NCGS), and IBD with a focus on ava...

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Bibliographic Details
Published in:Molecular nutrition & food research 2021-03, Vol.65 (5), p.e1901274-n/a
Main Authors: Weaver, Kimberly N., Herfarth, Hans
Format: Article
Language:English
Subjects:
Autoimmune diseases
Celiac disease
Crohn's disease
Diet
Gluten
gluten‐free diet
Inflammation
Inflammatory bowel disease
Inflammatory bowel diseases
Ingestion
Intestine
non‐celiac gluten sensitivity
Nutrient deficiency
nutrition
Permeability
Signs and symptoms
Ulcerative colitis
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Summary:Patients and providers alike are highly interested in identifying potentially useful dietary interventions in the management of inflammatory bowel diseases (IBD). This review examines the clinical associations of celiac disease (CeD), non‐celiac gluten sensitivity (NCGS), and IBD with a focus on available data of the therapeutic efficacy of gluten‐free diet (GFD) or low‐gluten‐containing diets in the therapy of IBD. There is a strong association between CeD and microscopic colitis, but the prevalence of CeD among IBD patients is similar to that of the general population. Interestingly, in cross‐sectional studies nearly one‐third of IBD patients report a diagnosis of NCGS, and many follow a GFD. Although animal studies have shown that gluten ingestion may promote intestinal inflammation and increase intestinal permeability, there have been no prospective studies evaluating the role of a GFD in the induction and maintenance of Crohn's disease and ulcerative colitis. Several cross‐sectional reports suggest that a GFD may improve symptoms in IBD patients, but due to a lack of high‐quality prospective clinical studies, current data do not support the universal use of a GFD in IBD. Nearly one‐third of patients with inflammatory bowel diseases (IBD) report a diagnosis of non‐celiac gluten sensitivity (NCGS), and many follow a gluten‐free diet. However, the scientific basis for such an approach is of low quality. This review examines the clinical associations of celiac disease, NCGS, and IBD with a focus on the therapeutic efficacy of gluten‐free or low‐gluten‐containing diets.
ISSN:1613-4125
1613-4133
DOI:10.1002/mnfr.201901274