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). There is a strong association between celiac disease (CeD) and microscopic colitis, but the prevalence of CeD among IBD patients is similar to that of the general population. Interestingly nearly one-third of IBD patients report a diagnosis of non-celiac gluten sensitivity (NCGS), and many follow a gluten-free diet (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 studies suggest that a GFD may improve symptoms in IBD patients, but available data do not support the universal use of a GFD. This review examines the clinical associations of CeD, NCGS and IBD with a focus on available data of the therapeutic efficacy of gluten-free or low gluten-containing diets such as the simple carbohydrate diet or a low FODMAP diet in the therapy of IBD. This article is protected by copyright. All rights reserved.