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

Molecular nutrition & food research
March 1, 2021
Kimberly N Weaver et al. (2 authors)
Journal ArticleReviewHuman Study
Study Details

Study Goal

The researchers aimed to evaluate the therapeutic efficacy of gluten-free or low-gluten diets in managing inflammatory bowel diseases (IBD) by examining clinical associations with celiac disease and non-celiac gluten sensitivity.

Results Summary

The study found no prospective evidence supporting the universal use of a gluten-free diet (GFD) for IBD, though cross-sectional reports suggest symptom improvement in some patients. Animal studies indicate gluten may promote intestinal inflammation, but human clinical data are lacking.

Population

Patients with inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, as well as those with celiac disease (CeD) or non-celiac gluten sensitivity (NCGS).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (5)
InterventionDirectionEndpointPopulationDosageImpactClaim #
gluten-free diet (GFD)
decrease
symptoms
IBD patients
-
may improve symptoms
#1
gluten ingestion
increase
intestinal inflammation
-
-
may promote
#2
gluten ingestion
increase
intestinal permeability
-
-
increase
#3
gluten-free diet (GFD)
no change
induction and maintenance of Crohn's disease and ulcerative colitis
-
no prospective studies
no prospective studies evaluating the role
#4
gluten-free diet (GFD)
no change
use in IBD
IBD patients
-
current data do not support the universal use
#5
Abstract

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.

Medical Subject Headings (MeSH)
Celiac DiseaseDiet, Carbohydrate-RestrictedDiet, Gluten-FreeHumansInflammatory Bowel Diseases
Study Links
Quality Scores
SafetyNot Assessed
Efficacy50/10
Quality60/10
Citation Metrics
Total Citations29
Citations/Year7.3
Relative Citation Ratio2.80
NIH Percentile83.4%
Research Impact Scores
APT Score0.75
Weight Score2.26
Normalized Score0.52
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