Prevalence of a gluten-free diet and improvement of clinical symptoms in patients with inflammatory bowel diseases

Inflamm Bowel Dis. 2014 Jul;20(7):1194-7. doi: 10.1097/MIB.0000000000000077.

Abstract

Background: Maintaining a gluten-free diet (GFD) without an underlying diagnosis of celiac disease has enjoyed widespread acceptance in the Unites States.

Methods: We performed a cross-sectional study using a GFD questionnaire in 1647 patients with inflammatory bowel diseases (IBD) participating in the CCFA Partners longitudinal Internet-based cohort.

Results: A diagnosis of celiac disease and non-celiac gluten sensitivity were reported by 10 (0.6%) and 81 (4.9%) respondents, respectively. Three hundred fourteen (19.1%) participants reported having previously tried a GFD and 135 (8.2%) reported current use of GFD. Overall 65.6% of all patients, who attempted a GFD, described an improvement of their gastrointestinal symptoms and 38.3% reported fewer or less severe IBD flares. In patients currently attempting a GFD, excellent adherence was associated with significant improvement of fatigue (P < 0.03).

Conclusions: In this large group of patients with IBD, a substantial number had attempted a GFD, of whom the majority had some form of improvement in gastrointestinal symptoms. Testing a GFD in clinical practice in patients with significant intestinal symptoms, which are not solely explained by the degree of intestinal inflammation, has the potential to be a safe and highly efficient therapeutic approach. Further prospective studies into mechanisms of gluten sensitivity in IBD are warranted.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Celiac Disease / diagnosis
  • Celiac Disease / diet therapy
  • Chi-Square Distribution
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / diet therapy
  • Crohn Disease / diagnosis
  • Crohn Disease / diet therapy
  • Cross-Sectional Studies
  • Diet, Gluten-Free / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammatory Bowel Diseases / diagnosis*
  • Inflammatory Bowel Diseases / diet therapy*
  • Male
  • Middle Aged
  • Patient Satisfaction / statistics & numerical data
  • Prevalence
  • Risk Assessment
  • Severity of Illness Index
  • Statistics, Nonparametric
  • Surveys and Questionnaires*
  • Treatment Outcome
  • Young Adult