Commonly avoided in IBD patients based on symptom relief
Microscopic colitis- around 50% also have celiac
With celiac- you will need to remove gluten to avoid GI damage.
Research is mixed, but growing support for temporary elimination in IBD as a whole
In microscopic colitis- more support for removal or testing for celiac

What we know about it

In some animal studies- increased risk for ileitis (last part of SI)
In animal studies- increased intestinal permeability (can be a risk factor for flare)
In 2020 a large study showed a 1.4 increased risk of colon cancer (proximal type)

Can a gluten free diet improve IBD symptoms?

One study found symptom improvement in 65% of the patients with IBD who tried a gluten free diet
In the same study, 40% reported less severe & frequent flares and less fatigue

Who should make changes?

Those that have Celiac should DEFINITELY avoid gluten containing foods
Those with Microscopic Colitis should have a celiac test and consider an elimination period without gluten since the rates are much higher in this group
Those with Crohn’s or Ulcerative Colitis should consider a trial elimination or just simply focus on including more gluten free grains (buckwheat, sorghum, millet, teff, rice, quinoa, oats etc)

The Bottom Line:

Symptom free doesn’t mean there isn’t inflammation present. Symptom improvement is only one goal, we would also like to see inflammation reduction too. More evidence is leaning towards gluten being a potential inflammatory trigger (even if it doesn’t trigger symptoms).

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