Should I follow a gluten free diet with Ulcerative Colitis?

Research summary of a recently published paper: Short-term effect of gluten-free diet on disease severity, quality of life, and inflammatory markers among patients with mild to moderate ulcerative colitis: A triple-blind randomized placebo-controlled trial


Background

Diet is an important underlying factor in ulcerative colitis (UC).

This study aimed to investigate the effect of a gluten-free diet (GFD) on disease severity, quality of life, and inflammatory markers in patients with UC.


The Study

This study was a triple-blind randomized placebo-controlled clinical trial. Lets break that down:

  • triple-blind - the patients, clinicians and the people carrying out the statistical analysis do not know which treatment patients had which helps make the results more reliable.

  • randomised - patients were put in the treatment or control group at random which again helps increase the reliability of results.

  • placebo-controlled - one group of patients received the gluten free diet, and the other group received a placebo diet, everything else in the study is kept the same between the groups, so any differences in the results can be attributed to the treatment diet, again increasing the reliability of the results.


Who, what, how

Who was studied: 26 patients with mild to moderate UC

Intervention: gluten free diet or placebo

What was tested:

Before and after the intervention patients had the following tests done:

  • erythrocyte sedimentation rate (ESR) - blood test marker for inflammation

  • C-reactive protein (CRP) - another blood test marker for inflammation

  • fecael calprotectin - marker for inflammation in the stool

  • disease severity - gauged using a validated tool

  • quality of life - gauged using a validated tool

Length of study: six weeks and were evaluated before and after the intervention.


Results

No statistically significant improvement was seen with the GFD for blood markers for inflammation, disease severity, or quality of life. Faecal calprotectin was increased in both groups but this wasn’t statistically significant.


Conclusions/Takeaway

This study could not find any significant positive or negative effects of a GFD on inflammatory markers, quality of life, and disease severity among patients with mild to moderate UC.

The guidelines we have already (ECCO, BDA, AGA, IOIBD) suggest that a GFD is not necessary for patients with IBD and this study reinforces this.

We routinely would not recommend a GFD to our patients, however, we do see and understand that some patients feel better on a GFD. This may be because many patients with IBD have overlapping IBS and a GFD has been shown to be helpful in reducing bowel symptoms in some patients with IBS. This is why we take each patient on a case by case basis and guide patients according to their disease and personal experience with food.


Limitations/Future Studies

This was a small and short but well designed study. There is a need for further investigations with larger sample sizes and longer follow-ups as clinical trials and cohort studies to obtain more reliable results. and to be able to say whether a GDF is safe and beneficial for UC patients.


If you would like support with your IBD, we can help you.

We are a nutrition and dietetics clinic specialising providing exceptional care to improve the quality of life of people living with IBD. We bring clarity around food and IBD and remove uncertainty and fear around food.

Our IBD specialist Nutritionist (Clemmie) and specialist gastroenterology and IBD Dietician (Jess) both have IBD too so ‘get it’ and are so passionate about helping others with IBD.

If you would like support with your IBD please book a free initial call via the button below so we can find out more about you, discuss how we can help and take you through our appointment options.

Disclaimer: All content found on the nalmclinic.com website, including: text, video, or other formats have been created for informational purposes only. The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your doctor, consultant or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.

We are all wonderfully unique and what works for one person may not work for another so please seek help and advice before changing your diet to work out the right way forward for you.

Clemmie Macpherson