Should You Go Gluten-Free for IBD?

So far, there’s not enough evidence to support a gluten-free diet for IBD, but some people — especially those who also have celiac disease — find it helps them feel better.

As the gluten-free diet has grown in popularity, more people with inflammatory bowel disease (IBD) have adopted it.

This makes sense: If you have IBD, then you’ve probably heard that changing your diet might help. The tricky part is that no one singular “IBD diet” exists, and navigating all the different possible diets or food triggers can feel overwhelming.

It’s no surprise that many people start by experimenting with eliminating gluten because it’s often the most familiar.

But is a gluten-free diet actually effective at reducing IBD symptoms or inflammation? Limited research suggests that it may, under very specific circumstances. Read on to learn more.

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First of all, what is gluten?

Gluten is a protein that is found in wheat, barley, rye, and foods derived from those substances. Some examples of foods that contain gluten include:

• bread
• pasta
• cakes
• beer
• soy sauce
• brewer’s yeast
• salad dressings

Gluten first fell out of favor when it was discovered to be a trigger for celiac disease, an autoimmune condition with some symptoms — like diarrhea and abdominal pain — that overlap with IBD.

Who needs a gluten-free diet?

In celiac disease, the body attacks the lining of the small intestine when someone consumes even trace amounts of gluten. Because of this, people with celiac disease must remove all gluten from their diets.

Over the past couple of decades, eating a gluten-free diet has become more popular, even among people without celiac disease. More and more people started removing gluten from their diets to treat various conditions and symptoms, although there was limited evidence to support this.

This included people with auto-immune diseases, including IBD.

The question remains: Do people with IBD truly benefit from eating gluten-free?

The connection between IBD and celiac disease

There’s definitely a connection between IBD and celiac disease, which could explain, in part, why some people with IBD feel much better on a gluten-free diet.

According to a 2020 study, people with celiac disease are nine times more likely than the general population to also have IBD, and people with IBD are four times more likely than the general population to also have celiac disease.

In addition, approximately one-third of people with IBD report having a diagnosis of non-celiac gluten sensitivity (NCGS), a condition whose existence is debated.

Can the gluten-free diet help if you have IBD without celiac disease?

Some research has attempted to examine the benefits of a gluten-free diet for people with IBD who do not have celiac disease.

A landmark 2014 study examined 1,647 people with IBD and their experience with a gluten-free diet. Of those people, 19.1% had tried a gluten-free diet and 8.2% were currently on it. Interestingly, the majority (65.6%) of people who had tried a gluten-free diet reported positive effects, including:

• reduced gastrointestinal symptoms
• improvement in fatigue
• fewer IBD flares
• less severe IBD flares

A smaller but more recent study found that about a quarter of people with IBD (23.6% of people with Crohn’s and 27.3% of those with ulcerative colitis) reported gluten sensitivity, with symptoms ranging from fatigue and bloating to abdominal pain, diarrhea, and blood in the stool after eating food with gluten. It was more common when people had had a recent IBD flare.

When it comes to more objective research — rather than people’s subjective opinions — the evidence is a bit less convincing.

A 2024 study examined the effects of a gluten-free diet on 26 adults with mild to moderate ulcerative colitis. It found that there was no effect on disease severity, quality of life, inflammatory indicators, or any other measure.

That study — like many others on this subject — was quite small, making it difficult to form conclusions.

There’s currently insufficient evidence that a gluten-free diet affects inflammation or mucosal healing among people with IBD, according to the International Organization for the Study of Inflammatory Bowel Diseases (IOIBD).

So … should you go gluten-free for IBD?

Given the lack of evidence, the IOIBD does not recommend that people with IBD make changes to the wheat or gluten content of their diets.

However, this doesn’t necessarily mean going gluten-free is a point-blank “no” for you. Though the current research is mixed, and limited, it’s still worth discussing with your healthcare professional, especially if you’ve never been tested for celiac disease.

One theory that scientists have is that people with IBD might feel better eating gluten-free because the gluten-free diet naturally removes many high FODMAP foods. The low FODMAP diet cuts out certain carbohydrates and may help reduce IBD symptoms (like diarrhea).

However, similar to the gluten-free diet, the low FODMAP diet does not appear to have an effect on inflammation.

One thing to keep in mind is that you should absolutely not start a gluten-free diet before being tested for celiac disease. The tests only work properly if you’re currently consuming gluten.

Downsides of a gluten-free diet

Gluten-free doesn’t automatically mean healthy.

Cutting out gluten often means removing important grains from your diet, which can lead to you eating less overall fiber. This is risky for people with IBD, because fiber can be anti-inflammatory and contribute to colon health.

The gluten-free diet is also associated with nutritional deficiencies, is expensive, and can make you feel isolated or excluded in social settings.

The takeaway

The bottom line is that there still isn’t enough evidence to support a gluten-free diet for people with IBD. That said, many people with IBD do say that a gluten-free diet is helpful for their symptoms.

Ultimately, your diet with IBD is a personal choice that you can collaborate on with your healthcare professionals. There’s no one “right” diet for IBD; rather it’s a process of trial-and-error to find what works best for you.