Could a Gluten-Free Diet Help You Manage Crohn’s Disease?

Because Crohn's disease is an inflammatory bowel disease (IBD), that means the condition involves chronic inflammation in the digestive tract, and it's possible that certain foods could worsen symptoms.

That's why it's helpful for individuals to track which foods tend to cause issues, and for some people, gluten might be on that list. This protein, found in wheat, barley, and rye, may prompt reactions for some people, including certain digestive issues that can worsen Crohn's symptoms.

“Those with Crohn's disease may also have celiac disease or a gluten sensitivity,” says Nayana George, MD, a gastroenterologist at Orlando Health Digestive Health Institute in Florida. “If that's the case, you would definitely benefit from a gluten-free diet. However, it's not an absolute must if you only have Crohn's, and in some cases, eliminating gluten completely may lead to nutrient deficiencies. That's why it's important to weigh the benefits with the potential drawbacks.”

The American College of Gastroenterology, a leading professional organization of gastroenterologists, does not currently recommend a gluten-free diet to treat Crohn’s disease, says Dr. George. However, it does suggest that some individuals may experience symptom improvement with a gluten-free diet, she says.

• Red, processed, fatty meats
• Lactose-containing dairy
• High-fat foods
• High-fiber foods
• Raw nuts and seeds
• Spicy foods
• Alcohol and caffeinated beverages
• Sugar

”Any improvement from cutting gluten might come from reducing processed foods that may cause digestive discomfort,” says Ali McGowan, RD, a Boston-based dietitian at Sprout Out Loud and creator of the Sprout Out Loud Podcast, a series addressing nutrition and behavior change.

“Without a clear medical reason, it might also make eating feel more stressful or limiting,” says McGowan. “It’s important to focus on what makes you feel your best. Working with a professional can help you avoid unnecessary restrictions and explore other helpful options that have stronger evidence for Crohn’s.”

For some with Crohn's, eliminating or minimizing gluten may lead to fewer symptoms, but it's possible that might be happening as a result of an undiagnosed gluten sensitivity, says George. If there's a considerable improvement, you may be dealing with celiac disease, an autoimmune condition triggered by gluten that requires a strict gluten-free diet for life. See your doctor for a diagnosis if you think you may have either of these conditions.

“If you're finding that you feel better on a gluten-free diet, it's very important to rule out sensitivity or especially celiac disease, because that can help you manage your Crohn's more effectively,” she says.

“Testing for celiac disease may become challenging if you’ve already stopped consuming gluten, so it's recommended to continue eating gluten products until after you've had those tests,” George says.

If you do get tested and find out you don't have a gluten sensitivity or celiac disease, but that continuing to eat gluten prompts symptoms, then at least you know it's those foods that are problematic for you personally — and not an underlying secondary condition.

If you’re thinking about trying a gluten-free diet, it’s a great idea to start by chatting with your gastroenterologist and a registered dietitian, says McGowan.

“A dietitian can support you in making sure your diet stays balanced and nutrient-rich,” she says. “Keeping track of how you feel during the trial can help figure out if gluten really affects your symptoms.”

Focusing on nutrients while ditching gluten is crucial because many gluten options provide thiamine, vitamin A, folate, magnesium, iron, and calcium, George says. Gluten-free diets can also cut down on your consumption of fiber, which may already be low with Crohn's if you're avoiding high-fiber vegetables that may worsen your symptoms.

“With fiber that goes too low, you could be at risk for impaired nutrient absorption and further aggravate nutritional deficiencies,” she says.

• Some people with Crohn's may have increased symptoms with gluten, but there's no evidence that everyone with the condition should be on a gluten-free diet.
• Those with Crohn's have higher risk of gluten sensitivity and celiac disease, which may be the reason gluten becomes a problem.
• If you're considering cutting gluten and you have Crohn's, it's recommended that you get tested for celiac disease first.