For some people with ulcerative colitis (UC), consuming gluten can trigger or worsen symptoms like abdominal pain, bloating, and diarrhea, potentially leading to more frequent or severe flare-ups.
While not everyone with UC is affected by gluten, a significant number experience digestive issues or increased symptoms when they consume it. Gluten is a protein found in wheat, barley, and rye, and it is common in foods such as:
- flour
- bread
- cereal
- pasta
- baked goods
- biscuits
- beer
Manufacturers often use it to thicken or stabilize food and non-food products such as cosmetics.
One way to manage UC symptoms is to avoid trigger foods. People with UC develop hypersensitivity to certain foods, and gluten commonly triggers symptoms. Following a gluten-free diet may help.
This article discusses the link between gluten and UC flares, what a gluten-free diet entails, and how to begin a gluten-free diet.
UC is a form of inflammatory bowel disease (IBD), characterized by inflammation in the colon and rectum. Another form of IBD is Crohn’s disease.
Gastrointestinal (GI) symptoms may occur with UC, such as diarrhea and abdominal pain.
Long-term medical treatment is twofold: Maintain remission — a period without symptoms — to prevent further flares of symptoms, or manage flares until symptoms enter remission.
Depending on symptoms and the medications, a doctor may also recommend dietary changes.
Common dietary modifications involve
People with UC are more sensitive to certain foods, such as gluten, which cause diarrhea, abdominal bloating, and pain. Research has identified several ways that gluten might trigger symptoms:
- Gut microbiome: The gut microbiome of people with UC may react differently to gluten, potentially causing excess gas production and leading to discomfort and diarrhea..
- FODMAPs: Foods containing gluten often contain FODMAPs (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols), which can cause digestive problems in people with IBD.
Not everyone with UC is sensitive to gluten. For those who are, the mechanisms above could play a role.
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Common symptoms included:
Similarly, in cross-sectional studies
People with UC may benefit from a gluten-free diet. Gluten is a
A person following a gluten-free diet can choose from many naturally gluten-free food options:
- gluten-free grains such as gluten-free oats
- carbohydrate sources such as sweet potatoes, brown rice, quinoa, and butternut squash
- nuts, seeds, nut butter, and nut flours such as almond flour, in place of wheat flour
- fresh and frozen fruits and vegetables
- animal and plant-based protein sources such as chicken, meats, fish, and lentils
- healthy fats such as olive oil, avocado, and Greek yogurt
Current data does not support the universal use of the diet for people with UC owing to the lack of clinical trials.
A person can work with a healthcare professional to devise a plan to eliminate gluten from their diet for a set time to determine if it helps reduce symptoms.
Before switching to the diet, a person should discuss it with their doctor. Before recommending the diet, the doctor may check them for celiac disease and talk with them about common sources of gluten and how to check food labels.
Moreover, partnering with a dietitian or nutritionist ensures the person receives balanced nutrition.
The following resources provide relevant information about a gluten-free diet, including diet plans:
No single diet will relieve symptoms for everyone with UC. However, by keeping a food diary, people can document how their bodies tolerate certain foods.
A gluten-free diet may have downsides. Prohibited grains can be a great source of dietary fiber as they contain essential nutrients and vitamins. Following a strict gluten-free diet long term may lead to nutritional imbalances, such as low fiber and complex carbs, high fat, sugar, and deficiencies in iron, calcium, vitamins D, E, and B.
Based on a
There is an overlap between UC and other autoimmune digestive conditions, such as celiac disease.
UC and celiac are both autoimmune diseases where certain factors cause an autoimmune response, resulting in gastrointestinal symptoms such as stomach pain and diarrhea. However, celiac disease affects the small intestine, while UC affects the large intestine and rectum.
More importantly, gluten is the only trigger for celiac disease. In contrast, many foods can
- dairy products
- refined sugar
- beverages
- spicy food
- certain fruits such as grapes and melon
- high fiber
However, UC and celiac disease can occur together.
Unlike UC and celiac disease, a person with gluten sensitivity does not experience gut inflammation and damage or trigger the production of antibodies against gluten.
A gluten-free diet excludes all foods containing gluten. It is the only treatment for celiac disease. People with the following conditions may also need to follow a strict gluten-free diet:
- dermatitis herpetiformis (DH) — an extraintestinal manifestation of celiac disease
- wheat allergy
- gluten ataxia — a neurological manifestation of celiac disease
A 2021 review found that a gluten-free diet can suppress harmful gut symptoms in people with non-gluten-dependent diseases, such as type 1 diabetes and rheumatoid arthritis.
A gluten-free diet may also effectively reduce seizure frequency or the need for drugs in people with epilepsy.
A gluten-free diet may help people with UC in the following ways:
- improve gut health
- reduce overall symptoms and need for medications
- improve overall quality of life
Many people with IBD and gluten sensitivity may need to be on a gluten-free diet indefinitely to prevent symptoms.
People may also consider restricting other foods from their diet, alongside gluten, based on how foods affect their symptoms. Other examples of diets include the specific carbohydrate diet or the paleo diet, which focuses on whole, minimally processed foods.
Many people with IBD find that removing gluten from their diets improves their symptoms. However, experts designed the gluten-free diet to treat celiac disease and other conditions that present with gluten sensitivity.
There are limited high quality studies on the diet’s benefits for IBD, specifically UC. However, some evidence suggests that a gluten-free diet may be beneficial for some people with UC.
A person with IBD considering a gluten-free diet should seek the advice of their doctor or dietitian before they start. Communicating with medical professionals will ensure they receive proper guidance about the diet and how to maintain balanced nutrition.