A gluten-free diet may be beneficial in relieving symptoms in people with UC. However, certain prohibited grains are a source of essential nutrients. A person must speak with a doctor to ensure they do not have any deficiencies when following restrictive diets.
One way to manage UC symptoms may be to follow a specific diet designed to reduce flares. An example of this is a gluten-free diet.
Many foods contain gluten, including:
- baked goods
Manufacturers often use it to thicken or stabilize food and non-food products such as cosmetics.
This article explores UC and what a gluten-free diet entails, its association with UC, and how to begin a gluten-free diet. It also differentiates UC from other conditions that entail following 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
Read more about foods to avoid for a person with ulcerative colitis.
One example of diet doctors use to treat UC is 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
Common symptoms included:
- abdominal pain
- blood in stool
Similarly, in cross-sectional studies
However, current data does not support the universal use of the diet for people with UC, owing to the lack of clinical trials.
The link between IBD and gluten-free diet
The link between IBD and a gluten-free diet may also relate to the association of IBD with celiac disease. People with IBD are at an increased risk of celiac.
However, more research is needed to make more definitive conclusions regarding diet. The International Organization for the Study of Inflammatory Bowel Disease states that there is insufficient evidence to restrict wheat and gluten in all people with IBD.
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
- 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.
Doctors can request tests for UC to help rule out other IBDs such as Crohn’s and check for possible complications, using:
- imaging scans
- blood tests
- stool studies
The primary way to diagnose UC is through endoscopy or colonoscopy.
A doctor will take a tissue sample from the person for laboratory analysis during the procedure.
Read more about the diagnosis of UC.
Celiac disease diagnosis
Meanwhile, blood tests that look at specific antibody proteins against gluten can diagnose celiac disease. Doctors perform these tests before a person starts following a gluten-free diet.
Most doctors will check a person for celiac disease. If tests are negative, the doctor may ask the person to follow a gluten-free diet for several weeks and rate their symptoms.
Similar to UC, doctors will also recommend an endoscopy to diagnose celiac disease. They may also take a biopsy to analyze for signs of disease or infection.
If a doctor suspects dermatitis herpetiformis, they may take a skin biopsy to check for celiac disease.
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)
This condition is an extraintestinal manifestation of celiac disease. It causes an itchy and blistering rash to appear on the skin.
If a person with a suspected wheat allergy has exposure to wheat, they may experience symptoms such as nasal congestion, hives, diarrhea, and vomiting. In some cases, anaphylaxis can occur. People should seek immediate medical treatment if they are experiencing difficulty swallowing or breathing.
Strict wheat avoidance can pose a challenge for some people due to its presence in many foods. There is also a risk of traces in foods and other products.
Currently, experts are also supporting alternative treatment methods, such as immunotherapy. This treatment aims to regulate the immune system and achieve remission of symptoms.
Gluten ataxia is a neurological manifestation of celiac disease.
At present, if doctors monitor a significant improvement in ataxia following a gluten-free diet, they will diagnose a person with gluten ataxia.
A 2021 review found that a gluten-free diet can suppress harmful gut symptoms in people with non-gluten-dependent diseases.
The diet may also be beneficial in other conditions. It may effectively reduce seizure frequency or the need for drugs in people with epilepsy.
However, the diet also has its downsides. Prohibited grain in the gluten-free diet can be a great source of dietary fiber as they contain essential nutrients and vitamins. Eliminating them without considering substitute sources
Based on a
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 first discuss it with their doctor. They may check them for celiac disease before recommending the diet and educate them on common sources of gluten and on how to check food labels.
Moreover, partnering with a dietitian or nutritionist ensures that the person receives balanced nutrition.
The following resources can give a person relevant information about a gluten-free diet, including diet plans:
- Celiac Disease Foundation
- Gluten Intolerance Group (GIG)
- Gluten-Free Resource Directory
- National Celiac Association
No single diet will relieve symptoms for every person with UC. A person can document how their body tolerates certain foods by keeping a food diary.
Restrictive diets, such as a gluten-free diet, can help:
- improve gut health
- promote gut healing
- 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 as a long-term treatment to prevent flares and prolong the remission of 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 appropriate and helpful 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 that they receive proper guidance about the diet and how to maintain balanced nutrition.