title: Prevalence of a gluten-free diet and improvement of clinical symptoms in patients with inflammatory bowel diseases.
abstract: BACKGROUND
  Maintaining a gluten-free diet (GFD) without an underlying diagnosis of celiac disease has enjoyed widespread acceptance in the Unites States.
  
  
  METHODS
  We performed a cross-sectional study using a GFD questionnaire in 1647 patients with inflammatory bowel diseases (IBD) participating in the CCFA Partners longitudinal Internet-based cohort.
  
  
  RESULTS
  A diagnosis of celiac disease and non-celiac gluten sensitivity were reported by 10 (0.6%) and 81 (4.9%) respondents, respectively. Three hundred fourteen (19.1%) participants reported having previously tried a GFD and 135 (8.2%) reported current use of GFD. Overall 65.6% of all patients, who attempted a GFD, described an improvement of their gastrointestinal symptoms and 38.3% reported fewer or less severe IBD flares. In patients currently attempting a GFD, excellent adherence was associated with significant improvement of fatigue (P < 0.03).
  
  
  CONCLUSIONS
  In this large group of patients with IBD, a substantial number had attempted a GFD, of whom the majority had some form of improvement in gastrointestinal symptoms. Testing a GFD in clinical practice in patients with significant intestinal symptoms, which are not solely explained by the degree of intestinal inflammation, has the potential to be a safe and highly efficient therapeutic approach. Further prospective studies into mechanisms of gluten sensitivity in IBD are warranted.
authors.affiliation: *Division of Gastroenterology and Hepatology, Department of Medicine, University of North Carolina, Chapel Hill, North Carolina; and †Department of Pediatrics, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Hans H
authors.initials: HH
authors.lastname: Herfarth
authors.forename: Christopher F
authors.initials: CF
authors.lastname: Martin
authors.forename: Robert S
authors.initials: RS
authors.lastname: Sandler
authors.forename: Michael D
authors.initials: MD
authors.lastname: Kappelman
authors.forename: Millie D
authors.initials: MD
authors.lastname: Long
mesh_terms: D000328:Adult; D002446:Celiac Disease / Q000175:diagnosis / Q000178:diet therapy; D016009:Chi-Square Distribution; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000178:diet therapy; D003424:Crohn Disease / Q000175:diagnosis / Q000178:diet therapy; D003430:Cross-Sectional Studies; D055050:Diet, Gluten-Free / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000178:diet therapy*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D015995:Prevalence; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult