GLUTEN IN CROHN'S DISEASE

Some people with Crohn's disease can't tolerate gluten.

Types of gluten related problems in Crohn's disease include:

• Celiac disease: where a strict gluten- free diet must be followed and gluten completely eliminated from the diet <<link-N4K>>
• Gluten sensitivity: some people have bloating, gas, or pain when eating foods that contain gluten (like wheat). Removing or limiting the gluten source usually improves symptoms <<link N4K gluten sensitivity>>
• Wheat Allergy: similar to gluten sensitivity except rashes or allergic reactions also occur when wheat is eaten. Other grains can be tolerated. <<link N4K-wheat allergy>>

If you think you have a problem with gluten you'll want to check first to make sure you don't have celiac disease. <<link N4K celiac>>

Tests for Celiac Disease <<link N4K celiac tests>>:

• Tissue transglutaminase (tTG-IgA and tTG-IgG)
• Endomysial antibody
• Serum IgA (because it has to be in a normal range to assure the tTG-IgA and Endomysial Antibody are meaningful) 
• These tests should be done while you are still including gluten and wheat in your diet

You might want to have a skin test or IgE-blood test for wheat allergy at the same time

Once you have reviewed the results with your doctor, you can eliminate gluten (or wheat)  from your diet for a month depending on what your results suggest to see if you do feel better.

You may also want to eliminate lactose in the beginning because you may have damage to the intestinal surface. The enzyme that digests lactose is located on the intestinal surface. If there is significant damage, your ability to digest lactose may be decreased.       

If you remove gluten from your diet, make sure you have enough sources of the B vitamins in your diet . If you restrict lactose, make sure you are still getting enough vitamin D and calcium.

If you don't respond to eliminating gluten from your diet, you may need a broader elimination of foods. The best way to do that is possibly as FODMAP diet under the guidance of a qualified dietitian.