The Gluten-Free Diet: Use in Digestive Disease Management

Gluten is a commonly ingested polymeric protein found in wheat, barley, and rye that has gained recent notoriety because of its relationship to disease and health. Avoidance of gluten is appropriate in patients with a diagnosed gluten-related disorder and may have treatment implications in other diseases of the digestive tract. This review highlights current knowledge of gluten related disorders and the use of a gluten-free diet in gastrointestinal disease management.

Gluten-free diets should be used in patients with a diagnosed gluten-related disorder including celiac disease, non-celiac gluten sensitivity, and wheat-sensitive eosinophilic esophagitis. Use of this diet in management of other digestive conditions including gastroesophageal reflux disease, irritable bowel syndrome, and inflammatory bowel disease is controversial and not currently supported by the literature. This review provides a framework for classifying gluten-related disorders in terms of pathogenesis, understanding the literature that supports dietary avoidance in modulation of gastrointestinal disease, and identifies limitations of dietary restriction in patients.