A little note- it's not the gluten you should be concerned about, unless you have celiac disease. Folks with celiac sprue need to worry about gluten in the sub-milligram range; it's an allergy, in effect. With Crohn's, you're trying to evade the wheat, not just the gluten. Unfortunately, gluten substitutes- rice, potato starch, etc.- will do just as good a job at feeding the gut bacteria as wheat (or BROW- barley, rye, oats, and wheat), resulting in diarrhea, pain, and discomfort. So- if gluten-free doesn't do it for you, take it a step further and look at the Specific Carbohydrate Diet.
Illini quite bravely asked for the references. As follows, in chronological order:
Br Med J. 1979 Sep 29;2(6193):764-6. Links=20
Treatment of Crohn's disease with an unrefined-carbohydrate, fibre-rich diet.
Heaton KW, Emmett PM.
Thirty-two patients with Crohn's disease were treated with a fibre-rich, unrefined-carbohydrate diet in addition to conventional management and followed for a mean of four years and four months. Their clinical course was compared retrospectively with that of 32 matched patients who had received no dietary instruction. Hospital admissions were significantly fewer and shorter in the diet-treated patients, who spent a total of 111 days in hospital compared with 533 days in the non-diet-treated control group. Whereas five of the controls required intestinal operation, only one diet-treated patient needed surgery. This is in strong contrast to general experience with this disease. Treatment with a fibre-rich, unrefined-carbohydrate diet appears to have a favourable effect on the course of Crohn's disease and does not lead to intestinal obstruction.
Z Gastroenterol. 1981 Jan;19(1):1-12.Links=20
[Sugar free diet: a new perspective in the treatment of Crohn disease? Randomized, control study]
[Article in German]
Brandes JW, Lorenz-Meyer H.
Since several studies have shown that patients with Crohn's disease have an increased consumption of refined carbohydrates, the influence of a diet excluding refined sugar on the course of the disease was examined. In a randomised control trial, 20 patients (10 patients in each group) with Crohn's disease were treated for an average of 18 months with two different diets. The patients used in the study had a low or middle activity of the disease. Drug treatment was omitted 14 days before commencement of the study. The first group was treated with a low carbohydrate diet (refined sugar excluded), the second group received a high carbohydrate diet (refined sugar-rich). In patients with higher activities of the disease (activity index 100-200 points), the diet which restricted refined sugar was superior to the sugar-rich diet; in 4 out of 5 patients the disease activity decreased and remained so throughout the study-period. In contrast to this 4 patients treated with the sugar-rich diet had to be taken off the treatment because of increasing activities of the disease. In patients with quiescent disease (activity index less than 100 points), neither of the diets showed detrimental effects. The statistical analysis of clinical and laboratory dates noted during the study period resulted in no significant differences between the two groups.
Hum Nutr Appl Nutr. 1984 Dec;38(6):469-73.Links=20
Diet in the management of Crohn's disease.
Workman EM, Alun Jones V, Wilson AJ, Hunter JO.
Thirty-three patients with Crohn's Disease were studied to see if their symptoms were related to food intolerances. Initial treatment to produce remission of symptoms was total parenteral nutrition (20), elemental diet (2) or elimination diet (11). Twenty-nine patients reported specific food intolerances, and 21 of these remained in remission on diet alone, the mean length of remission being 15.2 months. The most important foods provoking symptoms were wheat and dairy products.
Lancet. 1985 Jul 27;2(8448):177-80. Links=20
Crohn's disease: maintenance of remission by diet.
Jones VA, Dickinson RJ, Workman E, Wilson AJ, Freeman AH, Hunter JO.
20 patients with Crohn's disease took part in a controlled trial in which remission was maintained by either an unrefined carbohydrate fibre rich diet or a diet which excluded specific foods to which a patient was intolerant. 7 out of the 10 patients on the exclusion diet remained in remission for 6 months compared with none out of the 10 on an unrefined carbohydrate fibre rich diet (p less than 0.05, Fisher's exact test). In an uncontrolled study an exclusion diet allowed 51 out of 77 patients to remain well on the diet alone for periods of up to 51 months, and with an average annual relapse rate of less than 10%.
My commentary: Now- if Crohn's disease is autoimmune, how can the four studies cited above claim that an elimination diet can substantially ameliorate the symptoms of the disease? I could understand it if they were quickie studies running 6-12 months, but the Lancet article ran patients out to as long as 51 months (!) with an "average annual relapse rate of <10%." Holy cow!