The Impact of Celiac on the Gut Microbiome

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The microbiome is a group of trillions of microorganisms—including bacteria, fungi, and viruses—that live in the gut. Studies have shown that people with celiac disease typically have an altered composition of their gut microbiome compared to those without the disorder. These changes include reduced levels of beneficial bacteria as well as an increase in some strains of more problematic bacteria. 

There is what in my gut?

Bifidobacterium species are a strain of bacteria that have been shown to have a positive impact on gut health. An abundance of certain strains of Bifidobacterium has been linked to lowered inflammation and positive effects on the immune system. Additionally, Bifidobacterium has been shown to have antimicrobial and antiviral properties, protecting against infection or overgrowth of harmful bacteria and viruses.¹ 

Bifidobactirium and celiac disease

For those patients with both treated and untreated Celiac Disease, Bifidobacterium has been found in lower abundance when compared to those without the disease.²

^‍However, following a gluten-free diet can also lead to changes in the bacterial makeup of the gut. Interestingly, in individuals without Celiac Disease following a gluten-free diet appears to result in depletion of beneficial bacteria, however, in those with Celiac Disease following a gluten-free diet appears to decrease the population of proinflammatory species and improve the microbiota population.³‍‍

So why gluten-free?

Fortunately, there are many ways to encourage the growth of healthy bacteria in the gut. Given that Celiac disease is characterized by inflammation, following a strict gluten-free diet controls intestinal inflammation which is critical to maintaining a healthy gut microbiome.

Likewise, a diet filled with high-quality whole, unprocessed food can not only have a positive impact on the gut microbiome, but has also been shown to improve quality of life for those with Celiac Disease.⁴ More research is needed to determine the benefit of probiotics on improving GI symptoms and restoring the gut microbiome for patients with Celiac disease, though a recent study showed that for those with persistent symptoms despite following a gluten-free diet, probiotics may be beneficial.⁵

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References:

1. Lim HJ, Shin HS. Antimicrobial and Immunomodulatory Effects of Bifidobacterium Strains: A Review. J Microbiol Biotechnol. 2020 Dec 28;30(12):1793-1800. doi: 10.4014/jmb.2007.07046. PMID: 33144551; PMCID: PMC9728261.
2. Olshan KL, Leonard MM, Serena G, Zomorrodi AR, Fasano A. Gut microbiota in Celiac Disease: microbes, metabolites, pathways and therapeutics. Expert Rev Clin Immunol. 2020 Nov;16(11):1075-1092. doi: 10.1080/1744666X.2021.1840354. Epub 2020 Dec 27. PMID: 33103934; PMCID: PMC7796936.
3. Caio G, Lungaro L, Segata N, Guarino M, Zoli G, Volta U, De Giorgio R. Effect of Gluten-Free Diet on Gut Microbiota Composition in Patients with Celiac Disease and Non-Celiac Gluten/Wheat Sensitivity. Nutrients. 2020 Jun 19;12(6):1832. doi: 10.3390/nu12061832. PMID: 32575561; PMCID: PMC7353361.
4. Cadenhead JW, Martínez-Steele E, Contento I, Kushi LH, Lee AR, Nguyen TTT, Lebwohl B, Green PHR, Wolf RL. Diet quality, ultra-processed food consumption, and quality of life in a cross-sectional cohort of adults and teens with celiac disease. J Hum Nutr Diet. 2023 Jan 18. doi: 10.1111/jhn.13137. Epub ahead of print. PMID: 36653177.
5. Mozafarybazargany M, Khonsari M, Sokoty L, Ejtahed HS, Qorbani M. The effects of probiotics on gastrointestinal symptoms and microbiota in patients with celiac disease: a systematic review and meta-analysis on clinical trials. Clin Exp Med. 2023 Jan 7. doi: 10.1007/s10238-022-00987-x. Epub ahead of print. PMID: 36609792.