Gluten-free diet for AIDS-related diarrhea - Literature Review & Commentary - Brief Article

Townsend Letter for Doctors and Patients,  April, 2002  by Alan R. Gaby

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The effect of a gluten-free diet was studied in five men with AIDS-related enteropathy. Each patient had been suffering for 6-15 weeks with chronic diarrhea for which no cause could be found. The patients consumed a normal diet for one week, followed by a gluten-free diet for one week, then a normal diet during week three, and a gluten-free diet during week four. The mean number of bowel movements was 48 during week one, compared with only 18 during week two (62% reduction; p = 0.006). Mean body weight increased from 53 kg after the first week to 56 kg after the second week (p = 0.01). During the third week (normal diet), the mean number of bowel movements increased to 45 and mean body weight fell to 53 kg. During week four (second gluten-free period), these values again improved significantly: 15 bowel movements (p = 0.006), mean body weight of 55 kg (p = 0.01).

Comment: The results of this preliminary study suggest that consumption of a gluten-free diet may relieve diarrhea and promote weight gain in patients with AIDS-related enteropathy. Although it is not known why a gluten-free diet might be helpful, it has been observed that abnormalities of intestinal structure and function are similar in patients with HIV enteropathy and those with celiac disease (gluten-induced enteropathy). While AIDS-related diarrhea may have many different causes (including drug side effects, malabsorption, and abnormal intestinal flora), a gluten-free diet (medically supervised to ensure adequate nutrient intake) is worth considering in selected cases.

Nellen H, et al. Treatment of human immunodeficiency virus enteropathy with a gluten-free diet. Arch Intern Med 2000;160:224.

COPYRIGHT 2002 The Townsend Letter Group
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