Gluten-free Diet in Patients With Primary Sclerosing Cholangitis (PSC)

Gluten-free Diet in Patients With Primary Sclerosing Cholangitis (PSC) - a Pilot-Study

Gluten is a protein found in wheat and other cereals as barley and rye. It triggers an inflammatory reaction in the small-bowel of genetically predisposed persons. Alpha-amylase/trypsin inhibitors (ATIs) of wheat seem to be the responsible trigger of this intestinal Inflammation.

Intestinal inflammation is connected to other extra-intestinal autoimmune inflammations like PSC (as f.ex. the association of PSC with inflammatory bowel disease proves).

Hypothesis: Avoidance of ATIs through a gluten-free diet will reduce intestinal inflammation and thus also the the inflammatory activity in the liver.

Proof of hypothesis:

• Pilot study with n=20 patients with PSC
• Explorative, open-label, mono-centric study
• Inclusion criteria: age 18-65, diagnosed PSC-associated colitis without relevant clinical activity after last coloscopy.

Inclusion Criteria:

• diagnosed PSC-associated colitis without relevant clinical activity after last coloscopy.

Exclusion Criteria:

• patients with coeliac disease or wheat allergy
• patients with active colitis
• patients already on gluten-free diet
• liver transplanted patients
• patients also diagnosed with autoimmune hepatites (PSC-AIH overlap)
• coloscopy within 2 months before study
• Endoscopic retrograde cholangiopancreatography (ERCP) within 3 months before study
• antibiotics within 3 month before study