Food hypersensitivity and irritable bowel syndrome

Area of Science:

• Gastroenterology
• Immunology
• Dietary Science

Background:

• Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder with poorly understood mechanisms.
• A history of food intolerance is common in IBS patients, yet elimination and re-challenge data remain inconclusive.
• Limited understanding exists regarding the processing of food antigens by the gut immune system in health and disease.

Purpose of the Study:

• To review the existing evidence for the role of food hypersensitivity in irritable bowel syndrome (IBS).
• To formulate a potential pathophysiological hypothesis for IBS based on current data regarding food hypersensitivity.

Main Methods:

• Literature review of studies investigating food hypersensitivity markers (skin tests, serum IgG, IgE) in IBS.
• Analysis of data from dietary elimination and re-challenge studies in IBS patients.
• Synthesis of evidence to propose a pathophysiological model.

Main Results:

• Published data on food hypersensitivity markers (skin tests, serum IgG, IgE) in IBS are equivocal.
• Dietary elimination and re-challenge studies provide inconclusive evidence for food intolerance in IBS.
• A definitive, clinically useful marker for food hypersensitivity in IBS is currently unavailable.

Conclusions:

• The role of food hypersensitivity in IBS pathophysiology requires further investigation.
• Current diagnostic markers for food hypersensitivity in IBS lack clinical utility.
• A novel pathophysiological hypothesis for IBS is proposed based on the reviewed evidence.