Atopy and the gastrointestinal tract – a review of a common association in unexplained gastrointestinal disease

Walker, Marjorie M.; Powell, Nick; Talley, Nicholas J.

doi:10.1586/17474124.2014.881716

Cited by 37 publications

(46 citation statements)

References 118 publications

(123 reference statements)

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“…In this same group, atopic conditions were also found in excess among all FGID groups considered when compared with controls [42]. This association may be explained by a shared genetic susceptibility, or common disruption of the microbiome and similar immunological disorders in these conditions [43]. A study from the USA showed similar findings, in that adults with atopic symptoms report a high prevalence of IBS, suggesting a link between atopy and IBS [44].…”

Section: Fgids Autoimmune Diseases and Atopysupporting

confidence: 52%

Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

2015

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Functional gastrointestinal disorders (FGIDs) are common and distressing. They are so named because a defined pathophysiology in terms of structural or biochemical pathways is lacking. Traditionally FGIDs have been conceptualized as brain-gut disorders, with subgroups of patients demonstrating visceral hypersensitivity and motility abnormalities as well as psychological distress. However, it is becoming apparent that there are certain structural or biochemical gut alterations among subsets with the common FGIDs, most notably functional dyspepsia (FD) and irritable bowel syndrome (IBS). For example, a sodium channel mutation has been identified in IBS that may account for 2 % of cases, and subtle intestinal inflammation has been observed in both IBS and FD. Other research has implicated early life events and stress, autoimmune disorders and atopy and infections, the gut microbiome and disordered mucosal immune activation in patients with IBS or FD. Understanding the origin of symptoms in FGIDs will allow therapy to be targeted at the pathophysiological changes, not at merely alleviating symptoms, and holds hope for eventual cure in some cases.For example, there are promising developments in manipulating the microbiome through diet, prebiotics and antibiotics in IBS, and testing and treating patients for Helicobacter pylori infection remains a mainstay of therapy in patients with dyspepsia and this infection. Locally acting drugs such as linaclotide have been an advance in treating the symptoms of constipation-predominant IBS, but do not alter the natural history of the disease. A role for a holistic approach to patients with FGIDs is warranted, as brain-togut and gut-to-brain pathways appear to be activated.

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Section: Fgids Autoimmune Diseases and Atopysupporting

confidence: 52%

Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

2015

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“…2). 48 In some patients, this process can lead to tissue injury and symptoms, whereas in others eosinophils may be protective and promote healing. An inflamed duodenum may be sensitive to acid and induce reflex responses and cytokine release that alter gastroduodenal function and result in mealrelated symptoms.…”

mentioning

confidence: 99%

Functional Dyspepsia

2015

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“…An IgE-mediated immune reaction might be the bridge under this association, supported by the positive correlation among serum total IgE, HDM-specific IgE, and abdominal bloating in atopic patients. As is known, dysregulated immune activation on the epithelial barrier surfaces is common in both allergy and IBS [17]. Lillestol et al [16] reported earlier that elevated numbers of IgEpositive cells in duodenal mucosa were found in patients with atopy compared to nonatopic patients.…”

Section: Discussionmentioning

confidence: 97%

Association between Allergic Diseases and Irritable Bowel Syndrome: A Retrospective Study

Fang

Zhang

Lü

et al. 2018

Int Arch Allergy Immunol

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Background: The relationship between allergic disease and irritable bowel syndrome (IBS) is poorly understood. We aimed to investigate the potential association as well as the underlying immunological mechanisms. Methods: A retrospective case-control study of 108 atopic patients from among outpatients in an allergy clinic (allergic rhinitis [AR], n = 49; chronic urticaria [CU], n = 59) and 74 controls from among ward companions was conducted from November 2016 to March 2017. The detection rates and related gastrointestinal (GI) symptoms of IBS, as well as immunological indices, were calculated. Results: CU patients had a trend of increase in the detection of IBS compared to controls (OR = 4.846; 95% CI 0.967–24.279, p = 0.077). Loose stools (OR = 2.406; 95% CI 1.075–5.386, p < 0.05) and viscous stools (OR = 2.665; 95% CI 1.250–5.682, p < 0.05) were more common in CU patients. Atopic patients positive for serum total immunoglobulin E (IgE) (OR = 3.379; 95% CI 1.088–10.498, p < 0.05) or house dust mite (HDM)-specific IgE (OR = 3.640; 95% CI 1.228–10.790, p < 0.05) were more likely to have abdominal bloating. Besides, a positive association between levels of total IgE and severity of abdominal bloating was observed (p < 0.05). An HDM-specific IgE-positive reaction was independently associated with abdominal bloating in atopic patients (p < 0.05). Conclusions: Allergic disease has a clear clinical association with IBS with more frequent and severe symptoms of IBS. CU patients have a tendency to suffer from IBS, usually with diarrhea. Serum total IgE and HDM-specific IgE are positively correlated with GI symptoms in atopic patients.

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Atopy and the gastrointestinal tract – a review of a common association in unexplained gastrointestinal disease

Cited by 37 publications

References 118 publications

Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

Therapeutic strategies for functional dyspepsia and irritable bowel syndrome based on pathophysiology

Functional Dyspepsia

Association between Allergic Diseases and Irritable Bowel Syndrome: A Retrospective Study

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