Food Intolerance: A Major Factor in the Pathogenesis of Irritable Bowel Syndrome

Jones, Virginia; Shorthouse, M.; Mclaughlan, P.; Workman, Elizabeth; Hunter, John

doi:10.1016/s0140-6736(82)92782-9

Cited by 269 publications

(16 citation statements)

References 12 publications

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“…Food allergy will continue to be proposed as a potential confounding factor in this and similar studies. Although food has been implicated in the pathogenesis of IBS 54 –57 and improvements with exclusion diets 55 , 57 –60 or mast cell stabilisers 61 have been suggested, most adverse reactions to food in this disorder are not thought to be immune‐mediated 62 –64 . True food allergy (IgE mediated), is a rare condition, 65 its study is difficult and remains a contentious issue in IBS.…”

Section: Discussionmentioning

confidence: 99%

Increased mast cells in the irritable bowel syndrome

O’Sullivan

Clayton

Breslin

et al. 2000

Neurogastroenterology Motil

422

316

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Mast cells (MC) release potent mediators which alter enteric nerve and smooth muscle function and may play a role in the pathogenesis of the irritable bowel syndrome (IBS). The aim of this study was to determine if MC were increased in the colon of IBS patients compared to controls. Biopsy specimens were obtained from the caecum, ascending colon, descending colon and rectum of 28 patients: 14 IBS (Rome criteria); seven normal; and seven inflammatory controls. Tissue was stained immunohistochemically using a monoclonal mouse antibody for human mast cell tryptase (AA1). Tissue area occupied by tryptase-positive MC (volume density of mast cells) was quantified by image analysis. The number of plasma cells, lymphocytes, eosinophils, neutrophils and macrophages were each graded semiquantitatively (0-4) in haematoxylin and eosin stained sections. Mast cell volume density was significantly (P < 0.05) higher in IBS (0.91 +/- 0.18; CI 0.79; 1.0) than normal controls (0.55 +/- 0.14; CI 0.40; 0.69) in the caecum but not at other sites. Apart from MC, there was no evidence of increased cellular infiltrate in the IBS group. MC were significantly increased in the caecum of IBS patients compared to controls. The multiple effects of the intestinal mast cell alone, or as a participant of a persistent inflammatory response, may be fundamental to the pathogenesis of IBS.

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Section: Discussionmentioning

confidence: 99%

Increased mast cells in the irritable bowel syndrome

O’Sullivan

Clayton

Breslin

et al. 2000

Neurogastroenterology Motil

422

316

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“…These patients followed a strict elimination diet consisting of distilled or spring water, one meat, and one fruit for one week. Two thirds of patients who completed this diet noted symptom improvement followed by a worsening of symptoms when suspect foods were reintroduced [35]. This diet is not ideal as there is not enough evidence about its utility.…”

Section: Management Of Ibsmentioning

confidence: 99%

Irritable Bowel Syndrome: Clinical Manifestations, Dietary Influences, and Management

et al. 2017

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Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder that is characterized by symptoms of chronic abdominal pain and altered bowel habits in the absence of an overtly identifiable cause. It is the most commonly diagnosed functional gastrointestinal disorder, accounting for about one third of gastroenterology visits. It generally presents as a complex of symptoms, including psychological dysfunction. Hypersensitivity to certain foods, especially foods that contain high amounts of fructose, plays a role in the pathophysiology of IBS. Elevated consumption of high-fructose corn syrup (HFCS) has been discussed in this aspect. The treatment options for IBS are challenging and varied. In addition to dietary restrictions for HFCS-induced IBS, such as low-FODMAP (Fermentable Oligosaccharides, Disaccharide, Monosaccharides, and Polyols) diets, existing drug therapies are administered based on the predominant symptoms and IBS-subtype. Patients with IBS are likely to suffer from issues, such as anxiety, depression, and post-traumatic-stress disorder. Biopsychosocial factors particularly socioeconomic status, sex, and race should, thus, be considered for diagnostic evaluation of patients with IBS.

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“…The two major food groups implicated in food challenge studies by IBS patients in the west are cereal grains and dairy products 56 . These are now commonly promoted in Asian countries as elements of a healthy diet.…”

Section: Dietary Factorsmentioning

confidence: 99%

Irritable bowel syndrome in developing countries – a disorder of civilization or colonization?

2005

Neurogastroenterology Motil

166

139

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While irritable bowel syndrome (IBS) is common in the West, early studies suggest that the prevalence is low in developing countries. However, recent studies point to increasing prevalence in newly developed Asian economies. The presentation appears to differ from the West, with a lack of female predominance, a greater frequency of upper abdominal pain and defecatory symptoms perceived as being less bothersome. This difference, together with the preoccupation with organic disease, could explain why we may be missing IBS in Asia and also why excess surgery has been observed in some Asian countries. While a recent study from China, consistent with western studies, support an important role for infection and inflammation, early studies from India reporting no association between amoebic infection and IBS appear to dispute this observation. To reconcile these seemingly contradictory observations, an hygiene hypothesis model is proposed. Exposure to a variety of microorganisms early in life could result in the colonization of the intestine with microflora that can respond more efficiently to an episode of gastroenteritis. Together with the changes with evolution of Asian economies such as westernization of the diet and increased psychosocial stress, it is proposed that loss of this internal protective effect, could give rise to a more uniform worldwide prevalence of IBS.

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Food Intolerance: A Major Factor in the Pathogenesis of Irritable Bowel Syndrome

Cited by 269 publications

References 12 publications

Increased mast cells in the irritable bowel syndrome

Increased mast cells in the irritable bowel syndrome

Irritable Bowel Syndrome: Clinical Manifestations, Dietary Influences, and Management

Irritable bowel syndrome in developing countries – a disorder of civilization or colonization?

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