Asthma and Allergy Center – Greg E. Sharon MD

 

Is Food a trigger for Irritable Bowel Syndrome?

 

IgE = Allergic Antibody that causes allergies  IgG=Memory Antibody

 

" Food hypersensitivity as a cause of irritable bowel syndrome was suggested by means of exclusion diet and blind provocation. ." (Studies in the '80 showed.) Yeast was also shown to be a potential trigger. Why is this not widely known after 20 years of studies and patients who obviously improve with dietary changes.? G. Sharon MD

The irritable bowel syndrome (IBS) may be defined as a painful chronic abdominal symptom complex which is usually associated with altered bowel habit, and for which there is no discernible underlying structural abnormality. Most people complain of a bloating, cramping pain that can be associated with diarrhea or constipation.It is generally accepted that symptoms are generated by abnormalities of gut function, including altered sensory perception, abnormal motility and, in some patients, abnormalities of gut linings function. Behavioral factors are important, particularly feelings of anxiety or emotion.

Examine the Facts

A careful assessment of studies on this problem has shown reason for food elimination or restriction.

Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial Gut 2004:53:1459 Conclusion: Food elimination based on IgG antibodies is effective in reducing IBS symptoms and is worthy of further biomedical research
A probiotic mixture alleviates symptoms in irritable bowel syndrome patients: a controlled 6-month intervention Alimentary Pharmacology & Therapeutics Volume 22 Issue 5, Pages 387 - 394 Conclusions: The results indicate that this probiotic mixture is effective in alleviating irritable bowel syndrome symptoms. Considering the high prevalence of irritable bowel syndrome and the lack of effective therapies, even a slight reduction in symptoms could have positive public health consequences.

Food-Specific Serum IgG4 and IgE Titers to Common Food Antigens in Irritable Bowel Syndrome - Sugiura-Ogasawara M - Hum Reprod - 01-AUG-2005; 20(8): 2325-9 Serum levels of IgG4 correlated with foods which when ingested leads to increased IBS symptoms. RAST to IgG4 are still considered "experimental" in some insurance companies opinion.

Treating Irritable Bowel Syndrome with a Food Elimination Diet Followed by Food Challenge and Probiotics Journal of the American College of Nutrition, Vol. 25, No. 6, 514-522 (2006) Conclusion: These data demonstrate that identifying and appropriately addressing food sensitivity in IBS patients not previously responding to standard therapy results in a sustained clinical response and impacts on overall well being and quality of life in this challenging entity.

Commonly used treatments for IBS

Most of the treatments for IBS center on reduction in symptoms the patient suffers from. They do not address the cause of IBS. I am suggesting below a procedure that may work in many patients to find the cause of the IBS. I classify the patients as Atopic IBS or non-Atopic. Atopic patients are suffering from an known allergic disease i.e., asthma, allergic rhinitis, eczema, and/or food allergies.

IgE food skin testing We suggest that patients who present with IBS have standard prick skin testing to foods. Those foods that are positive are to be avoided for 3 weeks. After that time they are to be slowly reintroduced. One food at a time, eating that food multiple times in a three day period. If that food causes problems it is avoided. If the food is tolerated after 3 days we allow it to stay in the patients diet.

IgG4 food testing via RAST  Blood is drawn and sent to a lab for assay. We test to commonly eaten foods. If the food is positive we avoid it for 3 weeks then rechallenge to the food as in above.

Food Allergen Patch testing  In some patients who have Eosinophilic Enteritis only foods tested by patch testing have been shown to be specific for hypersensitivity. In this case the food suspected of causing a reaction is placed in a thin aluminum well and then taped to the skin of the back for 2 days. The reaction is then rated at 2 days to 3 days after placement.

Detoxification and Cleansing diet  We place the patient on a low allergen diet with avoidance of all unnatural foods, additives, preservatives, chemicals etc. We give 3 days of a special rice supplement then 7 to 10 days of a soy supplement. During this time we place the patient on nutritional supplements and a milk thistle extract Silybum marianum which aids the liver in excreting toxins.
Yeast removal We use an oral antifungal that systemically kills all yeast followed by a non-absorbable yeast killer that sterilized the GI tract for several weeks.