Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder with a reported prevalence of 12%-22% in the general population. In fact, IBS is the most common diagnosis made by gastroenterologists in the United States. IBS is a poorly understood disorder and conventionally treatments have proven variable success.
The gut is the largest lymphoid (immune system cells) organ in the body. In IBS, the gut-associated immune system is up regulated as seen by the presence of increased inflammatory markers. The reason for this altered immunity is unclear by may be related to food hypersensitivity and altered gastrointestinal (GI) microbial flora. This up-regulation of the immune system in the GI tract is known to stimulate various cells which release neurotransmitters (like serotonin and histamine) which results in many of the IBS associated GI symptoms.
Continuous inflammation in the GI tract can result in opening of tight junctions between our intestinal cells. This bond holds our intestinal cells together to protect us, create a barrier. These tight junctions maintain a barrier between what is suppose to be absorbed in our intestines and what is not suppose to be absorbed. When these tight junctions open up absorption of larger than normal food particles cross from the GI tract into our blood stream. The passage of these larger molecules is seen as invaders by the immune system and can trigger an immune reaction with the formation of antibodies to these otherwise harmless molecules. When this happens, a person can become hypersensitive to environmental factors or develop foods allergies or sensitivities to which they previously were not sensitive.
An open pilot study at the University of Kansas Medical Center enrolled 20 patients with IBS who had failed standard medical treatment. Baseline IgG and IgE food allergy panels were performed and based on the results, allergy elimination diets were recommended. At the beginning of the study 100% of participants had reactions to (IgG and IgE) to various foods. In addition all participants were given probiotics. Significant improvements were seen in stool frequency, pain, and quality of life assessments in the participants. There was also an increase in healthy intestinal microbial flora however there was still the presence of unhealthy microbial gut flora as well.
This study demonstrated that identifying and addressing food hypersensitivities and abnormal bowel flora results in large improvements of symptom management in patients with IBS. Testing for IgG food hypersensitivity is a blood test that differs from traditional IgE scratch tests used in many practices. Activation of the immune system by IgG food hypersensitivities plays a role in many of the observed reactions to food such as asthma, migraines, headaches, arthritis, gastrointestinal dysfunction and many more conditions. A simple blood test can be done to indicate what foods you are most sensitive to and may be contributing to your symptoms.
Dr. Joseph L Humpherys