Utility of Food Patch Testing in the Evaluation and Management of Irritable Bowel Syndrome
Main Article Content
Keywords
Irritable bowel syndrome, IBS, delayed-type hypersensitivity, type 4 hypersensitivity, patch testing, food allergy, skin tests
Abstract
Background
Irritable Bowel Syndrome (IBS) is a functional gastrointestinal (GI) disorder of unknown etiology.
Objective
We sought to investigate whether specific type 4 food allergens identified by skin patch testing, when eliminated from the diet, alleviate symptoms of IBS.
Methods
In this case series, skin patch testing was performed on 60 IBS patients using an extensive panel of type 4 food allergens after which food avoidance diets directed by the patch test results were implemented. Questionnaires assessing abdominal pain/discomfort and global improvement in IBS symptoms were used to assess one month and three or more month outcomes.
Results
There were statistically significant improvements in abdominal pain/discomfort and in global IBS symptoms after one month and again at an average of 7.6 months of patch test-guided food avoidance.
Conclusions
Sustained improvement with avoidance of type 4 food allergens identified by skin patch testing suggests a role for delayed-type food hypersensitivities in the pathogenesis of some cases of IBS. A subset of patients whose IBS symptoms resolve completely may be better characterized as having a newly proposed disease, allergic contact enteritis (ACE).
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Grace Shin, Lewis Katz School of Medicine at Temple University
Department of Medicine, Section of GastroenterologyMichael Smith, Icahn School of Medicine at Mount Sinai
Professor and Chairman
Department of Medicine, Section of Gastroenterology
Butros Toro, Lewis Katz School of Medicine at Temple University
Department of MedicineAdam Ehrlich, Lewis Katz School of Medicine at Temple University
Assistant Professor of Medicine
Department of Medicine, Section of Gastroenterology
Deena Midani, Lewis Katz School of Medicine at Temple University
Department of Medicine, Section of GastroenterologyMichael Stierstorfer, University of Pennsylvania School of Medicine
Clinical Associate Professor
Department of Dermatology
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