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Indications of ‘atopic bowel’ in patients with self‐reported food hypersensitivity
Author(s) -
LILLESTØL K.,
HELGELAND L.,
ARSLAN LIED G.,
FLORVAAG E.,
VALEUR J.,
LIND R.,
BERSTAD A.
Publication year - 2010
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2010.04261.x
Subject(s) - medicine , immunoglobulin e , irritable bowel syndrome , food allergy , tryptase , immunology , intestinal permeability , atopy , allergy , disease , gastroenterology , atopic dermatitis , inflammatory bowel disease , mast cell , antibody
Aliment Pharmacol Ther 31 , 1112–1122 Summary Background An association between atopic disease and gastrointestinal complaints has been suggested. Aim To explore the association between atopic disease, gastrointestinal symptoms, and possible gastrointestinal manifestations of atopic disease in patients with self‐reported food hypersensitivity. Methods Symptoms, skin prick tests, serum markers of allergy and intestinal permeability were recorded in 71 adult patients. Eosinophils, tryptase‐ and IgE‐positive cells were counted in duodenal biopsies. Results Sixty‐six (93%) patients had irritable bowel syndrome (IBS) and 43 (61%) had atopic disease, predominantly rhinoconjunctivitis. All 43 were sensitized to inhalant allergens, 29 (41%) to food allergens, but food challenges were negative. Serum total IgE and duodenal IgE‐positive cell counts were significantly correlated ( P < 0.0001) and both were significantly higher in atopic than in non‐atopic patients ( P < 0.0001 and P = 0.003 respectively). IgE‐positive cells appeared to be ‘armed’ mast cells. Intestinal permeability was significantly elevated in atopic compared with non‐atopic patients ( P = 0.02). Gastrointestinal symptoms and numbers of tryptase‐positive mast cells and eosinophils did not differ between groups. Conclusions Patients with self‐reported food hypersensitivity had a high prevalence of IBS and atopic disease. Atopic patients had increased intestinal permeability and density of IgE‐bearing cells compared with non‐atopic patients, but gastrointestinal symptoms did not differ between groups.