title: The effects of provocation by foods with raised IgG antibodies and additives on the course of Crohn's disease: a pilot study.
abstract: OBJECTIVE
  This study was designed to assess the role of foods with raised IgG antibodies and additives on the symptoms and inflammation of Crohn's disease.
  
  
  METHODS
  Eight patients with Crohn's disease in remission were studied. They followed a strict diet during phase I. Then, provocations with two, three-day periods (phases II and III) followed: in phase II, pure forms of foods with high IgG antibodies and in phase III, off-the-shelf forms of those foods were added. Stool samples were collected for fecal calprotectin assay. Blood samples were taken on the 11th and 17th days for highly sensitive C-reactive protein, ferritin, erythrocyte sedimentation rate, white blood cells, and platelets. Patients kept a diet-symptom diary.
  
  
  RESULTS
  Increased Crohn's disease activity index scores were found statistically significant (p=0.012) between pre- and during the provocation weeks. There were significant increases according to Harvey-Bradshaw Index when the highest values during the phases I, II (p=0.027) and I, III (p=0.027) were compared. The increases in highly sensitive C-reactive protein (p=0.025) and white blood cells (p= 0.036) were found statistically significant. Fecal calprotectin levels showed day-to-day variability. When compared, the levels of fecal calprotectin increased in all patients on the last day of the restriction (10th day) and the first day of the provocation (11th day) with the exception of one patient.
  
  
  CONCLUSIONS
  Foods with raised IgG antibody levels and food additives can provoke the symptoms and may stimulate the inflammation in patients with Crohn's disease. Addition of a proper diet with restriction of those foods may be beneficial in the medical treatment.
authors.affiliation: Department of Gastroenterology, İstanbul University Cerrahpaşa Medical School İstanbul/Turkey. hulyauzunismail@gmail.com
authors.forename: Hülya
authors.initials: H
authors.lastname: Uzunısmaıl
authors.forename: Mahir
authors.initials: M
authors.lastname: Cengız
authors.forename: Hafize
authors.initials: H
authors.lastname: Uzun
authors.forename: Fatma
authors.initials: F
authors.lastname: Ozbakir
authors.forename: Süha
authors.initials: S
authors.lastname: Göksel
authors.forename: Filiz
authors.initials: F
authors.lastname: Demırdağ
authors.forename: Günay
authors.initials: G
authors.lastname: Can
authors.forename: Huriye
authors.initials: H
authors.lastname: Balci
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000906:Antibodies / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D003424:Crohn Disease / Q000276:immunology*; D003967:Diarrhea / Q000209:etiology; D005243:Feces / Q000737:chemistry; D005260:Female; D005503:Food Additives / Q000008:administration & dosage*; D005512:Food Hypersensitivity / Q000276:immunology*; D006261:Headache / Q000209:etiology; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D007958:Leukocyte Count; D039841:Leukocyte L1 Antigen Complex / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology; D010865:Pilot Projects
chemical_list: D000906:Antibodies; D005503:Food Additives; D007074:Immunoglobulin G; D039841:Leukocyte L1 Antigen Complex; D002097:C-Reactive Protein