title: Food patch testing for irritable bowel syndrome.
abstract: BACKGROUND
  The traditional classification of irritable bowel syndrome (IBS) as a functional disorder has been challenged in recent years by evidence of ongoing low-grade gastrointestinal tract inflammation. Inflammation may alter gastrointestinal motility and thus be central to the pathogenesis of IBS. Many foods and food additives are known to cause allergic contact dermatitis. We hypothesize that allergenic foods and food additives may elicit a similar allergic reaction in the gastrointestinal tract, giving rise to symptoms suggestive of IBS.
  
  
  OBJECTIVE
  We sought to determine whether skin patch testing to a panel of foods and food additives may identify food allergens that may be responsible for symptoms of IBS.
  
  
  METHODS
  We performed skin patch testing to common allergenic foods and food additives on individuals with a history of or symptoms suggestive of IBS. We used patch test-guided avoidance diets to determine whether avoidance alleviates IBS symptoms.
  
  
  RESULTS
  Thirty of the 51 study participants showed at least 1 doubtful or positive patch test result. Fourteen of the participants reported symptomatic improvement, ranging from slight to great, upon avoidance of the foods/food additives to which they reacted.
  
  
  CONCLUSIONS
  Double-blind study design, inclusion of only patients with active IBS, larger sample size, more balanced gender distribution, testing of more foods/food additives, and longer duration of and more precise quantification of response to dietary avoidance are suggested for future studies.
  
  
  CONCLUSIONS
  Allergic contact enteritis to ingested foods, food additives, or both may contribute to IBS symptoms. Patch testing may be useful in identifying the causative foods.
authors.affiliation: East Penn Dermatology PC, North Wales, Pennsylvania 19454, USA. mstierstorfer@eastpennderm.com
authors.forename: Michael B
authors.initials: MB
authors.lastname: Stierstorfer
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Sha
authors.forename: Marvin
authors.initials: M
authors.lastname: Sasson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017449:Dermatitis, Allergic Contact / Q000150:complications*; D005260:Female; D005502:Food / Q000009:adverse effects; D005503:Food Additives / Q000009:adverse effects; D005512:Food Hypersensitivity / Q000175:diagnosis*; D006801:Humans; D043183:Irritable Bowel Syndrome / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010328:Patch Tests
chemical_list: D005503:Food Additives