title: IgG-based elimination diet in migraine plus irritable bowel syndrome.
abstract: OBJECTIVE
  To evaluate therapeutic potential of the immunoglobulin G (IgG)-based elimination diet among migraine patients with irritable bowel syndrome (IBS).
  
  
  BACKGROUND
  Food elimination has been suggested as an effective and inexpensive therapeutic strategy in patients with migraine and concomitant IBS in the past studies.
  
  
  METHODS
  A total of 21 patients (mean [standard deviation] age: 38.0 [11.2] years; 85.7% females) diagnosed with migraine and IBS were included in this double-blind, randomized, controlled, cross-over clinical trial composed of baseline (usual diet), first diet (elimination or provocation diets), and second diet (interchange of elimination or provocations diets) phases and 4 visits.
  
  
  RESULTS
  IgG antibody tests against 270 food allergens revealed mean (standard deviation) reaction count to be 23.1 (14.1). Compared with baseline levels, elimination diet per se was associated with significant reductions in attack count (4.8 [2.1] vs 2.7 [2.0]; P < .001), maximum attack duration (2.6 [0.6] vs. 1.4 [1.1] days; P < .001), mean attack duration (1.8 [0.5] vs. 1.1 [0.8] days; P < .01), maximum attack severity (visual analog scale 8.5 [1.4] vs. visual analog scale 6.6 [3.3]; P < .001), and number of attacks with acute medication (4.0 [1.5] vs. 1.9 [1.8]; P < .001). There was a significant reduction in pain-bloating severity (1.8 [1.3] vs. 3.2 [0.8]; P < .05), pain-bloating within the last 10 days (3.2 [2.8] vs. 5.5 [3.1]; P < .05), and improvement obtained in quality of life (3.6 [1.4] vs. 2.9 [1.0]; P < .05) by the elimination diet as compared with provocation diet.
  
  
  CONCLUSIONS
  Our findings indicate that food elimination based on IgG antibodies in migraine patients who suffer from concomitant IBS may effectively reduce symptoms from both disorders with possible positive impact on the quality of life of the patients as well as potential savings to the health-care system.
authors.affiliation: Department of Neurology, Acibadem University School of Medicine, Istanbul, Turkey. eilgaz@acibadem.com.tr
authors.forename: Elif Ilgaz
authors.initials: EI
authors.lastname: Aydinlar
authors.forename: Pinar Yalinay
authors.initials: PY
authors.lastname: Dikmen
authors.forename: Arzu
authors.initials: A
authors.lastname: Tiftikci
authors.forename: Murat
authors.initials: M
authors.lastname: Saruc
authors.forename: Muge
authors.initials: M
authors.lastname: Aksu
authors.forename: Hulya G
authors.initials: HG
authors.lastname: Gunsoy
authors.forename: Nurdan
authors.initials: N
authors.lastname: Tozun
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D018592:Cross-Over Studies; D004032:Diet / Q000379:methods*; D004311:Double-Blind Method; D004644:Emotions; D005260:Female; D005502:Food / Q000009:adverse effects*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000178:diet therapy / Q000276:immunology; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications / Q000178:diet therapy / Q000276:immunology; D011788:Quality of Life
chemical_list: D007074:Immunoglobulin G