title: Extra-intestinal symptoms in patients with irritable bowel syndrome: related to high total IgE levels and atopic sensitization?
abstract: Objective We have previously found that high levels of total IgE, but not atopic sensitization, was a significant predictor for functional gastrointestinal (GI) symptoms. In this study, we aimed to assess the prevalence of extra-intestinal symptoms in IBS patients, and explore their relation to total IgE levels and atopic sensitization. Materials and methods Seventy-one patients with functional GI complaints were included. Severity of GI symptoms, fatigue and musculoskeletal pain was evaluated using the following questionnaires: IBS-Severity Scoring System (IBS-SSS), Fatigue Impact Scale (FIS), FibroFatigue Scale (FFS), and Visual Analog Scales (VAS) for musculoskeletal pain. Levels of total IgE and specific IgE-antibodies were analyzed. Results Fatigue and musculoskeletal pain were demonstrated in 78.9 and 43.7% of the patients, respectively. IBS-SSS scores were significantly correlated with fatigue scores and musculoskeletal pain. Patients with fatigue and musculoskeletal pain had significantly higher IBS-SSS scores than patients without fatigue and musculoskeletal pain. Total IgE levels were significantly higher in IBS patients compared to a healthy control group from a previous study. However, neither total IgE nor atopic sensitization was significantly associated with extra-intestinal symptoms. Conclusions IBS, fatigue, and musculoskeletal pain were significantly associated. Total IgE levels were higher in IBS patients than healthy controls, but not related to intestinal or extra-intestinal symptom severity. Atopy was not associated with any of the co-morbidities. Thus, the clinical significance of high IgE levels in IBS remains unclear and further studies are warranted to explore a common underlying mechanism for the co-morbid triad of IBS, fatigue, and musculoskeletal pain.
authors.affiliation: a Department of Clinical Medicine , University of Bergen (UiB) , Bergen , Norway ;
authors.forename: Ellen Johanne
authors.initials: EJ
authors.lastname: Vara
authors.affiliation: b Unger-Vetlesen's Institute, Lovisenberg Diaconal Hospital , Oslo , Norway ;
authors.forename: Jørgen
authors.initials: J
authors.lastname: Valeur
authors.affiliation: a Department of Clinical Medicine , University of Bergen (UiB) , Bergen , Norway ;|c Section of Gastroenterology, Department of Medicine , Haukeland University Hospital (HUH) , Bergen , Norway ;|d National Centre for Functional Gastrointestinal Disorders, HUH , Bergen , Norway.
authors.forename: Trygve
authors.initials: T
authors.lastname: Hausken
authors.affiliation: a Department of Clinical Medicine , University of Bergen (UiB) , Bergen , Norway ;|c Section of Gastroenterology, Department of Medicine , Haukeland University Hospital (HUH) , Bergen , Norway ;|d National Centre for Functional Gastrointestinal Disorders, HUH , Bergen , Norway.
authors.forename: Gülen Arslan
authors.initials: GA
authors.lastname: Lied
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000150:complications; D007114:Immunization; D007073:Immunoglobulin E / Q000032:analysis*; D043183:Irritable Bowel Syndrome / Q000150:complications / Q000276:immunology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000209:etiology; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D007073:Immunoglobulin E
keywords: Atopic sensitization; fatigue; irritable bowel syndrome; musculoskeletal pain; total IgE