GROUNDBREAKING STUDY IDENTIFIES CAUSE FOR IRRITABLE BOWEL SYNDROME
April 3, 2013
In the March 2013 Journal of the American Academy of Dermatology, Dr. Michael Stierstorfer and his research team published a major advance in the understanding and treatment of irritable bowel syndrome (IBS). Results of a groundbreaking clinical study suggest that a specific type of food allergy occurring in the digestive tract gives rise to IBS symptoms in a significant percentage of individuals suffering from this common disease and that testing for allergic skin reactions may identify many of the foods responsible for IBS symptoms.
Stierstorfer, the lead investigator and Clinical Associate Professor of Dermatology at the University of Pennsylvania, reports “by applying a number of foods to the skin surface of people with IBS or IBS-like symptoms, we are able to screen for mild poison ivy-like reactions. When the foods causing these reactions are eliminated from the diet, many of these people reported significant improvement in their IBS symptoms. It may be that the same allergic reaction detected by these tests on the skin is occurring in the GI tract when the same foods are eaten. Inflammation resulting from the allergic reactions in the GI tract can alter normal intestinal function, giving rise to the IBS symptoms.”
10 to 15% of Americans suffer from IBS, which consists of unexplained belly discomfort or pain along with constipation, diarrhea or both. Traditionally, the medical community has felt IBS to be more of a “mental” than physical disease, and there has been no satisfactory treatment. The role of foods has been suspected since 50% of IBS sufferers report foods contribute to their symptoms. Until now there has been no effective way of identifying which foods are responsible. In their article (Stierstorfer MB, Sha CT, Sasson M. Food Patch Testing for Irritable Bowel Syndrome. J Am Acad Dermatol 2013;68:377-84), Stierstorfer’s group at East Penn Dermatology, P.C. tested 51 individuals with IBS or IBS-like symptoms to a panel of 40 select foods and food additives. All who were found to have an allergic skin reaction to one or more of the foods were instructed to avoid eating the foods in question. 27.5% of those participating in the study experienced significant relief from their IBS symptoms when the foods identified by the testing were eliminated from the diet.
A 51 year old woman with IBS who benefited from the study states: “It is very frustrating not knowing why you feel so bad but…the information I now have…makes it easier for me to make educated decisions on what I can eat. It truly has helped me to avoid feeling so poorly.”
Prior research efforts have focused on blood tests looking for antibodies to specific foods. A large consensus expert panel from the National Institute for Allergy and Infectious Diseases recently determined these blood tests not to be worthwhile and advised against performing them (Boyce JA, Assa’ad A, Burks AW, et al. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Summary of the NIAID-Sponsored Expert Panel Report. J Allergy Clin Immunol 2010;126:1105-18). Stierstorfer agrees, stating the search for food antibodies in most cases has “been like barking up the wrong tree, asking the wrong question.” The allergic skin reaction implicated by Stierstorfer’s group involves white blood cells (Type 4 allergy), and is a completely different type of allergy than the antibody-mediated allergies (Type 1 allergy) that have been the focus of prior research.
Stierstorfer is the founder of the IBS Centers for Advanced Food Allergy Testing, dedicated to helping individuals with IBS identify foods contributing to their condition. The Centers’ testing headquarters are located in North Wales, PA, with plans for testing centers in other parts of the U.S. in the near future. Testing is painless with no needles involved. The Centers have added 80 additional carefully selected foods and food additives to the 40 tested in the original study, with the expectation that a greater number of food allergies may be detected and greater number of individuals with IBS may benefit. More information can be found at www.IBSfoodallergy.com.