The DOI matches its Crossref record; 45 of the 45 references it cites were found in a registry or an index.
Confocal Endomicroscopy Shows Food-Associated Changes in the Intestinal Mucosa of Patients With Irritable Bowel Syndrome
Open accessAbstract
Background & aims We investigated suspected food intolerances in patients with irritable bowel syndrome (IBS) using confocal laser endomicroscopy (CLE) for real-time visualization of structural/functional changes in the intestinal mucosa after food challenge. Patients with functional changes after food challenge (CLE+) were placed on personalized exclusion diets and followed up for long-term symptom relief.Methods Thirty-six IBS patients with suspected food intolerance and 10 patients with Barrett's esophagus (controls) without IBS symptoms were examined by CLE at University Hospital Schleswig-Holstein (Kiel, Germany). Diluted food antigens were administered directly to the duodenal mucosa through the working channel of the endoscope. Epithelial breaks, intervillous spaces, and the number of intraepithelial lymphocytes (IEL) were measured before and after the food challenge. CLE+ patients were placed on exclusion diets, given symptom score questionnaires, and followed up for 1 year; controls resumed their previous diet.Results CLE showed a real-time response to food antigens in 22 of 36 patients; no responses were observed in 14 of 36 patients (CLE-) or any of the controls. Baseline IELs were significantly higher in CLE+ than CLE- subjects (P = .004); numbers increased significantly after food challenge (P = .0008). Within 5 minutes of exposure of CLE+ patients to food antigens, IELs increased, epithelial leaks/gaps formed, and intervillous spaces widened. Epithelial leaks and intervillous spaces also increased significantly in CLE+ vs baseline (both P < .001). The concordance of IELs measured by CLE and conventional histology was 70.6%; they did not correlate (P = .89; r(2) = 0.027). Symptom scores improved more than 50% in CLE+ patients after a 4-week exclusion diet and increased to 74% at 12 months; symptoms continued in CLE- patients.Conclusions Based on CLE analysis of IBS patients with a suspected food intolerance, exposure to candidate food antigens caused immediate breaks, increased intervillous spaces, and increased IELs in the intestinal mucosa. These changes are associated with patient responses to exclusion diets. Registered at clinicaltrials.gov (registration number: NCT01692613).
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“Removal of the reacting antigen from the diet improved symptoms significantly.67”
From British Society of Gastroenterology guidelines on the management of irritable bowel syndrome (2021) · cites this paper as [67]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Longstreth, G. F., Thompson, W. G., Chey, W. D., Houghton, L. A., Mearin, F., & Spiller, R. C. (2006) · Gastroenterology · doi:10.1053/j.gastro.2005.11.061 · Cited by 4,856
A Diet Low in FODMAPs Reduces Symptoms of Irritable Bowel Syndrome
Halmos, E. P., Power, V. A., Shepherd, S. J., Gibson, P. R., & Muir, J. G. (2014) · Gastroenterology · doi:10.1053/j.gastro.2013.09.046 · Cited by 1,249
Confocal laser endoscopy for diagnosing intraepithelial neoplasias and colorectal cancer in vivo
Kießlich, R., Burg, J., Vieth, M., Gnändiger, J., Enders, M., Delaney, P. M., Polglase, A. L., McLaren, W. J., Janell, D., Thomas, S., et al. (2004) · Gastroenterology · doi:10.1053/j.gastro.2004.06.050 · Cited by 843
Biesiekierski, J. R., Peters, S., Newnham, E., Rosella, O., Muir, J. G., & Gibson, P. R. (2013) · Gastroenterology · doi:10.1053/j.gastro.2013.04.051 · Cited by 794
Biesiekierski, J. R., Newnham, E., Irving, P. M., Barrett, J. S., Haines, M. L., Doecke, J. D., Shepherd, S., Muir, J. G., & Gibson, P. R. (2011) · The American Journal of Gastroenterology · doi:10.1038/ajg.2010.487 · Cited by 712
Böhn, L., Störsrud, S., Törnblom, H., Bengtsson, U., & Simrén, M. (2013) · American Journal of Gastroenterology · doi:10.1038/ajg.2013.105 · Cited by 655
Junker, Y., Zeißig, S., Kim, S., Barisani, D., Wieser, H., Leffler, D. A., Zevallos, V. F., Libermann, T. A., Dillon, S. T., Freitag, T. L., et al. (2012) · The Journal of Experimental Medicine · doi:10.1084/jem.20102660 · Cited by 641
Self-citationIrritable bowel syndrome: A technical review for practice guideline development
Drossman, D. A., Whitehead, W. E., & Camilleri, M. (1997) · Gastroenterology · doi:10.1053/gast.1997.v112.agast972120 · Cited by 571
Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial
Atkinson, W., Sheldon, T. A., Shaath, N., & Whorwell, P. J. (2004) · Gut · doi:10.1136/gut.2003.037697 · Cited by 534
Kießlich, R., Goetz, M., Lammersdorf, K., Schneider, C., Burg, J., Stolte, M., Vieth, M. W., Nafe, B., Galle, P. R., & Neurath, M. F. (2007) · Gastroenterology · doi:10.1053/j.gastro.2007.01.048 · Cited by 530
Cited by
Sorted by citations
Items 301–328 of 328
McKeen, S., Henning, S. M., Lewis, E. D., Evans, M., Graham, E., Jopson, N., Gu, J. L., & Rosendale, D. (2025) · Bioactive Carbohydrates and Dietary Fibre · doi:10.1016/j.bcdf.2025.100468
Confocal laser endomicroscopy of the digestive tract in children
Shavrov, A. A., Васильевна, В. Г., Shavrov, A. A., Морозов, Д. А., & Kharitonova, A. Y. (2025) · Клиническая эндоскопия. · doi:10.31146/2415-7813-endo-66-4-41-53
Leaky Gut – ernährungsassoziierte Störung der intestinalen Barriere
Heldt-Döpel, R., Schütz, L., & Berling, N. (2025) · Ernährung & Medizin · doi:10.1055/a-2439-5831
Νοσογόνος διατροφή ασθενών με στεφανιαία νόσο
Tsantsaridou, A. (2021) · doi:10.12681/eadd/59077
Staudacher, H. M., Batlle, C. C., Phillips, M., Andersen, S., McKenzie, Y. A., & Lomer, M. C. E. (2025) · Frontline Gastroenterology · doi:10.1136/flgastro-2024-102855
Gut Barrier Permeability, Microbiota, and Brain Health
Madison, A. A., Duff, A. F., & Bailey, M. T. (2025) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780190931544.013.17
The role of confocal laser endomicroscopy in pediatric gastrointestinal diseases: a narrative review
Dalpiaz, I., Scarallo, L., Andreini, M., Renzo, S., Russo, G., Ruggiero, C., Volpe, D., Lionetti, P., & Oliva, S. (2025) · Frontiers in Pediatrics · doi:10.3389/fped.2025.1681649
FODMAPs and functional dyspepsia: emerging evidence but unanswered questions
Black, C. J., & Staudacher, H. M. (2025) · Gut · doi:10.1136/gutjnl-2025-336428
Canard, J. M., Dalu, A., & Benkessou, B. (2025) · Food and Nutrition Sciences · doi:10.4236/fns.2025.1610085
Albrecht, A., Rakoczy, T., Bittel, M., Weyrauch, S., Öznur, Ö., Rauschenberger, V., Buslei, R., Tannapfel, A., & Langhorst, J. (2023) · Zeitschrift für Phytotherapie · doi:10.1055/s-0043-1769577
Targeted and individualized dietary interventions in disorders of gut-brain interaction
Routhiaux, K., Gils, T. V., & Balsiger, L. M. (2025) · Best Practice & Research Clinical Gastroenterology · doi:10.1016/j.bpg.2025.102076 · Cited by 2
Neerukonda, M., Geißlitz, S., Jöstl, S., Lingenfelder, R., Neufang, S., Koch, S., Begaj, K., Bockamp, E., Brandt, M., Scherf, K. A., et al. (2026) · Food Chemistry · doi:10.1016/j.foodchem.2026.150662
Self-citationWildner, D., Raithel, M., Waldner, M. J., Hagel, A. F., Neurath, M. F., & Pfeifer, L. (2025) · Ultrasound International Open · doi:10.1055/a-2735-9906
da Luz, B. D., Rondeau, L., Dang, R., Coppens, D., Boron, D., Muppidi, P., Linton, J., Vicentini, F., Marshall, J., de Palma, G., et al. (2026) · bioRxiv · doi:10.64898/2026.02.05.703147
Nahrungsmittelunverträglichkeiten
Theobald, S. (2026) · Springer eBooks · doi:10.1007/978-3-662-69828-0_24
Storr, M., Andresen, V., Frieling, T., Gschossmann, J., Keller, J., Langhorst, J., Pehl, C., Stengel, A., Tebbe, J., Wiemer, K., et al. (2026) · Gastroenterology Research and Practice · doi:10.1155/grp/2610765
Sensibilidad al gluten no celíaca: equilibrio entre la moda y la cruda realidad
Molina‐Infante, J., & Esteve, M. (2026) · Medicina Clínica · doi:10.1016/j.medcli.2026.107516
Das, S., Dubey, A., Khan, G., Patnaik, S., Shrivastava, S., & Singh, R. (2026) · Research Journal of Pharmacy and Technology · doi:10.52711/0974-360x.2026.00415
Pan, P., Gao, J., Zhang, Y., Pan, J.-Y., Zhang, W.-H., Wang, N.-N., Zhao, J.-L., Dong, Z., Xiao, Z.-H., Jin, Z.-D., et al. (2026) · Clinical and Translational Gastroenterology · doi:10.14309/ctg.0000000000001074
(2025) · Elsevier eBooks · doi:10.1016/b978-3-437-21349-6.00026-2
Irritable Bowel Syndrome and Allergic Diseases: A Nationwide Study of 1.5 Million Adolescents
Cohen, B., Dym, I., Nitzan, I., Shakartzi-Kaminsky, N., Fishman, B., Daher, S., Derazne, E., Tzur, D., Furer, A., Twig, G., et al. (2026) · Digestive Diseases and Sciences · doi:10.1007/s10620-026-10190-7
Balsiger, L. M., Schol, J., Raymenants, K., de Bruaene, C. V., Tóth, J., Routhiaux, K., Ceulemans, M., Vanderstappen, J., Verbiest, A., Jones, M., et al. (2026) · Gastroenterology · doi:10.1053/j.gastro.2026.08.026
Non-celiac gluten sensitivity: balance between hype and hard reality
Molina‐Infante, J., & Esteve, M. (2026) · Medicina Clínica (English Edition) · doi:10.1016/j.medcle.2026.107516
Simbrunner, B., Sorribas, M., Schaerer, J., Felber, M., Codinach, J., Rodrigues, S. G., Mandorfer, M., Berzigotti, A., Trauner, M., Reiberger, T., et al. (2026) · JHEP Reports · doi:10.1016/j.jhepr.2026.102037
The Role of Diet in Functional Dyspepsia
Bertin, L., de Bruaene, C. V., Formisano, E., Pesce, M., Piccirelli, S., Salvi, D., Routhiaux, K., Pasta, A., Calabrese, F., Caldart, F., et al. (2026) · Nutrients · doi:10.3390/nu18183064
16 231Zöliakie und Nicht-Zöliakie-Weizensensitivität
Schumann, M., & Studerus, D. (2026) · De Gruyter eBooks · doi:10.1515/9783112213056-016
da Luz, B. B., Rondeau, L. E., Dang, R., Coppens, D., Boron, D., Muppidi, P., Christoforou, A., Linton, J., Vicentini, F., Marshall, J. K., et al. (2026) · Gastroenterology · doi:10.1053/j.gastro.2026.07.042
Barrier dysfunction in allergic diseases: Mechanisms, diagnosis, and therapeutic targeting
Xiao, W., Wang, S., & 陶爱林 (2026) · Allergy medicine. · doi:10.1016/j.allmed.2026.100141
Metadata
- Authors
- Fritscher-Ravens, A., Schuppan, D., Ellrichmann, M., Schoch, S., Röcken, C., Brasch, J., Bethge, J., Böttner, M., Klose, J., & Milla, P. J.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- University Hospital Schleswig-Holstein (DE)
- University College London (GB)
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2014-11
- Volume
- 147
- Issue
- 5
- Pages
- 1012-1020.e4
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W1976947921
- Cited by
- 329
- References
- 45
- Citations by year
- 2026: 25 · 2025: 24 · 2024: 23 · 2023: 21 · 2022: 25 · 2021: 41 · 2020: 33 · 2019: 21 · 2018: 28 · 2017: 26 · 2016: 34 · 2015: 24 · 2014: 4
- FWCI
- 29.45
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Celiac Disease Research and Management
- Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
- Keywords
- irritable bowel syndrome, food intolerance, confocal laser endomicroscopy, food challenge, intestinal mucosa, intraepithelial lymphocytes, intervillous space, elimination diet, duodenal mucosa, Barrett's esophagus, symptom relief, food antigens, intestinal permeability, villous atrophy
- MeSH terms
- Adult, Aged, Duodenum, Feasibility Studies, Female, Food, Food Hypersensitivity, Humans, Immunologic Tests, Intestinal Mucosa, Male, Middle Aged, Pilot Projects, Predictive Value of Tests, Surveys and Questionnaires, Time Factors, Endoscopy, Gastrointestinal, Treatment Outcome, Microscopy, Confocal, Irritable Bowel Syndrome, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
