Cited by 134Gastrointestinal motility and disordersInflammatory Bowel DiseaseGut microbiota and health

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Food-specific IgG4 antibody-guided exclusion diet improves symptoms and rectal compliance in irritable bowel syndrome

Zar, Sameer, Mincher, Lynne, Benson, Martin J., Kumar, Devinder·2005·Scandinavian Journal of Gastroenterology

DOI 10.1080/00365520510015593

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Abstract

OBJECTIVE: Dietary modification improves symptoms in irritable bowel syndrome (IBS). Identification of offending foods by dietary elimination/re-challenge is cumbersome. IgG4 antibodies to common food antigens are elevated in IBS. The aim of this article was to evaluate the effect of exclusion diet based on IgG4 titres on IBS symptoms and rectal sensitivity and compliance. MATERIALS AND METHODS: The study comprised 25 patients with IBS (3 M, 22 F, mean age 43 years, Rome II criteria). IgG4 titres to 16 foods (milk, eggs, cheese, wheat, rice, potatoes, chicken, beef, pork, lamb, soya bean, fish, shrimps, yeast, tomatoes and peanuts) were measured. Foods with titres >250 microg/l were excluded for 6 months. Symptom severity was assessed with a previously validated questionnaire at baseline, at 3 months and at 6 months. Rectal compliance and sensitivity were measured in 12 patients at baseline and at 6 months. RESULTS: IgG4 antibodies to milk, eggs, wheat, beef, pork and lamb were commonly elevated. Significant improvement was reported in pain severity (p < 0.001), pain frequency (p = 0.034), bloating severity (p = 0.001), satisfaction with bowel habits (p = 0.004) and effect of IBS on life in general (p = 0.008) at 3 months. Symptom improvement was maintained at 6 months. Rectal compliance was significantly increased (p = 0.011) at 6 months but the thresholds for urge to defecate/discomfort were unchanged. CONCLUSIONS: Food-specific IgG4 antibody-guided exclusion diet improves symptoms in IBS and is associated with an improvement in rectal compliance.

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Authors: Zar, S., Mincher, L., Benson, M. J., & Kumar, D.
Affiliations: St George's Hospital (GB)
St Helier Hospital (GB)
Corresponding author: Kumar, Devinder
ORCID: Benson, Martin J.
Venue: Scandinavian Journal of Gastroenterology
Publisher: Informa UK Limited
Published: 2005-01
Volume: 40
Issue: 7
Pages: 800-807
ISSN: 0036-5521 (ISSN-L)
1502-7708
DOI: 10.1080/00365520510015593
OpenAlex: W2137453901
Cited by: 134
References: 24
Citations by year: 2025: 5 · 2024: 2 · 2023: 3 · 2022: 3 · 2021: 7 · 2020: 6 · 2019: 4 · 2018: 9 · 2017: 6 · 2016: 4 · 2015: 4 · 2014: 9 · 2013: 6 · 2012: 10
FWCI: 7.93
Type: journal article
Language: en
Open access: closed
Locations: Scandinavian Journal of Gastroenterology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Health Sciences › Medicine › Gastroenterology › Inflammatory Bowel Disease
Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
Keywords: irritable bowel syndrome, elimination diet, rectal compliance, rectal sensitivity, IBS symptoms, bloating, abdominal pain, food antigens
MeSH terms: Adult, Antibodies, Anti-Idiotypic, Diarrhea, Diet, Female, Food, Food Hypersensitivity, Humans, Immunoglobulin G, Male, Middle Aged, Quality of Life, Rectum, Sensory Thresholds, Severity of Illness Index, Treatment Outcome, Patient Satisfaction, Pain Threshold, Risk Assessment, Irritable Bowel Syndrome

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Food-specific IgG4 antibody-guided exclusion diet improves symptoms and rectal compliance in irritable bowel syndrome

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