Background: Patients with irritable bowel syndrome (IBS) often feel they have some form of dietary intolerance and frequently try exclusion diets. Tests attempting to predict food sensitivity in IBS have been disappoi...Background: Patients with irritable bowel syndrome (IBS) often feel they have some form of dietary intolerance and frequently try exclusion diets. Tests attempting to predict food sensitivity in IBS have been disappointing but none has utilised IgG antibodies. Aims: To assess the therapeutic potential of dietary elimination based on the presence of IgG antibodies to food. Patients: A total of 150 outpatients with IBS were randomised to receive, for three months, either a diet excluding all foods to which they had raised IgG antibodies (enzyme linked immunosorbant assay test) or a sham diet excluding the same number of foods but not those to which they had antibodies. Methods: Primary outcome measures were change in IBS symptom severity and global rating scores. Noncolonic symptomatology, quality of life, and anxiety/depression were secondary outcomes. Intention to treat analysis was undertaken using a generalised linear model. Results: After 12 weeks, the true diet resulted in a 10%greater reduction in symptom score than the sham diet (mean difference 39 (95%confidence intervals (CI) 5-72); p = 0.024) with this value increasing to 26%in fully compliant patients (difference 98 (95%CI 52-144); p<0.001). Global rating also significantly improved in the true diet group as a whole (p = 0.048, NNT = 9) and even more in compliant patients (p = 0.006, NNT = 2.5). All other outcomes showed trends favouring the true diet. Relaxing the diet led to a 24%greater deterioration in symptoms in those on the true diet (difference 52 (95%CI 18-88); p = 0.003). Conclusion: Food elimination based on IgG antibodies may be effective in reducing IBS symptoms and is worthy of further biomedical research.展开更多
Background/Goals: Irritable bowel syndrome is more common in women; and this is generally considered to be caused by increased susceptibility. However, the opposite possibility that being male might actually protect f...Background/Goals: Irritable bowel syndrome is more common in women; and this is generally considered to be caused by increased susceptibility. However, the opposite possibility that being male might actually protect from the disorder in some way, has largely been ignored. We have noticed that men with IBS seem to display less masculine and more feminine qualities and it was the purpose of this study to confirm or refute this clinical observation. Study: Seventy consecutive male, secondary care outpatients fulfilling the Rome 1 criteria for irritable bowel syndrome and 70 controls completed a questionnaire to determine male and female-trait scores. In addition,all subjects were assessed using the hospital anxiety depression inventory. Results: A highly significant reduction in male-trait scores was observed in the irritable bowel syndrome patients compared with controls (-10.5-15.7,-5.2 P < 0.001). There were no differences between the groups with respect to female-trait scores. The prevalence of homosexuality was no different between patients and controls. Conclusion: Men with irritable bowel syndrome exhibit less male characteristics and it remains to be determined whether this is cause or effect. Whatever the explanation, this study adds another dimension to the role of gender in functional gastrointestinal disorders.展开更多
文摘Background: Patients with irritable bowel syndrome (IBS) often feel they have some form of dietary intolerance and frequently try exclusion diets. Tests attempting to predict food sensitivity in IBS have been disappointing but none has utilised IgG antibodies. Aims: To assess the therapeutic potential of dietary elimination based on the presence of IgG antibodies to food. Patients: A total of 150 outpatients with IBS were randomised to receive, for three months, either a diet excluding all foods to which they had raised IgG antibodies (enzyme linked immunosorbant assay test) or a sham diet excluding the same number of foods but not those to which they had antibodies. Methods: Primary outcome measures were change in IBS symptom severity and global rating scores. Noncolonic symptomatology, quality of life, and anxiety/depression were secondary outcomes. Intention to treat analysis was undertaken using a generalised linear model. Results: After 12 weeks, the true diet resulted in a 10%greater reduction in symptom score than the sham diet (mean difference 39 (95%confidence intervals (CI) 5-72); p = 0.024) with this value increasing to 26%in fully compliant patients (difference 98 (95%CI 52-144); p<0.001). Global rating also significantly improved in the true diet group as a whole (p = 0.048, NNT = 9) and even more in compliant patients (p = 0.006, NNT = 2.5). All other outcomes showed trends favouring the true diet. Relaxing the diet led to a 24%greater deterioration in symptoms in those on the true diet (difference 52 (95%CI 18-88); p = 0.003). Conclusion: Food elimination based on IgG antibodies may be effective in reducing IBS symptoms and is worthy of further biomedical research.
文摘Background/Goals: Irritable bowel syndrome is more common in women; and this is generally considered to be caused by increased susceptibility. However, the opposite possibility that being male might actually protect from the disorder in some way, has largely been ignored. We have noticed that men with IBS seem to display less masculine and more feminine qualities and it was the purpose of this study to confirm or refute this clinical observation. Study: Seventy consecutive male, secondary care outpatients fulfilling the Rome 1 criteria for irritable bowel syndrome and 70 controls completed a questionnaire to determine male and female-trait scores. In addition,all subjects were assessed using the hospital anxiety depression inventory. Results: A highly significant reduction in male-trait scores was observed in the irritable bowel syndrome patients compared with controls (-10.5-15.7,-5.2 P < 0.001). There were no differences between the groups with respect to female-trait scores. The prevalence of homosexuality was no different between patients and controls. Conclusion: Men with irritable bowel syndrome exhibit less male characteristics and it remains to be determined whether this is cause or effect. Whatever the explanation, this study adds another dimension to the role of gender in functional gastrointestinal disorders.
