Su1344 ENDOMICROSCOPIC DETECTION OF ATYPICAL FOOD ALLERGY IN PATIENTS WITH IRRITABLE BOWEL SYNDROME – A NEW DIAGNOSTIC ERA?

Kießlich, Ralf; Adib-Tezer, Hanan; Teubner, Daniel; Frieling, Thomas; Mudter, Jonas; Bayerl, Christiane; Wenda, Nina; Gosepath, Jan

doi:10.1016/s0016-5085(20)32099-0

Cited by 5 publications

(3 citation statements)

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“…The diagnostic value of endomicroscopy for diagnosing food allergy and tailoring the exclusion diet is displayed in table 2. Here the results of 56 patients with IBS are shown (30). In conclusion, functional imaging with endomicroscopy for diagnosing atypical food allergies has a great potential to establish as an additional part of standard care for food allergy diagnosis.…”

Section: Duodenal Diseases -Celiac Disease and Atypical Food Allergiesmentioning

confidence: 86%

“…Endomicroscopy can be used to observe and quantify the duodenal reaction to food allergens (see table 1). The key findings are cell shedding and fluorescein leakage as indicators for positive reactions (29) (see figure 4) This response to food antigens is clearly visible with endomicroscopy and follows a defined pathophysiology sequence within 2-5 minutes of exposure to the food allergen (29)(30). Clinical studies showed that an exclusion diet based on endomicroscopic findings leads to symptom improvement of irritable bowel syndrome.…”

Section: Duodenal Diseases -Celiac Disease and Atypical Food Allergiesmentioning

confidence: 99%

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Diagnostic Value of Endomicroscopy for Gastrointestinal Diseases: New Possibilities and Concepts

Kießlich

2021

Techniques and Innovations in Gastrointestinal Endoscopy

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Section: Duodenal Diseases -Celiac Disease and Atypical Food Allergiesmentioning

confidence: 86%

Section: Duodenal Diseases -Celiac Disease and Atypical Food Allergiesmentioning

confidence: 99%

Diagnostic Value of Endomicroscopy for Gastrointestinal Diseases: New Possibilities and Concepts

Kießlich

2021

Techniques and Innovations in Gastrointestinal Endoscopy

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“…The magnification factor was 1000 x. DFC was performed always by the same sequential application of 5 different main food components diluted in 30 ml water (280-310 mosm/l) to the duodenal mucosa above the major papilla. The concentration of food allergens was standardized and applied as recommended in the literature [13]. These were 1.5 g dry bio-yeast, 3 g egg, 1.5 g bio-milk, and 3 g soy flour and 3 g wheat flour, respectively.…”

Section: Methodsmentioning

confidence: 99%

Gastrointestinal adverse reaction to food (GARF) and endoscopic confocal laser endomicroscopy (eCLE)

Frieling,

Gjini,

Melchior

et al. 2024

Z Gastroenterol

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Background and study aims Gastrointestinal adverse reaction to food (GARF) is reported frequently in the general population and even more in patients with disorders of the gut brain axis. However, there is a significant difference between self-reported and objective proven GARF. The aim of the study was to characterize a mucosal correlate of GARF by endoscopic confocal laser endomicroscopy (eCLE) with duodenal food challenge (DFC). Patients and methods In an observational and proof of concept study we evaluated 71 patients with disorders of the gut brain axis without (group I, n=19) and with (group II, n=52) GARF by eCLE and DFC. Spontaneous and food induced transfer of fluorescein into duodenal lumen was detected 10 minutes following intravenously application of fluorescein and 10 minutes after DFC. Results According to Rom IV, the patients (group I/II) could be classified as irritable bowel syndrome (IBS) 32%/31%, functional abdominal pain without changes in bowel movement 47 %/48 %, functional abdominal bloating/distension 0 %/10 %, functional diarrhea 5 %/ 2 %, and unspecified functional bowel disorder 16 %/10 %, respectively. 21 %/27 % of the patients responded with a fluorescein leakage into the duodenal lumen before and 74 %/69 % following to DFC. Frequency rank order of food components that induced a response were soy (55.5 %/60 %), wheat (60 %/45.5 %), egg (35.7 %/8.3), milk (30 %/18.2 %) and yeast (10 %/6.6 %), respectively. Histology of duodenal biopsies, number, form and distribution of intraepithelial lymphocytes and mucosal mast cells as well as mast cell function were normal. Overall, 14 %/79 % reported main symptom benefit following a food exclusion therapy according to eCLE and DFC that was significant different between the groups. Conclusion The results of our study indicate that eCLE with DFC is a technique to clinically evaluate patients with disorders of the gut brain axis and GARF resulting in a high proportion of patients reporting symptom benefit upon food exclusion dietary advice focussed on the results of eCLE.

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Advanced Imaging Techniques and In Vivo Histology: Current Status and Future Perspectives (Upper G.I)

Kießlich

2021

Gastrointestinal and Pancreatico-Biliary Diseases: Advanced Diagnostic and Therapeutic Endoscopy

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Su1344 ENDOMICROSCOPIC DETECTION OF ATYPICAL FOOD ALLERGY IN PATIENTS WITH IRRITABLE BOWEL SYNDROME – A NEW DIAGNOSTIC ERA?

Cited by 5 publications

References 0 publications

Diagnostic Value of Endomicroscopy for Gastrointestinal Diseases: New Possibilities and Concepts

Diagnostic Value of Endomicroscopy for Gastrointestinal Diseases: New Possibilities and Concepts

Gastrointestinal adverse reaction to food (GARF) and endoscopic confocal laser endomicroscopy (eCLE)

Advanced Imaging Techniques and In Vivo Histology: Current Status and Future Perspectives (Upper G.I)

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