Utility of Food Patch Testing in the Evaluation and Management of Irritable Bowel Syndrome

Shin, Grace H.; Smith, Michael; Toro, Butros; Ehrlich, Adam C.; Luther, Sanjana; Midani, Deena; Hong, Inki; Stierstorfer, Michael

doi:10.25251/skin.2.2.2

Cited by 3 publications

(11 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The freeze-dried vegetable formulations were taken from the 2018 report. 9 Standard skin patch test procedure protocols 12 were used, affixing the patches to the upper aspect of the back.…”

Section: Methodsmentioning

confidence: 99%

“…In addition to major disturbances in quality of life, 14,15 the cost to society in direct medical expenses and indirect costs associated with loss of productivity and work absenteeism is considerable; estimates range from $21 billion or more annually. 16 Food Hypersensitivities Triggering IBS-This study further evaluated a role for skin patch testing to identify delayed-type (type IV) food hypersensitivities that trigger IBS symptoms and differed from the prior investigations 9,10 in that the symptoms used to define IBS were updated from the Rome III 17 to the newer Rome IV 2 criteria. The data presented here show moderate to great improvement in global IBS symptoms in 58% (11/19) of patients, which is in line with a 2018 report of 40 study participants for whom follow-up at 3 or more months was available, 9 providing additional support for a role for type IV food allergies in causing the same gastrointestinal tract symptoms that define IBS.…”

Section: Commentmentioning

confidence: 99%

“…By following a patch test-guided food avoidance diet, a large subpopulation of patients with IBS experienced partial or complete IBS symptom relief. 9,10 Our study further investigates a role for food-related delayed-type hypersensitivities in the pathogenesis of IBS.…”

mentioning

confidence: 99%

“…Based on this body of literature, a large 2010 consensus report on all aspects of food allergies advises against food allergy testing for IBS. 8 In contrast, by utilizing type IV food allergen skin patch testing, 2 proof-of-concept studies 9,10 investigated a different allergic mechanism in IBS, namely cell-mediated delayed-type hypersensitivity. Because many foods and food additives are known to cause allergic contact dermatitis, 11 it was hypothesized that these foods may elicit a similar delayed-type hypersensitivity response in the intestinal lining in previously sensitized individuals.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Patch Test–Directed Dietary Avoidance in the Management of Irritable Bowel Syndrome

Stierstorfer¹

2021

Cutis

Self Cite

View full text Add to dashboard Cite

“…The freeze-dried vegetable formulations were taken from the 2018 report. 9 Standard skin patch test procedure protocols 12 were used, affixing the patches to the upper aspect of the back.…”

Section: Methodsmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Patch Test–Directed Dietary Avoidance in the Management of Irritable Bowel Syndrome

Stierstorfer¹

2021

Cutis

Self Cite

View full text Add to dashboard Cite

“…Atopy patch testing is a diagnostic procedure for identifying delayed hypersensitivity reactions that have been primarily useful in identifying allergens in contact dermatitis [ 72 ]. In very limited, uncontrolled studies of adults with IBS, patch testing has been reported to identify foods that, when restricted, resulted in clinical improvement [ 110 , 111 ]. There is currently insufficient data to support patch testing in FAPDs.…”

Section: Allergy and Functional Abdominal Pain Disordersmentioning

confidence: 99%

Update on the Role of Allergy in Pediatric Functional Abdominal Pain Disorders: A Clinical Perspective

2021

View full text Add to dashboard Cite

Both functional abdominal pain disorders (FAPDs) and food allergies are relatively common in children and adolescents, and most studies report an association between FAPDs and allergic conditions. FAPDs share pathophysiologic processes with allergies, including both immune and psychological processes interacting with the microbiome. No conclusive data are implicating IgE-mediated reactions to foods in FAPDs; however, there may be patients who have IgE reactions localized to the gastrointestinal mucosa without systemic symptoms that are not identified by common tests. In FAPDs, the data appears stronger for aeroallergens than for foods. It also remains possible that food antigens initiate an IgG reaction that promotes mast cell activation. If a food allergen is identified, the management involves eliminating the specific food from the diet. In the absence of systemic allergic symptoms or oral allergy syndrome, it appears unlikely that allergic triggers for FAPDs can be reliably identified by standard testing. Medications used to blunt allergic reactions or symptomatically treat allergic reactions may be useful in FAPDs. The purpose of the current manuscript is to review the current literature regarding the role of allergy in FAPDs from a clinical perspective, including how allergy may fit in the current model of FAPDs.

show abstract

Non-IgE-mediated Gastrointestinal Food Allergy in Children: Our Foods and Atopy Patch Test

Abbaslou,

Bazargan,

Ahmadipour

et al. 2023

Journal of Kerman University of Medical Sciences

View full text Add to dashboard Cite

Background: Food allergy (FA) is an increasing health problem in children. Previous studies have reported conflicting results about the diagnostic value of atopy patch test in food allergies. The aim of the present study was to investigate the accuracy of atopy patch test in identifying non-IgE-mediated gastrointestinal FA to pasteurized/homogenized cow›s milk, heated raw cow›s milk, white and yolk egg, soy, wheat, walnut, sesame, pistachio, almond, peanut, date and cumin which are popular food ingredients in southern Iran. Methods: This study was performed on children with gastrointestinal allergic problems who were not improved after at least 4 weeks of cow’s milk protein elimination. Atopy patch test (APT) was performed and the elimination diet was considered according to positive skin results and after resolving symptoms, introduction of each accused food was done sequentially. Results: Fifty tree children under 7 years old with mean age of 19.6 months underwent APT and the results were verified by open oral food challenge (OFC). Sensitivity in the range of 59%-95%, specificity of 80.7-92.8%, positive predictive values of 75-96.4% and negative predictive value of 23%-80.7% were calculated depending on the type of food. Compared to the heated raw cow’s milk, the pasteurized/homogenized cow’s milk reaction was significant. Conclusion: APT can be included in the diagnostic workup of non-IgE-mediated GI allergy because it is safe and has great accuracy. However, several aspects require further investigation especially to enable the standardization of the technique. We should be aware of the allergenicity of our foods due to processing and geographic region.

show abstract

Utility of Food Patch Testing in the Evaluation and Management of Irritable Bowel Syndrome

Abstract: Background. Irritable Bowel Syndrome (IBS) is a functional gastrointestinal (GI) disorder of unknown etiology.

Cited by 3 publications

References 20 publications

Patch Test–Directed Dietary Avoidance in the Management of Irritable Bowel Syndrome

Patch Test–Directed Dietary Avoidance in the Management of Irritable Bowel Syndrome

Update on the Role of Allergy in Pediatric Functional Abdominal Pain Disorders: A Clinical Perspective

Non-IgE-mediated Gastrointestinal Food Allergy in Children: Our Foods and Atopy Patch Test

Contact Info

Product

Resources

About