Improving quality of life in self-reported gastrointestinal disorders: An open trial of a food elimination diet guided by the ImmunoBloodprint food sensitivity test
Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
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Department of Dietetics and Nutrition, Florida International University, Miami, USA
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3Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
,
Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
,
Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
,
Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
,
Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
,
Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
,
Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
,
Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
,
Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
,
Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
,
Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
1 Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
2 Department of Dietetics and Nutrition, Florida International University, Miami, USA
3 3Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
4 Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
5 Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
6 Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
7 Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
8 Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
9 Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
10 Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
11 Department of Medicine, University of Miami Miller School of Medicine, Miami, USA
12 Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
13 Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
Purpose: Irritable bowel syndrome (IBS) and gastrointestinal (GI) disorders are genuine health problems that have serious consequences on a patient’s quality of life (QoL). IBS is a functional disorder characterized by chronically recurring symptoms, including abdominal pain or discomfort, altered stool frequency and consistency, and abdominal bloating in the ab sence of structural or biochemical abnormalities. Studies have indicated that symptoms and disability related to IBS and GI disorders correlate with QoL measures. Additionally, those who respond to therapy have an improvement in QoL. Therefore, we explored an open trial of a food elimination diet guided by the ImmunoBloodprint food sensitivity test and its effect on QoL in patients self-reporting an unresolved GI disorder. Methods: Eighty-four subjects aged 18 and above participated in the study. Subjects eliminated all IgG-mediated reactive foods from their diet for 90 days. QoL was assessed with the Irritable Bowel Syndrome-36 (IBS-36) and the Medical Outcomes Study Short Form-36 (SF-36) at baseline and 30-, 60-, and 90-day follow-up. The data were analyzed with linear mixed models. Results: Subjects had statistically significant improvements in all indicators of QoL according to the IBS-36 and SF-36 from baseline to 90- day follow-up. Conclusions: Subjects with unresolved self-reported GI disorders were able to improve all indicators of QoL in response to eliminating IgG- reactive foods from the diet. Given the inconvenience of keeping track of foods and symptoms to eliminate intolerant foods, a food sensitivity test combined with an elimination diet may be an effective method for improving subjective markers of QoL and health.
Owens, D.M., Nelson, D.K. and Talley, N.J. (1995) The irritable bowel syndrome: Long-term prognosis and the physician-patient interaction. Annals of Internal Medicine, 122, 107-112. doi:10.7326/0003-4819-122-2-199501150-00005
Hahn, B.A., Yan, S. and Strassels, S. (1999) Impact of irritable bowel syndrome on quality of life and resource use in the United States and United Kingdom. Digestion, 60, 77-81. doi:10.1159/000007593
El-Serag, H.B., Olden, K. and Bjorkman, D. (2002) Health-related quality of life among persons with irritable bowel syndrome: A systematic review. Alimentary Pharmacology & Therapeutics, 16, 1171-1185. doi:10.1046/j.1365-2036.2002.01290.x
Camilleri, M., Northcutt, A.R., Kong, S., Dukes, G.E., McSorley, D. and Mangel, A.W. (2000) Efficacy and safety of alosetron in women with irritable bowel syndrome: A randomised, placebo-controlled trial. Lancet, 355, 1035-1040. doi:10.1016/S0140-6736(00)02033-X
Watson, M.E., Lacey, L., Kong, S., Northcutt, A.R., McSorley, D., Hahn, B. and Mangel, A.W. (2001) Alosetron improves quality of life in women with diarrhea-predominant irritable bowel syndrome. The American Journal of Gastroenterology, 96, 455-459. doi:10.1111/j.1572-0241.2001.03525.x
Van, O.M., Mayeur, S., Meeus, M.A., Rosillon, D., Hendrickx, B. and Ceuppens, M. (1995) A double-blind crossover comparison study of the safety and efficacy of mebeverine with mebeverine sustained release in the treatment of irritable bowel syndrome. Journal of Clinical Pharmacy and Therapeutics, 20, 277-282. doi:10.1111/j.1365-2710.1995.tb00663.x
Inauen, W. and Halter, F. (1994) Clinical efficacy, safety and tolerance of mebeverine slow release (200 mg) vs. mebeverine tablets in patients with irritable bowel syndrome. Drug Investigation, 8, 234-240. doi:10.1007/BF03258483
Gilbody, J.S., Fletcher, C.P., Hughes, I.W. and Kidman, S.P. (2000) Comparison of two different formulations of mebeverine hydrochloride in irritable bowel syndrome. International Journal of Clinical Practice, 54, 461-464.
Lembo, A.J. (2007) The clinical and economic burden of irritable bowel syndrome. Practical Gastroenterology, 9, 3-9.
Cremonini, F. and Talley, N.J. (2005) Irritable bowel syndrome: Epidemiology, natural history, health care seeking and emerging risk factors. Gastroenterology Clinics of North America, 34, 189-204. doi:10.1016/j.gtc.2005.02.008
Talley, N.J. (1999) Irritable bowel syndrome: Definition, diagnosis and epidemiology. Best Practice & Research Clinical Gastroenterology, 13, 371-384. doi:10.1053/bega.1999.0033
Improving quality of life in self-reported gastrointestinal disorders: An open trial of a food elimination diet guided by the ImmunoBloodprint food sensitivity test — Oak Academic Publishing
Petitpierre, M., Gumowski, P. and Girard, J.P. (1985) Irritable bowel syndrome and hypersensitivity to food. Annals of Allergy, 54, 538-540.
Zar, S., Kumar, D. and Benson, M.J. (2001) Food hyper- sensitivity and irritable bowel syndrome. Alimentary Pharmacology & Therapeutics, 15, 439-449. doi:10.1046/j.1365-2036.2001.00951.x
Zwetchkenbaum, J.F. and Burakoff, R. (1988) Food allergy and the irritable bowel syndrome. The American Journal of Gastroenterology, 83, 901-904.
Awazuhara, H., Kawai, H. and Maruchi, N. (1997) Major allergens in soybean and clinical significance of IgG4 antibodies investigated by IgE- and IgG4-immunoblotting with sera from soybean-sensitive patients. Clinical & Experimental Allergy, 27, 325-332. doi:10.1111/j.1365-2222.1997.tb00711.x
Crowe, S.E. and Perdue, M.H. (1992) Gastrointestinal food hypersensitivity: Basic mechanisms of pathophysiology. Gastroenterology, 103, 1075-1095.
elRafei, A., Peters, S.M., Harris, N. and Bellanti, J.A. (1989) Diagnostic value of IgG4 measurements in patients with food allergy. Annals of Allergy, 62, 94-99.
Host, A., Husby, S., Gjesing, B., Larsen, J.N. and Low-enstein, H. (1992) Prospective estimation of IgG, IgG subclass and IgE antibodies to dietary proteins in infants with cow milk allergy. Levels of antibodies to whole milk protein, BLG and ovalbumin in relation to repeated milk challenge and clinical course of cow milk allergy. Allergy, 47, 218-229. doi:10.1111/j.1398-9995.1992.tb00654.x
Groll, D., Vanner, S.J., Depew, W.T., DaCosta, L.R., Simon, J.B., Groll, A., Roblin, N. and Paterson, W.G. (2002) The IBS-36: A new quality of life measure for irritable bowel syndrome. The American Journal of Gastroenterology, 97, 962-971. doi:10.1111/j.1572-0241.2002.05616.x
Ware, J., Kosinski, M. and Dewey, J. (2000) How to score version two of the sf-36 health survey. Quality Metric, Incorporated, Lincoln, RI.
Drisko, J., Bischoff, B., Hall, M. and McCallum, R. (2006) Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics. Journal of the American College of Nutrition, 25, 514-522. doi:10.1080/07315724.2006.10719567
Asero, R., Ballmer-Weber, B.K., Beyer, K., Conti, A., Dubakiene, R., Fernandez-Rivas, M., Hoffmann-Sommergruber, K., Lidholm, J., Mustakov, T., Oude Elberink, J.N., Pumphrey, R.S., Stahl, S.P., van, R.R., Vlieg-Boerstra, B.J., Hiller, R., Hourihane, J.O., Kowalski, M., Papadopoulos, N.G., Wal, J.M., Mills, E.N. and Vieths, S. (2007) IgE-mediated food allergy diagnosis: Current status and new perspectives. Molecular Nutrition & Food Research, 51, 135-147. doi:10.1002/mnfr.200600132
Ortolani, C., Bruijnzeel-Koomen, C., Bengtsson, U., Bindslev-Jensen, C., Bjorksten, B., Host, A., Ispano, M., Jarish, R., Madsen, C., Nekam, K., Paganelli, R., Poulsen, L.K. and Wuthrich, B. (1999) Controversial aspects of adverse reactions to food. European Academy of Allergology and Clinical Immunology (EAACI) reactions to food subcommittee. Allergy, 54, 27-45. doi:10.1034/j.1398-9995.1999.00913.x
Atkinson, W., Sheldon, T.A., Shaath, N. and Whorwell, P.J. (2004) Food elimination based on IgG antibodies in irritable bowel syndrome: A randomised controlled trial. Gut, 53, 1459-1464. doi:10.1136/gut.2003.037697
Husby, S., Oxelius, V.A., Teisner, B., Jensenius, J.C. and Svehag, S.E. (1985) Humoral immunity to dietary antigens in healthy adults. Occurrence, isotype and IgG subclass distribution of serum antibodies to protein antigens. International Archives of Allergy and Immunology, 77, 416-422. doi:10.1159/000233819
King, H.C. (1994) Exploring the maze of adverse reactions to foods. Ear, Nose & Throat Journal, 73, 237-241.
Kruszewski, J., Raczka, A., Klos, M. and Wiktor-Jedrzejczak, W. (1994) High serum levels of allergen specific IgG-4 (asIgG-4) for common food allergens in healthy blood donors. Archivum Immunologiae et Therapia Experimentalis (Warsz), 42, 259-261.
Nanda, R., James, R., Smith, H., Dudley, C.R. and Jewell, D.P. (1989) Food intolerance and the irritable bowel syndrome. Gut, 30, 1099-1104. doi:10.1136/gut.30.8.1099
Sicherer, S.H. (2001) Clinical implications of cross-reactive food allergens. Journal of Allergy and Clinical Immunology, 108, 881-890. doi:10.1067/mai.2001.118515
Sicherer, S.H. (1999) Food allergy: When and how to perform oral food challenges. Pediatric Allergy and Immunology, 10, 226-234. doi:10.1034/j.1399-3038.1999.00040.x
Gordon, B.R. (2003) Approaches to testing for food and chemical sensitivities. Otolaryngologic Clinics of North America, 36, 917-940. doi:10.1016/S0030-6665(03)00059-8
Sampson, H.A. and Burks, A.W. (1996) Mechanisms of food allergy. Annual Review of Nutrition, 16, 161-177. doi:10.1146/annurev.nu.16.070196.001113