Randomized Trial on Dietary Elimination Based on IBS-Specific IgG Testing: Has the Evidence for Food Sensitivity Arrived?
Food-related symptoms are reported in the majority of individuals with irritable bowel syndrome (IBS),1–3 many of whom use exclusion diets for symptom management. Although there is a substantial body of evidence demonstrating the efficacy of restriction of common triggers such as fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs),5–8 there is a need for other strategies that are guided by an assessment of the mechanisms that induce food-related symptoms. Multiple mechanisms including immune-mediated and non–immune-mediated reactions, such as luminal distention from osmotic effects and microbial fermentation of dietary carbohydrates, chemical reactions, local food antigen interactions, central responses, and individual expectations may drive food sensitivity-related symptoms in IBS.
