Neither self‐reported atopy nor IgE‐mediated allergy are linked to gastrointestinal symptoms in patients with irritable bowel syndrome

• Published in: Neurogastroenterology and motility Vol. 30; no. 10; pp. e13379 - n/a
• Main Authors: Nybacka, S., Öhman, L., Störsrud, S., Mybeck, M., Böhn, L., Wilpart, K., Winkvist, A., Bengtsson, U., Törnblom, H., Simrén, M.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.10.2018
• Subjects: activated mast-cells; Asthma; atopic disease; Atopy; Clinical Medicine; clinical-significance; correlate; depression; disorders; Eczema; Food allergies; food hypersensitivity; Food intolerance; Gastroenterology & Hepatology; IgE; Immunoglobulin E; Intestine; Irritable bowel syndrome; Klinisk medicin; Neurosciences & Neurology; proximity; quality-of-life; Regression analysis; Rhinoconjunctivitis; self-perceived food intolerance; somatic symptoms; atopic disease; self-perceived food intolerance; irritable bowel syndrome; IgE
• ISSN: 1350-1925; 1365-2982; 1365-2982
• DOI: 10.1111/nmo.13379

Background Among patients with irritable bowel syndrome (IBS), atopic disease has been proposed as a common comorbidity increasing the IBS symptom burden. We therefore assessed the prevalence of self‐reported atopy among patients with IBS as compared to non‐IBS controls, and whether atopy and higher serum IgE levels were associated with increased IBS symptom severity. Methods Levels of total and specific IgE in serum were measured and questionnaires assessing the presence of atopic disease (ie, eczema, asthma, rhinoconjunctivitis, and pollen allergy), gastrointestinal symptom burden, food intolerance, somatic, and psychological symptoms were completed. Key results In total, 223 patients with IBS and 47 controls participated. Presence of atopic disease was reported in 55% of patients with IBS compared to 40% of controls (P = .07). IBS patients with atopic manifestations (N = 123) had higher total serum IgE levels (median 31 vs 16 kUA/L, P < .001) and higher prevalence of self‐reported food intolerance (28% vs 9%, P = .002) than non‐atopic IBS patients (N = 100), respectively, but no major difference in gastrointestinal or psychological symptom burden was noted. However, severe somatic symptoms were more common among atopic than non‐atopic patients with IBS (38% vs 27%, P = .028). We found no associations between self‐reported atopy and IBS symptom severity using linear regression models. Conclusions & Inferences Atopic disease is common in patients with IBS, but that is also true for subjects without IBS. The presence of atopic disease in IBS is associated with self‐reported food intolerance and somatic symptom severity, but unrelated to IBS symptom severity. This article focuses on the link between atopic disease and IBS, and if atopic patients have more severe IBS symptoms than non‐atopic patients. We saw that atopic disease is common in patients with IBS, but not associated with the severity of IBS symptoms. Compared to non‐atopic IBS patients, atopic IBS patients had an increased prevalence of self‐reported food allergy/intolerance and more severe somatic symptoms.