Irritable Bowel Syndrome

Twenty-one patients with irritable bowel syndrome followed a strict elimination diet, consisting of a single meat, a single fruit, and distilled or spring water, for one week. Symptoms disappeared in 14 of the 21 patients. Subsequently, individual food challenges identified the following symptom-evoking foods (number of cases in parentheses): wheat (9), corn (5), dairy products (4), coffee (4), tea (3), citrus fruits (2). Jejunal biopsies were normal in all nine cases of wheat intolerance, indicating the patients did not have celiac disease. Six patients underwent food challenges in double-blind fashion through a nasogastric tube; the food intolerance was confirmed in each case. Changes in plasma levels of histamine, immune complexes, and eosinophils were similar after challenge with offending foods and control foods, indicating that these food intolerances were probably not immunologically mediated. In contrast, rectal prostaglandin E2 levels increased significantly after challenge with symptom-evoking foods, but only among patients whose gastrointestinal symptoms included diarrhea.

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