食物特异性IgG4抗体指导的限制性饮食可改善肠易激综合征症状和直肠顺应性

作     者：Zar S. Mincher L. Benson M.J. Kumar D. 郝筱倩 

作者机构：Department of Gastrointestinal Surgery St. George' s Hospital Medical SchoolCranmer Terrace London SW17 0QT United Kingdom Dr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2005年第1卷第12期

页      面：51-52页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：肠易激综合征 IgG 抗体滴度 特异性 顺应性 罗马Ⅱ标准 证实有效 食物构成 评价根据 排便习惯 

摘      要：Objective. Dietary modification improves symptoms in irritable bowel syndrome (IBS). Identification of offending foods by dietary elimination/re- challenge is cumbersome. IgG4 antibodies to common food antigens are elevated in IBS. The aim of this article was to evaluate the effect of exclusion diet based on IgG4 titres on IBS symptoms and rectal sensitivity and compliance. Material and methods. The study comprised 25 patients with IBS (3M, 22 F,mean age 43 years,Rome II criteria). IgG4 titres to 16 foods (milk, eggs, cheese, wheat, rice, potatoes, chicken, beef, pork, lamb, soya bean, fish, shrimps, yeast, tomatoes and peanuts) were measured. Foods with titres 250 μ g/l were excluded for 6 months. Symptom severity was assessed with a previously validated questionnaire at baseline, at 3 months and at 6 months. Rectal compliance and sensitivity were measured in 12 patients at baseline and at 6 months. Results. IgG4 antibodies to milk, eggs, wheat, beef, pork and lamb were commonly elevated. Significant improvement was reported in pain severity (p 0.001), pain frequency (p = 0.034), bloating severity (p = 0.001), satisfaction with bowel habits (p = 0.004) and effect of IBS on life in general (p = 0.008) at 3 months. Symptom improvement was maintained at 6 months. Rectal compliance was significantly increased (p = 0.011) at 6 months but the thresholds for urge to defecate/discomfort were unchanged. Conclusions. Food- specific IgG4 antibody- guided exclusion diet improves symptoms in IBS and is associated with an improvement in rectal compliance.