Rizzi Angela, Nucera Eleonora, Laterza Lucrezia, Gaetani Eleonora, Valenza Venanzio, Corbo Giuseppe M, Inchingolo Riccardo, Buonomo Alessandro, Schiavino Domenico, Gasbarrini Antonio
Allergy Unit, Department of Rheumatology, Immunology, Dermatology and Uro-Nefrological Sciences, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy.
Division of Gastroenterology, Department of Internal Medicine, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy.
J Neurogastroenterol Motil. 2017 Jan 30;23(1):101-108. doi: 10.5056/jnm16027.
BACKGROUND/AIMS: Irritable bowel syndrome (IBS) is characterized by chronic abdominal pain or discomfort accompanied by abnormal bowel movements. In sensitized subjects, ingested nickel (Ni) may induce gastrointestinal symptoms similar to IBS, in addition to typical systemic cutaneous lesions (systemic nickel allergy syndrome [SNAS]). A low nickel diet could improve the systemic manifestations. We evaluated prevalence of nickel allergy in IBS and effects of low Ni diet on (1) gastrointestinal symptoms control, (2) intestinal barrier function, (3) quality of life, and (4) psychological status of patients with IBS and Ni-sensitized patients.
Twenty consecutive patients affected by IBS and suspected SNAS underwent intestinal permeability tests. Gastrointestinal symptoms were evaluated using the visual analogue scale before and after 3 months low Ni diet. Subjects with increased intestinal permeability at baseline repeated nuclear examination after the diet.
The most frequent profile was diarrhea-predominant IBS (8/20). The low Ni diet induced a significant and constant improvement of gastrointestinal symptoms and an equally significant improvement of visual analogue scale. Mean urinary output of ⁵¹Chromium ethylene-diamine-tetra-acetate (⁵¹Cr-EDTA) was 5.91%/24 hr (± 2.08), significantly different from the control group (2.20%/24 hr ± 0.60, < 0.0001).
This pilot study shows that low Ni diet improves gastrointestinal symptoms in patients with IBS and SNAS.
背景/目的：肠易激综合征（IBS）的特征为慢性腹痛或不适并伴有肠道运动异常。在致敏个体中，摄入镍（Ni）除了会引发典型的全身性皮肤病变（全身性镍过敏综合征[SNAS]）外，还可能诱发类似于IBS的胃肠道症状。低镍饮食可改善全身症状。我们评估了IBS患者中镍过敏的患病率以及低镍饮食对（1）IBS患者和镍致敏患者胃肠道症状控制、（2）肠道屏障功能、（3）生活质量和（4）心理状态的影响。
连续20例患有IBS且疑似SNAS的患者接受了肠道通透性测试。在低镍饮食3个月前后，使用视觉模拟量表评估胃肠道症状。基线时肠道通透性增加的受试者在饮食后重复进行核素检查。
最常见的类型是以腹泻为主的IBS（8/20）。低镍饮食使胃肠道症状得到显著且持续的改善，视觉模拟量表评分也有同样显著的改善。51铬乙二胺四乙酸（51Cr-EDTA）的平均24小时尿排出量为5.91%（±2.08），与对照组（2.20%/24小时±0.60，P<0.0001）有显著差异。
这项初步研究表明，低镍饮食可改善IBS和SNAS患者的胃肠道症状。
