Fang Zhi-Yun, Zhang Hong-Tao, Lu Chao, Lu Qi-Ming, Yu Chao-Hui, Wang Hui-Ying
Department of Gastroenterology, The Second Affiliated Hospital, School of Medicine, Jiaxing College, Jiaxing, China.
Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Int Arch Allergy Immunol. 2018;177(2):153-159. doi: 10.1159/000489611. Epub 2018 Aug 21.
The relationship between allergic disease and irritable bowel syndrome (IBS) is poorly understood. We aimed to investigate the potential association as well as the underlying immunological mechanisms.
A retrospective case-control study of 108 atopic patients from among outpatients in an allergy clinic (allergic rhinitis [AR], n = 49; chronic urticaria [CU], n = 59) and 74 controls from among ward companions was conducted from November 2016 to March 2017. The detection rates and related gastrointestinal (GI) symptoms of IBS, as well as immunological indices, were calculated.
CU patients had a trend of increase in the detection of IBS compared to controls (OR = 4.846; 95% CI 0.967-24.279, p = 0.077). Loose stools (OR = 2.406; 95% CI 1.075-5.386, p < 0.05) and viscous stools (OR = 2.665; 95% CI 1.250-5.682, p < 0.05) were more common in CU patients. Atopic patients positive for serum total immunoglobulin E (IgE) (OR = 3.379; 95% CI 1.088-10.498, p < 0.05) or house dust mite (HDM)-specific IgE (OR = 3.640; 95% CI 1.228-10.790, p < 0.05) were more likely to have abdominal bloating. Besides, a positive association between levels of total IgE and severity of abdominal bloating was observed (p < 0.05). An HDM-specific IgE-positive reaction was independently associated with abdominal bloating in atopic patients (p < 0.05).
Allergic disease has a clear clinical association with IBS with more frequent and severe symptoms of IBS. CU patients have a tendency to suffer from IBS, usually with diarrhea. Serum total IgE and HDM-specific IgE are positively correlated with GI symptoms in atopic patients.
变应性疾病与肠易激综合征（IBS）之间的关系尚不清楚。我们旨在研究其潜在关联以及潜在的免疫机制。
2016年11月至2017年3月，对一家过敏诊所门诊的108例特应性患者（变应性鼻炎[AR]，n = 49；慢性荨麻疹[CU]，n = 59）和74例病房陪护人员进行回顾性病例对照研究。计算IBS的检出率及相关胃肠道（GI）症状以及免疫指标。
与对照组相比，CU患者IBS检出率有增加趋势（比值比[OR]=4.846；95%置信区间[CI]0.967 - 24.279，p = 0.077）。CU患者中稀便（OR = 2.406；95% CI 1.075 - 5.386，p < 0.05）和黏便（OR = 2.665；95% CI 1.250 - 5.682，p < 0.05）更为常见。血清总免疫球蛋白E（IgE）阳性（OR = 3.379；95% CI 1.088 - 10.498，p < 0.05）或屋尘螨（HDM）特异性IgE阳性（OR = 3.640；95% CI 1.228 - 10.790，p < 0.05）的特应性患者更易出现腹胀。此外，观察到总IgE水平与腹胀严重程度呈正相关（p < 0.05）。HDM特异性IgE阳性反应与特应性患者的腹胀独立相关（p < 0.05）。
变应性疾病与IBS存在明确的临床关联，IBS症状更频繁、严重。CU患者有患IBS的倾向，通常伴有腹泻。血清总IgE和HDM特异性IgE与特应性患者的胃肠道症状呈正相关。
