Bischoff S C, Herrmann A, Manns M P
Department of Gastroenterology and Hepatology Medical School of Hanover, Germany.
Allergy. 1996 Nov;51(11):811-8.
The role of allergic reactions in the pathogenesis of inflammatory bowel disease and irritable bowel syndrome has been disputed. This study aimed to determine the prevalence of adverse reactions to food in patients with gastrointestinal disease. A total of 375 adult patients of a gastroenterologic outpatient clinic were examined by history, skin tests, measurements of laboratory parameters, and intestinal provocation with food allergens by colonoscopy. Some 32% complained of adverse reactions to food as a cause of their abdominal symptoms. In 14.4%, the diagnosis of intestinal food allergy could be suspected according to several criteria such as elevated total IgE, specific IgE against food antigens, eosinophilia, responsiveness to cromoglycate, and clinical signs of atopic disease. In 3.2%, the diagnosis could be confirmed by endoscopic allergen provocation and/or elimination diet and rechallenge. In conclusion, the data suggest that allergic reactions to food antigens may be a causative factor in a subgroup of patients with inflammatory and functional gastrointestinal disease.
过敏反应在炎症性肠病和肠易激综合征发病机制中的作用一直存在争议。本研究旨在确定胃肠道疾病患者食物不良反应的发生率。通过病史、皮肤试验、实验室参数测量以及结肠镜检查对食物过敏原进行肠道激发试验,对一家胃肠病门诊诊所的375名成年患者进行了检查。约32%的患者抱怨食物不良反应是其腹部症状的原因。根据总IgE升高、针对食物抗原的特异性IgE、嗜酸性粒细胞增多、对色甘酸的反应性以及特应性疾病的临床体征等多项标准,14.4%的患者可怀疑为肠道食物过敏诊断成立。3.2%的患者可通过内镜过敏原激发试验和/或排除饮食及再激发试验确诊。总之,数据表明食物抗原过敏反应可能是炎症性和功能性胃肠道疾病亚组患者的致病因素。