Bengtsson U, Hanson L A, Ahlstedt S
Asthma and Allergy Research Centre, Sahlgren's University Hospital, Göteborg, Sweden.
Clin Exp Allergy. 1996 Dec;26(12):1387-94.
Food intolerance in adults is mostly associated with vague symptoms and not clearly related to atopy and food allergy. A combination of different pathogenetic mechanisms may be responsible for the symptoms.
The aim of this study was to describe patients with a history of food-related gastrointestinal symptoms in relation to the presence of mucus in the stools, joint swelling and arthralgia and to determine whether or not there is an association between the presence of these parameters, atopic disease and the presence of immune complexes in serum.
Fifty-eight patients consecutively referred to our clinic with food-related gastrointestinal symptoms were investigated.
Thirty-five patients (60%) had mucus in their stools, 24 patients (41%) complained about joint swelling and 41 patients (71%) had arthralgia. There were no correlations between these parameters and atopy according to Phadiatope test or skin prick test (SPT). No correlations were found between the occurrence of mucus in the stools, arthralgia and joint swelling. There were significantly higher levels of circulating immune complexes in patients with a history of arthralgia compared with patients with no such history (P < 0.03) and the number of individuals with the presence of such immune complexes was higher among the patients with arthralgia than among the patients without. In general the patients did not relate the exposure to certain foods to symptoms like joint swelling, arthralgia and presence of mucus in the stools. However, there were significant positive correlations between food-related gastrointestinal symptoms in the following instances: chocolate-induced gastrointestinal symptoms and mucus in the stools (P = 0.006), vegetable-induced gastrointestinal symptoms and mucus in the stools (P = 0.002) and meat-induced gastrointestinal symptoms and mucus in the stools (P = 0.003). In a group of individuals without food-related symptoms investigated separately, a very low frequency of mucus in the stools, joint swelling and arthralgia was seen (none, two and three individuals of the 20 subjects, respectively). Of 41 patients with immediate onset of gastrointestinal symptoms, 20 were atopic according to Phadiatope and SPT. Of 11 patients with late onset of symptoms 10 were negative in Phadiatope and SPT (P < 0.05). The most frequently involved foods were fruits, vegetables, milk, fish and meat.
The results suggest the involvement of different inflammatogenic mechanisms in food-related gastrointestinal symptoms.
成人食物不耐受大多与模糊症状相关，且与特应性和食物过敏无明显关联。多种不同的致病机制可能共同导致这些症状。
本研究旨在描述有食物相关胃肠道症状病史的患者，这些症状与粪便中黏液、关节肿胀和关节痛的存在情况有关，并确定这些参数的存在、特应性疾病以及血清中免疫复合物的存在之间是否存在关联。
对连续转诊至我们诊所的58例有食物相关胃肠道症状的患者进行了调查。
35例患者（60%）粪便中有黏液，24例患者（41%）主诉关节肿胀，41例患者（71%）有关节痛。根据Phadiatope试验或皮肤点刺试验（SPT），这些参数与特应性之间无相关性。粪便中黏液的出现、关节痛和关节肿胀之间未发现相关性。与无关节痛病史的患者相比，有关节痛病史的患者循环免疫复合物水平显著更高（P < 0.03），且有关节痛的患者中存在此类免疫复合物的个体数量高于无关节痛的患者。总体而言，患者并未将接触某些食物与关节肿胀、关节痛和粪便中黏液等症状联系起来。然而，在以下情况下食物相关胃肠道症状之间存在显著正相关：巧克力引起的胃肠道症状与粪便中黏液（P = 0.006）、蔬菜引起的胃肠道症状与粪便中黏液（P = 0.002）以及肉类引起的胃肠道症状与粪便中黏液（P = 0.003）。在另一组单独调查的无食物相关症状的个体中，粪便中黏液、关节肿胀和关节痛的发生率非常低（20名受试者中分别为无、2例和3例）。在41例胃肠道症状急性发作的患者中，根据Phadiatope和SPT检测，20例为特应性。在11例症状迟发的患者中，10例Phadiatope和SPT检测为阴性（P < 0.05）。最常涉及的食物为水果、蔬菜、牛奶、鱼类和肉类。
结果表明不同的炎症发生机制参与了食物相关胃肠道症状的发生。
