Utility of Food Patch Testing in the Evaluation and Management of Irritable Bowel Syndrome

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Grace Shin
Michael Smith
Butros Toro
Adam Ehrlich
Sanjana Luther
Deena Midani
Inki Hong
Michael Stierstorfer http://orcid.org/0000-0002-0505-7431


Irritable bowel syndrome, IBS, delayed-type hypersensitivity, type 4 hypersensitivity, patch testing, food allergy, skin tests



Irritable Bowel Syndrome (IBS) is a functional gastrointestinal (GI) disorder of unknown etiology.


We sought to investigate whether specific type 4 food allergens identified by skin patch testing, when eliminated from the diet, alleviate symptoms of IBS.


In this case series, skin patch testing was performed on 60 IBS patients using an extensive panel of type 4 food allergens after which food avoidance diets directed by the patch test results were implemented. Questionnaires assessing abdominal pain/discomfort and global improvement in IBS symptoms were used to assess one month and three or more month outcomes.


There were statistically significant improvements in abdominal pain/discomfort and in global IBS symptoms after one month and again at an average of 7.6 months of patch test-guided food avoidance.


Sustained improvement with avoidance of type 4 food allergens identified by skin patch testing suggests a role for delayed-type food hypersensitivities in the pathogenesis of some cases of IBS. A subset of patients whose IBS symptoms resolve completely may be better characterized as having a newly proposed disease, allergic contact enteritis (ACE). 



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