Functional bowel symptoms, fibromyalgia and fatigue: A food-induced triad? – Source: Scandinavian Journal of Gastroenterology, May 18, 2012

[Note: The most familiar food reaction is a specific immune system response to some protein, involving the immunoglobulin (antibody) IgE - e.g., fairly prompt inflammation, hives, eye and airway swelling. Other immunoglobulins are thought to play a role in other types of food related symptoms. In this study, 83 of 84 'food hypersensitivity' candidates were diagnosed with IBS; the large majority also met FM and/or chronic fatigue criteria; IgE activity did not seem to be implicated; and fat malabsorption affected about 1 in 4.]
 
Objective: Patients with perceived food hypersensitivity typically present with multiple health complaints. We aimed to assess the severity of their intestinal and extra-intestinal symptoms.

Materials and methods: In a prospective study, 84 patients referred to our outpatient clinic for investigation of perceived food hypersensitivity were enrolled consecutively.

Irritable bowel syndrome (IBS) was diagnosed according to the Rome III criteria. Severity and impact of bowel symptoms, fatigue and musculoskeletal pain were evaluated by using the following questionnaires: The IBS Severity Scoring System (IBS-SSS), the Fatigue Impact Scale (FIS), the FibroFatigue Scale (FFS), and visual analogue scales (VAS) for scoring of musculoskeletal pain.

Results:

• All but one patient were diagnosed with IBS, 58% with severe symptoms.

• Extra-intestinal symptoms suggestive of chronic fatigue and fibromyalgia were demonstrated in 85% [chronic fatigue] and 71% [fibromyalgia], respectively.

• Neither IgE-mediated food allergy nor organic pathology could explain the patients' symptoms.

• Nevertheless, malabsorption of fat was demonstrated in 10 of 38 subjects.

Conclusions:

Perceived food hypersensitivity may be associated with severe, debilitating illness.

The comorbid triad of IBS, chronic fatigue, and musculoskeletal pain is striking and may point to a common underlying cause.

Source: Scandinavian Journal of Gastroenterology, May 18, 2012. PMID:22594347, by Berstad A, Undseth R, Lind R, Valeur J. Unger-Vetlesen's Institute and Department of Surgery, Lovisenberg Diakonale Hospital, Oslo; Institute of Medicine, University of Bergen, Bergen, Norway. [Email: Arnold.Berstad@med.uib.no]