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1: Digestion 2001;63(2):108-15 Food-related gastrointestinal symptoms in the irritable bowel syndrome. Simren M, Mansson A, Langkilde AM, Svedlund J, Abrahamsson H, Bengtsson U, Bjornsson ES. Department of Internal Medicine, Section of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Goteborg, Sweden. magnus.simren###medicine.gu.se BACKGROUND/AIMS: Postprandial symptoms are common in patients with irritable bowel syndrome IBS. However, existing studies have come to different conclusions about the role of food in the pathophysiology of IBS. We explored the prevalence of subjective food-related gastrointestinal GI symptoms and its relationship to clinical characteristics and psychological factors in IBS. METHODS: 330 patients with IBS and 80 healthy volunteers completed a food questionnaire developed for this study. The subjects graded their subjective symptoms after 35 different foods and a food score was obtained by adding the item scores. The relationship between subjective food-related GI symptoms and referral status, IBS subgroup predominant bowel pattern, sex, anxiety, depression and body mass index BMI was estimated. RESULTS: In 209 63% of the patients the GI symptoms were related to meals. Gas problems and abdominal pain were the most frequently reported symptoms. Foods rich in carbohydrates, as well as fatty food, coffee, alcohol and hot spices were most frequently reported to cause symptoms. The food score was higher in patients than in controls p < 0.0001. In the IBS group higher scores were observed in patients with anxiety p = 0.005, and females p < 0.001, but the results were unrelated to IBS subgroup, referral status or BMI. The BMI did not differ between groups. CONCLUSION: A majority of IBS patients consider their symptoms to be related to meals. Especially foods rich in carbohydrates and fat cause problems. Nevertheless, the majority of IBS patients are normal or overweight. Female sex and anxiety predict a high degree of food-related symptoms in IBS. Copyright 2001 S. Karger AG, Basel
 
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Interesting article. I'm not sure what it says, though. Forgive me, some of my more well-meaning brain cells have gone to sleep for the evening.
 

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TR:There is so much in my files on gastrointestinal problems and food or additive related symptom provocation that it is almost unmanageable to try to, in the space of a post, use the lengthy trail of studies, even just the abstarcts, to help interpret what is seen by such studies as are based on patient self reporting.Even those who work in the filed of food and chemical allergy and other hypersensitivity will acknowledge the limitations of symptomology and perceived links to dietary intake.In vivo studies have shown that patient suffering symptoms of any kind linked to non IgE mediated food reactions have great difficulty accuratley linking the true provoking agent to the onset of symptoms. This is becasue of the delayed onset and dose depnedent nature of these reactions compared to allergies.Plus almots all studies of diet repsonse in IBS report only the obvious results of chronic upregulation of the entire Brain-Gut axis, NOT its actual etiologies. These can be allergic, non-allergic but proinflammatory linked to immunologic fasctors, inflammatory but linked to emotional stress factors, inflammatory but linked to endocrinologic factors, and non of the systme mechansism have clear origins ...only links to provoking insults OR non-apparent cuases (hence the view of "functional").Plus, the male-female differentiation shown in certain studies driven by medtaor or endocrinoligic factors is unclear as to whther that is etioligoc, OR is it selection bias OR reporting bias (which creeps into and pollutes many self reporting of outcomes compilations).So really it is not possible to draw concrete conclusions from the self-reporting investigations about male-female differences...you have to go to the in vivo studies you have seen so far. As you know they are limited in number but definitley suspicious...but under what causal basis is still unclear.[PS to readrs other thyan TR: if it seems like that was too fast written jargon that is only becasue it is.
I have no time today, and becasue I am talking to Tom directly per his question and he has much experience in studying the subject AND a high specific educational credential so to him its not jargon...not trying to be cutesy etc just trying to talk to TR...thanks for your patience]. Can come back when thetre is more time to go slower and site examples of what I mean.SPIRIT OF ART:What that article boils down to is that of the people selected for survey, the perceived relationships between ditary intake and the listed symptoms showed some higher probabilities for certain types or classes of foods than others that patients perceived as eliciting symptoms, and that there were thus certain patterns of beleief.But it has to then be read in the context of sother work that the same investigator has done in vivo (in body by invasive procedures to loink ACTUAL provoking foods to ACTUAL proinflmmatory reactions in the small bowel) to be able to see the whole picture of what actaully happens "inside". Plus, combined with some of the same lines of work of others in other countries and times over the years, the botom line is that there are indeed non food allergy mechanisms of symptom generation from dietary intake, sometimes called food hypersensitivity, and among the many symptom sets they present with clinically is what is often diagnosed as 'IBS" since it presents as 'IBS".So if you use a symptom based diagnostic criteria, people with food sensitivity symptoms are often diagnosed as IBS. If you use a causal based diagnosis for IBS then depending upon what the diagnostician considers IBS to actaully BE determines whether or not the person is said to have IBS or is described as having "food sensitivity" or "food intolerance" or "food whatever". This is becasue there is no universal causal basis as of yet determined as to what evryone agrees so called 'IBS " is, and symptom based diagnsotics cannot discriminate gut symptoms precipiatetd by hypersensitivity reactiosn of variosu types to dietary componenets and other causal factors for the same symptoms, if they do exist. This is still in a transitional phase.These books together can help enlighten many people to the actual facts behind a complex and controversial subject....IBS: A DOCTORS PLAN FOR CHRONIC DIGESTIVE TROUBLESBy Gerard Guillory, M.D.; Vanessa Ameen, M.D.; Paul Donovan, M.D.; Jack Martin, Ph.D. http://www.amazon.com/exec/obidos/search-h...9085785-1742301 "FOOD ALLERGIES AND FOOD INTOLERANCE: THE COMPLETE GUIDE TO THEIR IDENTIFICTION AND TREATMENT", Professor Jonathan Brostoff , M.D.. Allergy, Immunology and Environmental Medicine, Kings' College, Londonhttp://www.amazon.com/exec/obidos/ASIN/089...r=2-1/102-64875 08-3420903[/URL]Gotta go running late.Eat well, Think well. Be well.MNLMNL
 

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Ohnometo - thanks for the link. Part of my reason for asking for this was so that people could see that there are 106 related articles in this particular data base.An interesting thing to me in the article you posted is that the food intolerance connection is more comon for women and for those who are anxious.tom
 
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Thanx, Mike..... I will read your post in more detail and check out the links you left when I have more time. Right now I gotta dance
 
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