Food intolerance in patients with functional abdominal pain: Evaluation through endoscopic confocal laser endomicroscopy.

Autor: Gjini B; Department of Internal Medicine and Gastroenterology, Helios Clinic Krefeld, Germany., Melchior I; Department of Internal Medicine and Gastroenterology, Helios Clinic Krefeld, Germany., Euler P; Department of Internal Medicine and Gastroenterology, Helios Clinic Krefeld, Germany., Kreysel C; Department of Internal Medicine and Gastroenterology, Helios Clinic Krefeld, Germany., Kalde S; Department of Internal Medicine and Gastroenterology, Helios Clinic Krefeld, Germany., Krummen B; Department of Internal Medicine and Gastroenterology, Helios Clinic Krefeld, Germany., Kiesslich R; Department of Internal Medicine and Gastroenterology, Helios Clinic Wiesbaden, Germany., Hemmerlein B; Department of Pathology, Helios Clinic Krefeld, Germany., Frieling T; Department of Internal Medicine and Gastroenterology, Helios Clinic Krefeld, Germany.
Jazyk: angličtina
Zdroj: Endoscopy international open [Endosc Int Open] 2023 Jan 13; Vol. 11 (1), pp. E67-E71. Date of Electronic Publication: 2023 Jan 13 (Print Publication: 2023).
DOI: 10.1055/a-1978-6753
Abstrakt: Background and study aims  Gastrointestinal symptoms assumed to be caused by food intolerance are reported frequently in the general population. There is a significant difference between self-reported and objective proven food intolerance, as shown by placebo-controlled, double-blind, randomized trials. This discrepancy may be overcome by endoscopic confocal laser endomicroscopy (eCLE). Patients and methods  In an observational study we evaluated 34 patients with functional abdominal pain and adverse reaction to food by eCLE and local duodenal food challenge for the first time. Spontaneous and food-induced transfer of fluorescein into the duodenal lumen was detected 10 minutes after intravenously application of fluorescein and 10 minutes after duodenal food challenge (DFC). Results  Of the patients, 67.6 % responded with a fluorescein leakage into the duodenal lumen. Frequency rank order of food antigens that induced a response were soy (50 %), wheat (46.1 %), milk (20 %), egg (12 %), and yeast (11.5 %), respectively. Of the patients, 23.5 % showed spontaneous leakage of fluorescein, suggesting leaky gut syndrome. Histology of duodenal biopsies and mast cell function were normal. Overall, 69.5 % of patients improved with food exclusion therapy and 13 % were symptom-free according to eCLE. Conclusions  The results of our study indicate that eCLE is a clinically useful tool to evaluate patients with functional abdominal pain and adverse reaction to food and to create individualized dietary therapy with clinical benefit for patients.
Competing Interests: Competing interests The authors declare that they have no conflict of interest.
(The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).)
Databáze: MEDLINE