Irritable bowel syndrome may not be all in your head

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Irritable bowel syndrome, otherwise known as IBS, may be the result of an abdominal infection that triggers an allergic response, according to The New England Journal of Medicine.

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The journal noted gastrointestinal infections often cause abdominal pain after eating in both children and adults, with millions diagnosed with irritable bowel syndrome after a negative workup, frustrating patients because of the very few effective treatments that are available.

Little boy holding hands over his stomach.

"Moreover, clinicians often have the impression that the disease is all in the head," added Dr. Marc E. Rothenberg, the director of the division of allergy and immunology at Cincinnati Children’s Hospital Medical Center.

Man clutches aching stomach.

The current theory suggests patients with IBS have abdominal pain during their daily activities because their intestinal nerves are more sensitive compared to those who don’t have the syndrome, but in times of emotional and physical stress, such as a gastrointestinal infection, these symptoms flare because of the way the nerve signals are processed in the brain, according the article.

"Stress modifies, and can exacerbate, the underlying disease physiology," Rothenberg noted. "But stress is not the cause of IBS."

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A new mouse study by Aguilera-Lizarraga et al., however, found a gastrointestinal bacterial infection breaks the protective lining of the colon, making it more susceptible to food allergens which can penetrate the mucosal lining, triggering an allergic response.

Young woman clutches her stomach.

The researchers compared their basic science findings to 12 patients with IBS versus eight patients without the syndrome by injecting common allergens into their rectal lining, finding all IBS patients had a localized reaction to at least one of the antigens studied versus only two of the controls, who only had a reaction to one single allergen.

The study has limitations because of the small patient sample size and the results of the mice research can’t be equally compared to the clinical research where they injected antigens in the patients’ rectal mucosa, which the authors noted was unconventional.

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Rothenberg summarized, "… although a great deal remains to be elucidated, recent data support the hypothesis that common gastrointestinal ailments, such as IBS and functional abdominal pain, may instead be food-induced allergic disorders."