Archive for ottobre, 2012

Reazioni avverse agli alimenti – Reflusso esofageo e Sindrome da colon irritabile

ECIM 2012 – 5th European Congress for Integrative Medicine – “The Future of Comprehensive Patient Care” – 21-22 September 2012 – Palazzo dei Congressi, Florence


Francesco Cosentino, PhD Gastroenterology and Hepatology Department Milton Keynes General Hospital NHS –Milton Keynes – UK 

Maria Concetta GiulianoPhD General Practice Gravina di Catania, NHS Italy

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Recent insights into the role of innate immunity in the intestinal tract underline that role of specific receptors and specialized immunity cells is the basis of tolerance to a food and microrganism. Food adverse reactions can be quite often the cause of reflux acid symptoms and IBS. Recently eosinophilic oesophagitis has been recognized as cause of chronic  GORD symptoms despite PPI therapy. On our experience, we have been recognizing reflux acid symptoms and chronic diarrhoea due to food adverse reactions when every specific diagnostic exam has been unable to demonstrate any remarkable abnormality. Food adverse reactions is responsible for increase in cytokines and histamine, serotonin and nitric oxide production. Nitric oxide is also neuromediator of TLOR and participates in regulating interdigestive motility complex phase III. In many cases of IBS syndrome does exist evidence of triptase increase; further in large bowel mucosa we notice many mastocites which contain many granules rich in histamine and are near to the intestinal nerves. We report retrospective study conducted in the last two years about elimination diet in fifty patients (25 patients with  acid reflux symptoms; 25 patients with chronic diarrhoea). The elimination diet was formulated on the basis of  food adverse reactions emerged by IGG4 Food Intolerance. None of the 25 GERD patients was on proton pump inhibitor or antiacid  therapy either at the time of the test or during three months of exclusion diet (GERD control group13 pts). IBS  patients were taking at the time of test metoclopramide or loperamide tablets without any good improvement. IBD and particularly microscopic colitis had been excluded by colonoscopy and histological colonic biopsies. The specific exclusion diet proved to be effective for ameliorating symptoms in Gerd and IBS patients. After three months, going on  elimination diet, we used reintroduction diet to assess any symptomatology recurrence and then  specific SLIT  for other  three months. After one meal without dietary restriction  was allowed once a week.We increased one meal, without dietary restriction, a week for every month till to reach six  meals a week. Rarely we stopped our schedule. A total period of 12 months was necessary to recover food  tolerance. Food adverse reaction is more often mediated by IGG antibodies  than IGE; IGG4 food intolerance test should be requested  every time we don’t improve patient’s symptoms by therapy and realize the exact nature of symptomatology.


4 ottobre 2012 at 21:14 9 commenti

Patologie Ambientali – stress ossidativo e polimorfismi genetici

ECIM 2012 – 5th European Congress for Integrative Medicine – “The Future of Comprehensive Patient Care” – 21-22 September 2012 – Palazzo dei Congressi, Florence


F. Cosentino1, M.C. Giuliano, F. Bisicchia3 
1Gastroenterology and Hepatology Department Milton Keynes General Hospital NHS – UK, Milton Keynes – 2Ph GP NHS Italy, Gravina di Catania  3Ph GP Trainee NHS Italy, Catania

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The increasing industrialization and globalization have led to an increasing of volatile organic compounds (VOC an increasing of the concentration of heavy metals (lead, mercury, arsenic, cadmium) that in the past were not at concentrations not harm, and an aggravating electromagnetic pollution. All that is the cause of environmental illness. The way in which environmental disease are expressed depends on how the environmental agent enters the body, how it is metabolized, and route of excretion. L ‘increased load of xenobiotics and the consequent increase in oxidative stress would be behind the rise of allergic diseases and in many cases of neoplastic diseases. In particular, some genetic polymorphisms (CYP2D6, PON1, MnSOD, SOD3, GSTP1, GSTM1 GSTT1) or epigenetic alterations through a reduced or absent elimination of superoxide and the subsequent production of peroxynitrite and hydroxyl groups could be responsible for worsening chronic degenerative diseases such as SBS (Sick BuildingSyndrome), CFS (Crhonic Fatigue Syndrome), FMS (Fibromyalgia Syndrome) and MCS (Multi Chemical Sensitivity). Some of these diseases are often diagnosed in the same individual, would suggest that they may represent an epiphenomenon of a common denominator across the nuclear membrane lipid peroxidation damage. DNA damage (epigenetic alteration) and relative decrease of the enzymatic functions of superoxide dismutase, catalase, glutathione peroxidase and transferase justify the low threshold of sensitivity to xenobiotics. The purpose of this research is to perform a retrospective analysis of patients who have already been given the diagnosis of environmental disease, but where neurological symptoms of acute respiratory or may instead be related to somatoform disorders. All patients will undergo tests at the first level, to verify the actual presence of increased oxidative stress, possible involvement of the immune system, presence of neoplastic diseases. Confirmed the presence of increased oxidative stress, are subjected to subsequent investigations (second level) such as the dosages of these enzyme activities in leukocyte and therefore searched for genetic polymorphisms.

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3 ottobre 2012 at 21:17 12 commenti