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

4 ottobre 2012 at 21:14 9 commenti

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

CLINICAL AUDIT ON FOOD ADVERSE REACTIONS AND ELIMINATION DIET. A  RETROSPECTIVE  STUDY

Francesco Cosentino, PhD Gastroenterology and Hepatology Department Milton Keynes General Hospital NHS –Milton Keynes – UK  Francesco.Cosentino@mkhospital.nhs.uk 

Maria Concetta Giuliano, PhD General Practice Gravina di Catania, NHS Italy mcstudio@hotmail.it

Download presentazione: http://www.asf.toscana.it/images/stories/pubblicazioni/ecim2012/22/m-c-giuliano.pdf

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.

http://www.europeanintegrativemedicinejrnl.com/article/S1876-3820(12)00720-2/fulltext

Entry filed under: 1, Health, medical.