Extra-intestinal symptoms in patients with irritable bowel syndrome: related to high total IgE levels and atopic sensitization?

• Published in: Scandinavian journal of gastroenterology 2016-08, Vol.51 (8), p.908-913
• Main Authors: Vara, Ellen Johanne, Valeur, Jørgen, Hausken, Trygve, Lied, Gülen Arslan
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Atopic sensitization; fatigue; Fatigue - etiology; Female; Humans; Hypersensitivity - complications; Immunization; Immunoglobulin E - analysis; irritable bowel syndrome; Irritable Bowel Syndrome - complications; Irritable Bowel Syndrome - immunology; Irritable Bowel Syndrome - physiopathology; Male; Middle Aged; musculoskeletal pain; Musculoskeletal Pain - etiology; Surveys and Questionnaires; total IgE; Young Adult
• ISSN: 0036-5521; 1502-7708
• DOI: 10.3109/00365521.2016.1157890

Objective We have previously found that high levels of total IgE, but not atopic sensitization, was a significant predictor for functional gastrointestinal (GI) symptoms. In this study, we aimed to assess the prevalence of extra-intestinal symptoms in IBS patients, and explore their relation to total IgE levels and atopic sensitization. Materials and methods Seventy-one patients with functional GI complaints were included. Severity of GI symptoms, fatigue and musculoskeletal pain was evaluated using the following questionnaires: IBS-Severity Scoring System (IBS-SSS), Fatigue Impact Scale (FIS), FibroFatigue Scale (FFS), and Visual Analog Scales (VAS) for musculoskeletal pain. Levels of total IgE and specific IgE-antibodies were analyzed. Results Fatigue and musculoskeletal pain were demonstrated in 78.9 and 43.7% of the patients, respectively. IBS-SSS scores were significantly correlated with fatigue scores and musculoskeletal pain. Patients with fatigue and musculoskeletal pain had significantly higher IBS-SSS scores than patients without fatigue and musculoskeletal pain. Total IgE levels were significantly higher in IBS patients compared to a healthy control group from a previous study. However, neither total IgE nor atopic sensitization was significantly associated with extra-intestinal symptoms. Conclusions IBS, fatigue, and musculoskeletal pain were significantly associated. Total IgE levels were higher in IBS patients than healthy controls, but not related to intestinal or extra-intestinal symptom severity. Atopy was not associated with any of the co-morbidities. Thus, the clinical significance of high IgE levels in IBS remains unclear and further studies are warranted to explore a common underlying mechanism for the co-morbid triad of IBS, fatigue, and musculoskeletal pain.