Analysis Of The Relationship Among Food Intolerance,severity Of Symptom And The Number Of Mast Cells In Ileocecal Junction In Diarrhea-dominant Irritable Bowel Syndrome

ObjectiveTo estimate the status of perceived food intolerance in patients with D-IBS and healthy controls,analyse the relationship among food intolerance,severity of symptom and the number of mucosal mast cells in ileocecal junction,and explore the influence of food intolerance on D-IBS.Methods22 patients with D-IBS fulfilling the Rome III criteria and 21 asymptomatic healthy controls underwent colonoscopy in which two adjacent biopsy samples were taken from ICJ.The mucosal MCs were detected by toluidine blue stains.Food intolerance questionary was used to evaluate the perceived FI status of D-IBS patients and controls.FBDSI and IBS-SSS were used to evaluate the severity of symptom in D-IBS group.The relationship among the scores of FBDSI and IBS-SSS,the number of MCs and the scores of FI in D-IBS were analyzed respectively.ResultsThe number of mucosal MCs in ICJ were significantly higher in patients with D-IBS (4.68±0.55/HP)than those in the controls (1.33±0.54/HP) (P<0.001). Compared with controls,the status of perceived FI in patients with D-IBS was more frequent(P<0.05).The scores of FBDSI and IBS-SSS were positively correlated with the scores of FI in D-IBS (FBDSI: r=0.992,P<0.001; IBS-SSS: r=0.970,P<0.001),and with the number of mucosal MCs in ICJ (FBDSI: r=0.957, P<0.001; IBS-SSS: r=0.985,P<0.001).The scores of FI in D-IBS were positively correlated with the number of mucosal MCs in ICJ(r=0.964,P<0.001).The number of mucosal MCs in ICJ were significantly higher in healthy subjects with self-reported FI than those in the controls without FI(P<0.05).ConclusionThe symptoms of D-IBS are positively corelated with the increased number of enteric mucosal MCs which could were activated by numerous stimuli, including food antigen.D-IBS patients show more frequent in perceived FI than controls.D-IBS symptoms may be caused or exacerbated by FI.