woman on toilet that dyspepsia or dirrheaA study was performed and published in the Lancet (November 20, 1982:1115-1117); It had three parts and looked at food sensitivity and its role in IBS. In one study, 25 patients with IBS followed a strict elimination diet. For one week their entire diet consisted of one kind of meat and a single fruit. If the IBS symptoms abated, they were to reintroduce one food per day until symptoms occurred. If it seemed that the food created the symptoms, the subjects were challenged with it on three different occasions.

Six of the IBS patients were symptom free while on the elimination diet in the first part of the study. They were hospitalized for four days and given only foods that did not cause IBS symptoms, eating the same menu each day. Breakfast was given as a double-blind food challenge.

In the third part of the study, five of the patients were admitted for four days on two different occasions that were four weeks apart. The subjects received the food that triggered symptoms disguised and hidden in a soup twice each day. Foods that commonly triggered symptoms included wheat, corn, dairy, coffee, tea and citrus. The double-blind and single-blind challenges in the second and third parts of the study confirmed that the foods triggered symptoms. Plasma glucose, histamine, immune complexes, haematocrit, eosinophil count, or breath hydrogen excretion did not change after challenge or control foods. Rectal prostaglandin E2 (PGE2) did increase, and in a further 5 patients rectal PGE2 correlated with wet faecal weight. Food intolerance associated with prostaglandin production is an important factor in the pathogenesis of IBS.