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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 21, 2015; 21(23): 7089-7109
Published online Jun 21, 2015. doi: 10.3748/wjg.v21.i23.7089
Food allergy in irritable bowel syndrome: The case of non-celiac wheat sensitivity
Pasquale Mansueto, Alberto D’Alcamo, Aurelio Seidita, Antonio Carroccio
Pasquale Mansueto, Alberto D’Alcamo, Aurelio Seidita, Antonio Carroccio, Biomedical Department of Internal Medicine and Specialist, University Hospital of Palermo, 90141 Palermo, Italy
Antonio Carroccio, Internal Medicine Department, Hospital of Sciacca (Agrigento), 92019 Sciacca (AG), Italy
Author contributions: All the authors reviewed international literature performing a critical revision for important intellectual content.
Conflict-of-interest: All the authors have no conflicts to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Antonio Carroccio, Professor, Internal Medicine Department, Hospital of Sciacca (Agrigento), contrada Seniazza, 92019 Sciacca (AG), Italy.
Telephone: +39-925-962492 Fax: +39-925-84757
Received: February 10, 2015
Peer-review started: February 11, 2015
First decision: March 26, 2015
Revised: April 4, 2015
Accepted: May 7, 2015
Article in press: May 7, 2015
Published online: June 21, 2015

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal disorders, having a prevalence of 12%-30% in the general population. Most patients with IBS attribute their symptoms to adverse food reactions. We review the role of diet in the pathogenesis of IBS and the importance of dietary factors in the management of these patients. The MEDLINE electronic database (1966 to Jan 2015) was searched using the following keywords: “food”, “diet”, “food allergy”, “food hypersensitivity”, “food intolerance”, “IBS”, “epidemiology”, “pathogenesis”, “pathophysiology”, “diagnosis”, “treatment”. We found 153 eligible papers; 80 were excluded because: not written in English, exclusive biochemical and experimental research, case reports, reviews, and research otherwise not relevant to our specific interest. We selected 73 papers: 43 original papers, 26 reviews and 4 letters to the editor. These papers focused on IBS pathogenesis, the association between IBS and atopy, and between IBS and food allergy, the relationship between IBS and non-celiac wheat sensitivity, the role of diet in IBS. Pending further scientific evidence, a cautious approach is advisable but the concept of food allergy should be included as a possible cause of IBS, and a dietary approach may have a place in the routine clinical management of IBS.

Keywords: Irritable bowel syndrome, Food allergy, Food intolerance, Non-celiac wheat sensitivity, Atopy, Asthma, Elimination diet

Core tip: Starting from the late evidences about the non-celiac wheat sensitivity, we reviewed the role of diet in the pathogenesis of irritable bowel syndrome and the importance of dietary factors in the management of these patients. We found 183 papers about the matter, selecting 73 for review. We concluded that food allergy could be a possible cause of irritable bowel syndrome, and a dietary approach should be implemented in clinical practice.