Study of Immune Reactions to Food in Adults With Irritable Bowel Syndrome Using Advanced Imaging and Diet Changes

What this Trial Is About

This research aims to understand how local immune reactions in the gastrointestinal tract to food antigens occur in patients with Irritable Bowel Syndrome IBS, both with and without Brachyspira infection. The study explores the idea that Brachyspira infection may trigger IBS symptoms by causing a loss of tolerance to certain foods, leading to food-specific intestinal immune responses and increased gut sensitivity. Advanced imaging techniques are used to investigate these immune responses. Participants undergo several procedures including confocal laser endomicroscopy CLE andor a colonoscopic antigen provocation test COLAP to identify food items causing reactions. Other tests include rectal barostat examination and a sigmoidoscopy without laxatives. Based on the food reactions found, participants may follow a diet excluding the identified foods for four weeks, followed by a reintroduction phase. Additional visits include questionnaires, blood and stool sample collection, and assessments by an allergologist and dietician. During the study, participants complete various questionnaires measuring IBS symptoms, psychological distress, anxiety, and quality of life. Biological samples such as blood, stool, urine, and biopsies are collected for detailed immune and metabolic analysis. The main outcome is the change in IBS symptom severity score four weeks after food exclusion. The study includes multiple visits over several weeks to monitor symptoms, dietary effects, and immune responses, with safety and detailed assessments throughout participation.

Brachyspira and Intestinal Allergy-like Immune Reactions in Patients With Irritable Bowel Syndrome (IBS)