SURVEY OF GASTROINTESTINAL REACTIONS TO FOODS IN ADULTS IN RELATION TO ATOPY, PRESENCE OF MUCUS IN THE STOOLS, SWELLING OF JOINTS AND ARTHRALGIA IN PATIENTS WITH GASTROINTESTINAL REACTIONS TO FOODS

Background Food intolerance in adults is mostly associated with vague symptoms and not clearly related to atopy and food allergy. A combinat ion of different pathogenetic mechanisms may be responsible for the sy mptoms. Objective The aim of this study was to describe patients with a history of food-related gastrointestinal symptoms in relation to the presence of mucus in the stools, joint swelling and arthralgia and to determine whether or not there is an association between the presence of these parameters, atopic disease and the presence of immune comple xes in serum. Methods Fifty-eight patients consecutively referred to o ur clinic with food-related gastrointestinal symptoms were investigate d. Results Thirty-five patients (60%) had mucus in their stools, 24 pa tients (41%) complained about joint swelling and 41 patients (71%) had arthralgia. There were no correlations between these parameters and a topy according to Phadiatope test or skin prick test (SPT). No correla tions were found between the occurrence of mucus in the stools, arthra lgia and joint swelling. There were significantly higher levels of cir culating immune complexes in patients with a history of arthralgia com pared with patients with no such history (P < 0.03) and the number of individuals with the presence of such immune complexes was higher amon g the patients with arthralgia than among the patients without. In gen eral the patients did not relate the exposure to certain foods to symp toms like joint swelling, arthralgia and presence of mucus in the stoo ls. However, there were significant positive correlations between food -related gastrointestinal symptoms in the following instances: chocola te-induced gastrointestinal symptoms and mucus in the stools (P = 0.00 6), vegetable-induced gastrointestinal symptoms and mucus in the stool s (P = 0.002) and meat-induced gastrointestinal symptoms and mucus in the stools (P = 0.003). In a group of individuals, without food-relate d symptoms investigated separately, a very low frequency of mucus in t he stools, joint swelling and arthralgia was seen (none, two and three individuals of the 20 subjects, respectively). Of 41 patients with im mediate onset of gastrointestinal symptoms, 20 were atopic according t o Phadiatope and SPT. Of 11 patients with late onset of symptoms 10 we re negative in Phadiatope and SPT (P < 0.05). The most frequently invo lved foods were fruits, vegetables, milk, fish and meat. Conclusion Th e results suggest the involvement of different inflammatogenic mechani sms in food-related gastrointestinal symptoms.