Histamine response is key to understanding IBS

Researchers are a step closer to understanding, and treating, IBS (irritable bowel syndrome), a gastric problem that affects around one in five adults.

They have discovered that the release of histamine, a chemical that fights allergic reactions, is responsible for typical IBS symptoms such as stomach pains and discomfort.

IBS often begins following a stomach infection and makes it intolerant to some foods. When these foods are eaten, mast cells release histamine which causes digestive problems.

Researchers at KU Leuven proved the theory when they infected laboratory mice with a stomach bug before feeding them ovalbumin, a protein in egg white. Only the mice that had been infected had the immune response which included histamine release.

The immune response was only in the part of the intestine that had been infected. This local response is typical in IBS symptoms, said researcher Guy Boeckxstaens, unlike cases of food allergy, which is a generalised mast cell activation, affecting breathing and blood pressure and causing life-threatening reactions.

The results were similar in 12 volunteers who all had IBS. They were given some of the common food allergens, such as wheat, soy, gluten and cow’s milk, and they all suffered localized allergic reactions in the small intestine.

A larger study is now underway, but the discovery already opens the door to better therapies. Several foods can reduce histamine response—fermented foods such as yogurt and sauerkraut, dried fruits, avocados and spinach—and IBS sufferers should be adding these to their diets. Supplements such as quercetin, or foods including onions and apples, and bromelain also reduce histamine activity.

(Source: Nature, 2021; doi: 10.1038/s41586-020-03118-2)

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