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Are there any connections between food allergen-related skin reactions causing intestinal (or more broadly, gastrointestinal) generalized inflammation?

If such a link exists, is it related to any of the inflammatory bowel diseases (Crohn's, colitis, irritable bowel syndrome)?

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  • $\begingroup$ Related: biology.stackexchange.com/questions/14995/… $\endgroup$ – jonsca Nov 4 '14 at 21:56
  • $\begingroup$ I don't see how that question is related. It deals with extra-intestinal diseases, of which, dermatologic conditions may be a subsequent symptom. This question deals with the reverse direction of causation. Skin contact -> intestinal issues. $\endgroup$ – user560 Nov 4 '14 at 23:52
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    $\begingroup$ It's not the same situation, I realize, but they are two sides of the same coin. I also did it so that the two questions could reference each other in the sidebar ---> $\endgroup$ – jonsca Nov 5 '14 at 6:18
  • $\begingroup$ I was not implying they were duplicates, so I apologize if it came across that way. $\endgroup$ – jonsca Nov 5 '14 at 6:20
  • $\begingroup$ Oh, I see what you did then. No harm done. $\endgroup$ – user560 Nov 5 '14 at 12:54
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Afaik the most probable trigger of IBDs (Crohn's, colitis ulcerosa) are changes in the gut microbiota due to western lifestyle (high intake of some nutrients e.g. milk fat). These changes cause an inflammation in the susceptible (genetic factors) people. So the cause of IBDs is very likely not an allergic reaction.

According to wikipedia IBS is not an IBD (inflammatory bowel disease). It is a functional disorder of the bowel, so not so serious as the IBDs. Its possible causes are low grade inflammation of the bowels and neuroendocrine disregulation. It has genetic factors as well. The pathomechanism is not fully understood yet.

There are many bowel diseases which can be caused by specific foods, e.g. celiac disease, lactose intolerance, and so on, the list is long, many of them can be caused by food protein intolerance. It is my understanding of protein sensitivity that skin conditions are caused by B-cell (IgE) mediated immune response, while bowel conditions are caused by T-cell mediated immune response. Ofc. there is connection between them, so it is possible that a certain type of protein induces skin symptoms and intestinal symptoms as well. Based on the current studies I think food sensitivity is not related to IBDs, and probably not related to IBS as well.

CD is associated with dramatic changes in the gut microbiota and this was particularly evident for individuals with ileal CD.

Molecular profiling of faecal bacteria revealed abnormalities of intestinal microbiota in UC and IBS patients, while different patterns of Bacteroides species loss in particular, were associated with UC and IBS.

Breakdown of the normal microbial community increases the risk of pathogen infection, the overgrowth of harmful pathobionts and inflammatory disease. Understanding the interaction of the microbiota with pathogens and the host might provide new insights into the pathogenesis of disease, as well as novel avenues for preventing and treating intestinal and systemic disorders.

Crohn's disease and ulcerative colitis are idiopathic, chronic, relapsing, inflammatory conditions that are immunologically mediated. Although their exact etiologies remain uncertain, results from research in animal models, human genetics, basic science and clinical trials have provided important new insights into the pathogenesis of chronic, immune-mediated, intestinal inflammation. These studies indicate that Crohn's disease and ulcerative colitis are heterogeneous diseases characterized by various genetic abnormalities that lead to overly aggressive T-cell responses to a subset of commensal enteric bacteria. The onset and reactivation of disease are triggered by environmental factors that transiently break the mucosal barrier, stimulate immune responses or alter the balance between beneficial and pathogenic enteric bacteria. Different genetic abnormalities can lead to similar disease phenotypes; these genetic changes can be broadly characterized as causing defects in mucosal barrier function, immunoregulation or bacterial clearance. These new insights will help develop better diagnostic approaches that identify clinically important subsets of patients for whom the natural history of disease and response to treatment are predictable.

The composite human microbiome of Western populations has probably changed over the past century, brought on by new environmental triggers that often have a negative impact on human health1. Here we show that consumption of a diet high in saturated (milk-derived) fat, but not polyunsaturated (safflower oil) fat, changes the conditions for microbial assemblage and promotes the expansion of a low-abundance, sulphite-reducing pathobiont, Bilophila wadsworthia2. This was associated with a pro-inflammatory T helper type 1 (TH1) immune response and increased incidence of colitis in genetically susceptible Il10−/−, but not wild-type mice. These effects are mediated by milk-derived-fat-promoted taurine conjugation of hepatic bile acids, which increases the availability of organic sulphur used by sulphite-reducing microorganisms like B. wadsworthia. When mice were fed a low-fat diet supplemented with taurocholic acid, but not with glycocholic acid, for example, a bloom of B. wadsworthia and development of colitis were observed in Il10−/− mice. Together these data show that dietary fats, by promoting changes in host bile acid composition, can markedly alter conditions for gut microbial assemblage, resulting in dysbiosis that can perturb immune homeostasis. The data provide a plausible mechanistic basis by which Western-type diets high in certain saturated fats might increase the prevalence of complex immune-mediated diseases like inflammatory bowel disease in genetically susceptible hosts.

The pathogenesis of IBS seems to be multifactorial, with the following factors playing a central role in the pathogenesis of IBS: heritability and genetics, dietary/intestinal microbiota, low-grade inflammation, and disturbances in the neuroendocrine system (NES) of the gut

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I doubt there can be causality in the direction "irritation of skin by allergen" --> "intestinal problems". I have seen several articles where skin prick testing was done on patients, but none of them mentioned intestinal problems as side effects. In rare cases, the skin testing may result in anaphylaxis, which is why it must be done in hospital with the help at hand. The possible warning symptoms are: low grade fever, lightheadedness or dizziness, wheezing or shortness of breath, extensive skin rash, swelling of face, lips or mouth, difficulty swallowing or speaking - again, the intestinal problems are not mentioned. ( http://en.wikipedia.org/wiki/Skin_allergy_test ).

Disclaimer: I am not a doctor. I am a chemist / molecular biologist developing food analysis methods to detect allergenic materials undeclared on food label. The clinical papers are not my most focused field, but I have seen some.

EDIT: Maybe I misunderstood the question. I thought that it was about whether the skin irritation from outside only and without actually consuming the food allergen can lead to digestive problems. I doubt that. On the other hand, eating the food allergen often results in digestive problems for allergic people. Skin and digestive problems can occur simultaneously. If these digestive problems are IBS or IBD-like or neither - I have no idea.

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  • $\begingroup$ Considering, that depression and anxiety are risk factors for IBS (en.wikipedia.org/wiki/Irritable_bowel_syndrome), the sheer unpleasantness of skin testing could theoretically irritate the person on psychological level and lead to symptoms. This, however, feels like a stretch to me, and probably was not the mechanism leonardo was looking for. $\endgroup$ – Barbara Nov 5 '14 at 13:30
  • $\begingroup$ I don't know for certain that is the causal direction, but that is the direction I was intending when considering that immediate contact with the food allergen initiates an allergic reaction, so it may stand to reason (I'm not an immunologist), that if the food is ingested, may then later cause gastrointestinal problems. $\endgroup$ – user560 Nov 5 '14 at 13:44
  • $\begingroup$ @Barbara I agree with your answer, it is not necessary a common thing. I found that for instance oat protein sensitivity can have skin and bowel symptoms as well. $\endgroup$ – inf3rno Nov 5 '14 at 13:47
  • $\begingroup$ O.K., sorry, ingesting food allergens can obviously lead to gastrointestinal problems, or simultaneous gatrointestinal and skin problems. I do not know whether or not these gastrointestinal problems can ever be in the cathegories of generalised inflammation, Chron's, coliitis or IBS. $\endgroup$ – Barbara Nov 5 '14 at 13:50
  • $\begingroup$ @inf3brno, do you mean specifically, that iritating the skin with oat protein from outside, i.e. not by eating it can trigger bowel symptoms ? $\endgroup$ – Barbara Nov 5 '14 at 13:54

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