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Methods to objectively determine food intolerance in patients with irritable bowel syndrome (IBS) are lacking.
In the current pilot feasibility study, investigators used confocal laser endomicroscopy (CLE) to perform imaging in 36 patients with IBS and 10 control patients. The deep duodenum was imaged while infusions of antigens such as milk, wheat, and yeast were delivered. Twenty-two of 36 patients developed visible responses to food antigens, beginning with migration of intraepithelial lymphocytes and followed by rupture of epithelium at the apex of the villi with resultant leaks or gaps. One or more epithelial cells were lost, and fluorescein was seen to rush through the gaps into the lumen. None of these changes occurred in the control …