Celiac.com 08/12/2019 – Individuals with sure kinds of diarrhea might reply to antihistamine remedy, in response to a current case sequence printed on-line in Annals of Allergy, Bronchial asthma & Immunology. As much as 5% of adults endure from persistent diarrhea, whereas a small subset of these sufferers endure from idiopathic postprandial diarrhea (PPD)–diarrhea with sudden onset, and unknown origin. Diarrhea is among the most typical complaints and signs for individuals with celiac illness.
“Antihistamine-responsive PPD is seen in sufferers with persistent idiopathic urticaria and/or dermatographia and could be distinguished from mast cell activation syndrome (MCAS),” write Yasmin Hassoun, MD, College of Cincinnati, Ohio, and colleagues.
The group describes instances of idiopathic PPD in 5 sufferers aged 26 to 63 years with a diarrhea period of eight weeks to 13 years.
All 5 sufferers had concurrent dermatographia. Three sufferers (two feminine and one male) additionally had a present or prior historical past of persistent urticaria, and three girls had a present or earlier historical past of angioedema. Not one of the sufferers had skilled an preliminary triggering occasion corresponding to viral sickness.
In all 5 instances, diarrhea occurred solely after meals or snacks, and inside three hours of consuming. Not one of the sufferers confirmed any proof of meals allergy or meals intolerance.
The group screened 4 of the 5 sufferers for food-specific IgE, and all 4 examined adverse. Three of the sufferers eradicated lactose and different widespread allergens with no change in signs.
The group carried out checks for anti-tissue transglutaminase IgA and serum tryptase in 4 sufferers, 24-hour urinary prostaglandin F2α in three sufferers, and 24-hour urinary N-methylhistamine in two sufferers. All take a look at outcomes got here up regular. 4 sufferers additionally obtained higher endoscopy and colonoscopy, which revealed lesions in two sufferers.
One 55-year-old girl had lymphocytic colitis and a 63-year-old girl had gastric irritation and ulcers. Nonetheless, none of those pointed to any underlying GI situation that may to clarify the persistent bouts of diarrhea.
Till researchers can conduct extra randomized, placebo-controlled trials medical doctors ought to think about PPD when assessing “sufferers presenting with meals intolerance after excluding meals allergy and different gastrointestinal (GI) problems,” provides Dr. Hassoun.
Learn extra within the Annals of Allergy, Bronchial asthma & Immunology