Small bowel stomas are associated with higher risk of circulating food-specific-IgG than patients with organic gastrointestinal conditions and colostomies

Authors

Walker K. Carson, University of Nebraska-LincolnFollow
Joseph L. Baumert, University of Nebraska - LincolnFollow
Jennifer Clarke, University of Nebraska-LincolnFollow
Jacques Izard, University of Nebraska-LincolnFollow

ORCID IDs

Jacques Izard http://orcid.org/0000-0002-5904-5436

Date of this Version

2022

Citation

Carson WK, Baumert JL, Clarke JL, et al. Small bowel stomas are associated with higher risk of circulating food-specific- IgG than patients with organic gastrointestinal conditions and colostomies. BMJ Open Gastro 2022;9:e000906. doi:10.1136/ bmjgast-2022-000906

Comments

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license,

Abstract

Objective The effects of food sensitivity can easily be masked by other digestive symptoms in ostomates and are unknown. We investigated food-specific- IgG presence in ostomates relative to participants affected by other digestive diseases.

Design Food-specific- IgG was evaluated for 198 participants with a panel of 109 foods. Immunocompetency status was also tested. Jejunostomates, ileostomates and colostomates were compared with individuals with digestive tract diseases with inflammatory components (periodontitis, eosinophilic esophagitis, duodenitis, ulcerative colitis, Crohn’s disease and appendicitis), as well as food malabsorption due to intolerance. A logistic regression model with covariates was used to estimate the effect of the experimental data and demographic characteristics on the likelihood of the immune response.

Results Jejunostomates and ileostomates had a significant risk of presenting circulating food-specific- IgG in contrast to colostomates (OR 12.70 (p=0.002), 6.19 (p=0.011) and 2.69 (p=0.22), respectively). Crohn’s disease, eosinophilic esophagitis and food malabsorption groups also showed significantly elevated risks (OR 4.67 (p=0.048), 8.16 (p=0.016) and 18.00 (p=0.003), respectively), but not the ulcerative colitis group (OR 2.05 (p=0.36)). Individuals with profoundly or significantly reduced, and mild to moderately reduced, levels of total IgG were protected from the formation of food-specific IgG (OR 0.09 (p=<0.001) and 0.33 (p=0.005), respectively). Males were at higher risk than females.

Conclusion The strength of a subject’s immunocompetence plays a role in the intensity to which the humoral system responds via food-specific- IgG. An element of biogeography emerges in which the maintenance of a colonic space might influence the risk of having circulating food-specific- IgG in ostomates.

Includes supplementary materials.