# Food Intolerance Tests!



## Guest (Feb 10, 2004)

Where do I start. I have had every test imaginable, all of which have come back negative. One Specialist said that I have IBS and another has said that I don't because they think it's something that doctors say when they don't know whats wrong with you (even though he wasn't able to tell me what was wrong with me!). The crux of my problem is that after over a year of stomach pains, bloating and debilitating headaches I have finally bitten the bullet and spent a fortune on a food intolerance test. I am currently waiting for the results but I wondered if anyone out there has undergone this test and has found the results have helped them. The type of test I had is where you give them a pinprick of your blood and you send it back to them for analysis. Please, please can anyone advise?


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## stinky too (May 21, 1999)

I hear that there is a Doctor here that will do thoes test for you but wasn't sure how accurate they would be. I had the skin test done years ago. But Doctor left half of them out. Let us know once you get the results of the test done. If you knew for sure which things you can and can't eat it would be a place to start.Joyce in OH


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## Mike NoLomotil (Jun 6, 2000)

Posted 2/16/04 http://www.ibsgroup.org/ubb/ultimatebb.php...ic;f=5;t=000493 CASE SUMMARIESSubmitted by LEAP Affiliate PhysiciansCase # 1: Male, Irritable Bowel SyndromeThe patient is a 39 year old white male who complained of a six year history of having three to five loose, non-bloody bowel movements per day. He denied other symptoms including nausea, vomiting, constipation, weight loss, or fever. He reported that sometimes these symptoms seemed to increase with stress. He was seen by his primary care physician at which time a physical exam was unremarkable. He was placed on hyoscyamine 0.125 mg po every four hours as needed. Approximately five years ago he was referred to a gastroenterologist and underwent evaluation that included a colonoscopy with colonic biopsies, upper gastrointestinal series with small bowel follow through, stool studies for giardia antigen, Clostridium difficile toxin, ova and parasites, fecal white blood cells, and stool culture for salmonella, shigella and campylobacter. All the above studies were normal. A diagnosis of Irritable Bowel Syndrome was made and the patient was begun on dicyclomine 10 mg po twice a day. The dicyclomine initially resulted in a decrease his diarrhea. However, approximately one year later, the diarrhea worsened despite the ongoing use of dicyclomine, and the patient returned to the gastroenterologist. A complete blood count, Westergren sedimentation rate, and anti-transgluatminase IgA antibody were obtained and all were normal. The patient was told to continue the dicyclomine and use loperamide on an as needed basis. He returned approximately two years later stating that he had stopped the dicyclomine and found that if he used loperamide either once or twice a day on a regular basis his diarrhea was controlled. A decision was made to continue with loperamide and add amitriptyline 20mg po every night. Approximately, one year later the patient again presented complaining of the same symptoms. The amitriptyline was minimally effective, and the patient continued to require the frequent use of loperamide to control the diarrhea. The patient then underwent LEAP testing for food and chemical sensitivities and was counseled in a LEAP diet devoid of test-positive foods. Within two weeks the diarrhea had completely resolved and loperamide was no longer needed. He has been on the diet for six months and continues to do well. He has found that his symptoms often return when he consumes foods to which he has been found to be sensitive. ____________________Case # 2: Male, Irritable Bowel SyndromeThe patient is a 51 year old white male who has had years of left lower quadrant pain, flatulence and one to five loose bowel movements per day. His past medical history and physical exam were unremarkable. Three years ago he underwent a colonoscopy into the terminal ileum that was normal. He was placed on dicyclomine 10 mg po twice a day. The dicyclomine did not seem to be effective and the patient tried various dietary manipulations. He noted that his symptoms improved to some extent when he avoided milk products and several grains including wheat, corn, and rice. Because of the improvement of his symptoms on a wheat-free diet, he underwent an esophagogastroduodenoscopy to evaluate for celiac disease. The endoscopy including small bowel biopsies was normal. The patient then underwent LEAP testing for food and additive hypersensitivities. He was found to have several hypersensitivities including wheat and corn, but not rice. He was begun on a LEAP diet lacking in the offending foods. The patient very quickly noticed an improvement in his symptoms. He has now been on the diet for eight months and reports that he is markedly improved. His diarrhea, flatulence and cramping have decreased significantly. In addition, he previous had problems with gastroesophageal reflux and insomnia, and they have also significantly improved. _________________________Case # 3: Female, Irritable Bowel Syndrome and GERDThe patient is a 17 year old white female who has had a several year history of lower abdominal pain and cramping, diarrhea, gastroesophageal reflux, nausea, chest tightness, chronic sinusitis, headaches and allergies. The physical exam was unremarkable. An evaluation one year ago included an abdominal ultrasound, and abdominal and pelvic CAT scan which were normal. An upper gastrointestinal series showed moderate gastroesophageal reflux. An esophagogastroduodenoscopy showed grade I esophagitis and normal small bowel biopsies. The patient was started on esomeprazole 40 mg po once a day and noted a good improvement in her reflux, chest tightness and nausea. The lower abdominal pain and cramping did not improve with fiber supplementation and hyoscyamine 0.125 mg p.o. every four hours as needed. The patient tried a lactose free diet. She did not notice any improvement, but she did find that she had some improvement in her lower abdominal symptoms with the avoidance of fructose containing foods. However, a fructose hydrogen breath test did not show that the patient was fructose intolerant. The patient underwent LEAP testing for food sensitivities and was subsequently started on a LEAP oligoantigenic diet [that eliminated offending foods]. Within one month, the patient noted an improvement in her overall health with a marked decrease in her lower abdominal pain, cramping, diarrhea, heartburn, headaches, sinusitis, and chest tightness. Her level of energy has increased. She has been able to stop the esomeprazole. The patient has been on the LEAP diet for five months and continues to do well. She has noted that her symptoms quickly return when she varies from the diet and consumes any test-positive foods. ________________________Case # 4: Female, Irritable Bowel Syndrome and MigraineThe patient is a 47 year old white female who complains of years of heartburn, bloating, flatulence, diarrhea, and migraine headaches. Otherwise her history was unremarkable and her physical exam was normal. An upper endoscopy was performed that was normal. The patient was placed on ranitidine 300 mg twice a day and had good improvement in her gastroesophageal reflux symptoms but continued to complain of bloating, flatulence, and diarrhea. Fructose and lactose hydrogen breath tests were performed and were both negative. The patient underwent LEAP testing for food sensitivities and was subsequently started on a diet that eliminated offending foods. Within one month her flatulence, bloating, diarrhea, and headaches have completely resolved. She continues to take ranitidine 300 mg po twice a day but has noted less breakthrough reflux symptoms since starting the LEAP diet. She also has had less insomnia and fatigue and more energy. After five months on the diet she continues to do well, and has noted that her symptoms return if she strays from the diet. ___________________________Link to extensive discussions on the subject http://www.ibsgroup.org/ubb/ultimatebb.php...ic;f=1;t=033220 MNL


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## CDG1228 (Aug 12, 2003)

How is LEAP testing different from the LI and FI testing?


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## bonniei (Jan 25, 2001)

LI and FI breath hydrogen tests are done by conventional, mainsrtream docs. After you ingest they measure the hydrogen in your breath every half an hour or so for a couple of hours. It measures malabsorptionLeap tests measure the immunological by-products of certain foods to see if you are sensitive to them.


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## Mike NoLomotil (Jun 6, 2000)

Yep. In some detail, reviewable on the website, the LEAP method uses a testing technology called Mediator Release testing. 150 different foods and additives are assayed to see if the body's cellular immune system reacted abnormally to being exposed to the subject food under conditions similar to those which occur in the body.The circulating immunocytes in normal people do not react to food antigens due to the fact they are able to differentiate food antigen from pathogens. In diarrheic IBS and functional diarrhea victims, as well as many migraine victims, the lymphocytes, granulocytes, macrophages or othe cell-classes,even platelets (different pattern for everyone) misidentify some foods or additives as if they were pathogenic bacteria and release chemical mediators within the gut and the plasma as they begin to mount an inappropriate immune response.The person has no circulating IgE antibodies to the provoking food, so it is not food allergy, and often IgG is NOT implicated as the person may form IgG just because they ate a lot of the food...this does not denote clinical delayed hypersensitivity all the time.Besides, often NO altered immunoglobulin levels are present as the mechanism of response may not require Ig[x], rather it is one of the other pathways to cell mediated repsonses.What is somewhat ironic is that so called carb malabsorption may simply be a side-effect...a consequence...of a loss of oral tolerance and the localized inflammatory reactions which chronically occcur as the reactive foods are consumed. At other times, the malabsorption AND the loss of oral toleranc e may both be secopndary to dysbiosis...something very difficult to detetc and treat at this timeSo at least we can, using these tests, isolate what foods are highly probable to be tolerated and which are probable to not be tolerated and build an eating plan specific to a patients needs which brings releif of synptoms.That in and of itself is a lot better than we have been able to do in the past!MNL


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## Guest (Feb 17, 2004)

Thank you very much for extensive replies. I am still waiting for the results, but bearing in mind how much it cost me, I am now much more confident that it will be money well spent. Here's looking forward to a pain free future!!


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## Kellie2003 (Nov 4, 2003)

The case studies provided are people with IBS-d, has LEAP testing helped anyone who is IBS-A (alternating between D and C)?


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## bonniei (Jan 25, 2001)

Your insurance money will be well spent if you do the breath hydrogen tests IMO Julia


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## Mike NoLomotil (Jun 6, 2000)

KPSorry I should have been more clear.Any subject whose symptoms include a diarrheic component, be it chronic diarrheic episodes or diarrhea and constipation in alteration, are among the target population.Often a patient who gets diarrheic episodes which are followed by constipation suffers from nothing more then the normal consequences of having painful sever diarrhea and how it alters fluid and food intake and "loss"...so they become constipated not because of some mysterious pathology that differentiates them from the person who does not seem to get constipated routinely after her diarrheic bouts, it is usually just the consequence ofhow we loose a lot of fluid, stop taking in solid food while we are sick as a dog, evacuate the GI tract down to nothing but a little mucousy fluid, then post-diarrhea episode when we are dehydrated and devoid of GI contents may only eat a little food for awhile.Also the patient may have taken industrial doses of antidiarrheals and spasmolytics to put ther intestines to sleep at the same time. This is a recipe for "delayed resumption of defecation"...sometime what little stuff is left in there them stays too liong when it does reach the sleepy colon and too much water is reabsorbed...and the vicous cycle pattern is set.If we do a really really really careful even tracking log as part of the patient assessment this is the kind of pattern that usually emerges.So the 2/3 of IBS patients who have a dirrheic component cand and do benefit from this type of approach.Experience has shown, as has the literature confirmed, that there are distinct differences in the gastroimmune scenario beteen so called IBS-c and other IBS types regardless if they are or are not post-infectious onset (this only differntiates the type of inflammatory reactions seen and tssiue changes seen).The subset of c-types who do seem to have some lost oral tolerance are those who suffer what would be termed at this time "functional abdominal pain".It appears that there ar subjects whose pathogenesis, whatever it is, leads to upregulated pain perception and it can involve both local and central anomalies.These people at times test positive for a few food or chemical sensitivities and when the foods are removed the FAP is diminished. But whatever the process is that is causing retention of the contents is unaffected as it does not appear to invlove the same process.In fact it is difficult to see how it could since the classic gastroneuroimmune response is GI evacuation, NOT retention!Hope that makes more sense.MNL


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