Extra-intestinal symptoms in patients with irritable bowel syndrome: related to high total IgE levels and atopic sensitization?

Scand J Gastroenterol. 2016 Aug;51(8):908-13. doi: 10.3109/00365521.2016.1157890. Epub 2016 May 10.


Objective We have previously found that high levels of total IgE, but not atopic sensitization, was a significant predictor for functional gastrointestinal (GI) symptoms. In this study, we aimed to assess the prevalence of extra-intestinal symptoms in IBS patients, and explore their relation to total IgE levels and atopic sensitization. Materials and methods Seventy-one patients with functional GI complaints were included. Severity of GI symptoms, fatigue and musculoskeletal pain was evaluated using the following questionnaires: IBS-Severity Scoring System (IBS-SSS), Fatigue Impact Scale (FIS), FibroFatigue Scale (FFS), and Visual Analog Scales (VAS) for musculoskeletal pain. Levels of total IgE and specific IgE-antibodies were analyzed. Results Fatigue and musculoskeletal pain were demonstrated in 78.9 and 43.7% of the patients, respectively. IBS-SSS scores were significantly correlated with fatigue scores and musculoskeletal pain. Patients with fatigue and musculoskeletal pain had significantly higher IBS-SSS scores than patients without fatigue and musculoskeletal pain. Total IgE levels were significantly higher in IBS patients compared to a healthy control group from a previous study. However, neither total IgE nor atopic sensitization was significantly associated with extra-intestinal symptoms. Conclusions IBS, fatigue, and musculoskeletal pain were significantly associated. Total IgE levels were higher in IBS patients than healthy controls, but not related to intestinal or extra-intestinal symptom severity. Atopy was not associated with any of the co-morbidities. Thus, the clinical significance of high IgE levels in IBS remains unclear and further studies are warranted to explore a common underlying mechanism for the co-morbid triad of IBS, fatigue, and musculoskeletal pain.

Keywords: Atopic sensitization; fatigue; irritable bowel syndrome; musculoskeletal pain; total IgE.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Fatigue / etiology
  • Female
  • Humans
  • Hypersensitivity / complications
  • Immunization
  • Immunoglobulin E / analysis*
  • Irritable Bowel Syndrome / complications
  • Irritable Bowel Syndrome / immunology
  • Irritable Bowel Syndrome / physiopathology*
  • Male
  • Middle Aged
  • Musculoskeletal Pain / etiology
  • Surveys and Questionnaires
  • Young Adult


  • Immunoglobulin E