Research Studies
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August 28, 2024

Advanced Imaging Uncovers New Approaches to Diagnosing and Managing Food Intolerance

Written By
Medically Reviewed by
Dr. Emilie Wilson ND, L.Ac.
Updated On
January 13, 2025

Stomach pain after eating is something many people can relate to. You might enjoy a meal, only to find yourself feeling uncomfortable afterward, wondering what you ate that didn’t agree with you. 

This common experience leads many to suspect they have food intolerances, but figuring out exactly what’s causing the pain can be tricky.

An observational Study published in Endoscopy International Open in 2023 explored this issue using an innovative technique. The study utilized advanced technology to directly observe how the gut reacts to different foods in real-time, providing new insights into the relationship between food and functional abdominal discomfort.

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The Study At A Glance

The study aimed to explore the connection between food intolerance and abdominal discomfort in patients who had no clear diagnosis from standard tests. 

Conducted at the Helios Clinic in Germany, the study focused on understanding how certain foods might cause discomfort in these individuals, particularly through the use of advanced technology that offers a more precise way to identify food-related issues.

Researchers selected 34 patients, mostly women around the age of 46, who reported stomach discomfort after eating. To investigate, they used a procedure called endoscopic confocal laser endomicroscopy (eCLE), which is like using a microscope inside the body to observe how the gut reacts to different foods. 

After fasting for eight hours, small amounts of common food allergens—such as soy, wheat, and milk—were applied directly to participants’  gut linings. 

This allowed the researchers to observe real-time changes in the gut lining which indicate increased permeability, a condition often referred to as leaky gut. Leaky gut can indicate food intolerance.

The detailed observations provided by eCLE offered a more objective and accurate measure of food intolerance, helping to identify specific foods that could be contributing to abdominal discomfort. 

The findings from this study could lead to more personalized dietary recommendations, offering a new way to manage functional abdominal discomfort and improve the quality of life for those affected.

Key Findings of the Study

The study found that nearly 68% of participants reacted to at least one food allergen, with soy and wheat being the most common triggers. 

About 24% of the participants showed signs of increased gut permeability, often referred to as "leaky gut," making this the first time such direct evidence was observed in patients with functional abdominal discomfort.

Overall, 69.5% of the participants reported an improvement in discomfort intensity and a reduction in discomfort frequency after following a food exclusion diet based on the results of the endoscopic confocal laser endomicroscopy (eCLE) food challenge.

13% of the participants became completely symptom-free following the dietary changes.

Additionally, 21.7% of participants reported a reduction in discomfort frequency to less than once a week.

However, 30.4% of participants did not report any benefit from dietary therapy.

Significance of the Findings

The study provides a more accurate, objective and highly personalized way to explore food intolerances in patients with unexplained stomach discomfort. 

Higher Diagnostic Accuracy

By using advanced imaging technology, doctors can directly observe how the gut reacts to specific foods, reducing the reliance on subjective self-reports and indirect testing methods.

This approach effectively connects patient symptoms with measurable gut reactions, offering a clearer understanding of the potential causes of abdominal discomfort. 

It highlights the higher detection rate of food-related gut reactions compared to traditional methods, suggesting that many intolerances may have been previously overlooked.

Personalized Dietary Interventions

Observing real-time reactions in the gut enables more personalized dietary recommendations. 

Tailoring diets based on these precise observations can lead to more effective management of symptoms and significantly improve the quality of life for those experiencing functional abdominal discomfort.

Clinical Application

For individuals experiencing abdominal discomfort, the study’s findings enable the creation of personalized nutritional plans by identifying specific food triggers that can then be removed from an individual’s diet. 

This high level of personalization can lead to quicker symptom management and better long-term gut health. 

For health practitioners, this advanced diagnostic method objectively identifies the underlying factors of a patient’s functional digestive issues, allowing for more precise dietary recommendations and more effective interventions.

Limitations of the Study

While the study's results are encouraging, the relatively small sample size and the specific demographics of the participants limit the generalizability of the findings to a broader population. 

Additionally, since the research was conducted in a single medical center, there may be variations in outcomes if the study were replicated in different regions or healthcare settings.

The study also focused on short-term outcomes and did not explore the long-term sustainability of the dietary interventions. 

It's unclear if the symptom management observed would persist over time, and the study did not account for other factors like stress or underlying health conditions that might have influenced the results. 

Additionally, this procedure is relatively invasive and more costly than standard elimination diets and symptom trackers, which may make it unattainable for some patients.

Functional Medicine Labs for Exploring Food Intolerances

Functional medicine labs that specialize in food sensitivities and gut health can provide deeper insights into potential food intolerances. 

Some lab tests and panels available through Rupa Health include:

FIT Test - 132 Foods

Offered by KBMO Diagnostics, this test measures immune responses to 132 different foods, helping to identify food sensitivities that may be contributing to symptoms.

88 Food Antigen IgE, IgG4, IgG Panel

Available through Infinite Allergy Labs, this panel evaluates immune reactions to 88 food antigens, providing insights into both immediate and delayed food sensitivities.

Comprehensive Food Sensitivity Testing

Offered by various labs through Rupa Health, this testing assesses a wide range of food sensitivities, allowing for a tailored approach to managing food-related symptoms and improving overall gut health.

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Key Takeaways

  • The study introduces a new method for exploring and managing food intolerance by directly observing gut reactions to specific foods, leading to more accurate identification of food triggers and personalized dietary interventions.
  • By tailoring dietary plans based on real-time observations of gut reactions, the potential to significantly reduce or even manage discomfort is greatly enhanced. This personalized approach could improve the quality of life for individuals who experience unexplained abdominal discomfort.
  • Although the findings are promising, the study highlights the need for further research to validate the long-term benefits and explore the broader applicability of this technique in diverse populations and clinical settings.
The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

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Lab Tests in This Article

[1.] Anderson, S. (2022, June 6). How to talk to your patients about leaky gut: An overview. Rupa Health. https://www.rupahealth.com/post/what-is-leaky-gut

[2.] Cloyd, J. (2023, March 29). Top 5 differential diagnosis for abdominal pain and how to treat with functional medicine. Rupa Health. https://www.rupahealth.com/post/top-5-differential-diagnoses-for-abdominal-pain-and-how-to-treat-with-functional-medicine

[3.] Food allergy and sensitivity testing (FAST 88 foods: IgE/IgG4 & igg) by infinite allergy labs. (n.d.). Rupa Health. https://www.rupahealth.com/lab-tests/infinite-allergy-lab-88-food-antigen-ige-igg4-igg

[4.] Gargano D, Appanna R, Santonicola A, De Bartolomeis F, Stellato C, Cianferoni A, Casolaro V, Iovino P. Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns. Nutrients. 2021 May 13;13(5):1638. doi: 10.3390/nu13051638. PMID: 34068047; PMCID: PMC8152468.

[5.] Gjini, B., Melchior, I., Euler, P., Kreysel, C., Kalde, S., Krummen, B., Kiesslich, R., Hemmerlein, B., & Frieling, T. (2023). Food intolerance in patients with functional abdominal pain: Evaluation through endoscopic confocal laser endomicroscopy. Endoscopy International Open, 11(1), E67–E71. https://doi.org/10.1055/a-1978-6753

[6.] Greenan, S. (2021, November 17). The 8 most common signs of A food sensitivity. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-food-sensitivities-testing-and-treatment

[7.] Pilonis, N. D., Wladyslaw Januszewicz, & Massimiliano di Pietro. (2022). Confocal laser endomicroscopy in gastro-intestinal endoscopy: Technical aspects and clinical applications. Translational Gastroenterology and Hepatology, 7, 7–7. https://doi.org/10.21037/tgh.2020.04.02

[8.] Sweetnich, J. (2023, June 1). Integrative treatment options for common stomach disorders: Specialty testing, nutrition, supplements. Rupa Health. https://www.rupahealth.com/post/integrative-treatment-options-for-common-stomach-disorders-specialty-testing-nutrition-supplements

[9.] Withinpixels. (2024a). Rupa health | A simpler way to order specialty labwork. Rupahealth.com. https://labs.rupahealth.com/discover-labs/search?lab-test-name=FIT+Test+-+132+Foods&lab-test-company-name=KBMO+Diagnostics&lab_company=labcmp_XqP1kQG%7CKBMO+Diagnostics&search=fit&page=1&action=CATALOG

[10.] Withinpixels. (2024b). Rupa health | A simpler way to order specialty labwork. Rupahealth.com. https://labs.rupahealth.com/discover-labs/search?page=1&search=food+sensitivity&action=CATALOG

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