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NMU 82 – Simple Blood Test (Lcat Test) Identifies Food Triggers in Irritable Bowel Syndrome

Nutrition / Natural Medicine Update No. 82 (March 8, 2018)

with Dr. James Meschino


Research Topic: Simple Blood Test (Lcat Test) Identifies Food Triggers in Irritable Bowel Syndrome

Source: British Medical Journal (Open) Gastroenterology (March 2018)


Approximately one in five adults meet the criteria for irritable bowel syndrome (IBS), a disorder that can cause chronic abdominal pain, gas, diarrhea, and constipation. Some of these individuals also have sleep disorders and increased propensity for depression, anxiety, and fatigue. As such, it can be quite debilitating.  Some standard recommendations for IBS management include:

  • Limit or eliminate foods that may make diarrhea, gas, and bloating worse. These may include caffeine, alcohol, carbonated (fizzy) drinks, milk products, foods high in sugar, fatty foods, gas-producing foods (such as beans, cabbage, and broccoli), and the artificial sweeteners sorbitol and xylitol (often used in sugarless gum and sugarless candy).
  • To reduce constipation, add fiber to your diet, drink plenty of water, and get regular exercise.
  • Drink plenty of fluids, enough so that your urine is light yellow or clear like water
  • It might help to limit the amount of high-fiber foods you eat, especially if you have a lot of gas and bloating. This especially includes whole grain bread, cereals, pasta, and rice.
  • Reduce the amount of “resistant starch” you eat. Resistant starch isn’t digested well by your body and can cause gas and bloating. It is found in foods like cold or reheated potatoes, bread, and cereal.
  • Limit your intake of fresh fruit to 3 portions a day.
  • Eat slowly and have meals in a quiet, relaxing environment. Don’t skip meals.
  • Ingest probiotics, the friendly bacteria, to help populate the gut with bacteria that improve digestion and elimination
  • Try taking digestive enzymes with your largest meals to help improve digestion.

So, those are general shot-gun recommendations. The exciting news is that Yale researchers showed that it is now possible to identify specific food sensitivities and provide patients with a more personalized dietary approach to the management of IBS, which has been shown to produce significant improvement in IBS patients. The study was published in the British Medical Journal Open Gastroenterology in March of 2018. Using the Leukocyte Activation Test – Alcat Test (a simple blood test that examines the white blood cell inflammation response to certain foods) researchers showed that it is possible to identify foods to which an IBS patient is sensitive.Eliminating those foods from the diet was shown to significantly improve IBS symptoms in patients who eliminated foods from their diet that were identified by the Alcat Test.

How was the study conducted? The Yale team conducted a double-blind, randomized clinical trial of 58 patients with IBS. For each individual, the researchers collected blood samples and used the Lcat Test to measure immune cell activation in response to individual foods. The study participants were then put on individualized diets that either restricted foods consistent with test results or restricted foods inconsistent with test results. After several weeks on the individualized diets, participants were assessed for IBS symptoms and quality of life. The research team found that while both sets of participants experienced improvement, the individuals on diets consistent with test results fared much better overall and in terms of symptom severity.

The bottom line appears to be that if you suffer IBS, you may want to ask your doctor to perform the simple Lcat Test to see what foods you are most sensitive. The Yale research indicates that it may make a very big difference to your comfort level and quality of life.I have included a link to the research paper below in case you wish to share it with your health practitioner.


Ather Ali, Theresa R Weiss, Douglas McKee, Alisa Scherban, Sumiya Khan, Maxine R Fields, Damian Apollo, Wajahat Z Mehal. Efficacy of individualized diets in patients with irritable bowel syndrome: a randomized controlled trialBMJ Open Gastroenterology, 2017; 4 (1)  10.1136/bmjgast-2017-000164

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