Irritable bowel syndrome is a common condition but its pathophysiology rema
ins poorly understood. Many irritable bowel syndrome patients give a histor
y of food intolerance, but data from dietary elimination and re-challenge s
tudies are inconclusive. Multiple aetiopathological mechanisms have been po
The gut has an extensive immune system but current understanding of process
ing of food antigens in health and disease is limited. There is no clinical
ly useful marker available to test for food hypersensitivity in irritable b
owel syndrome. Researchers have employed both skin tests and serum immunogl
obulins (IgG and IgE) as markers of food hypersensitivity in various disord
ers including irritable bowel syndrome, but published data are equivocal.
In this article, the evidence for the role of food hypersensitivity in irri
table bowel syndrome is reviewed and, based on the available data, a possib
le pathophysiological hypothesis has been formulated.