Overview
This Journal of Neurogastroenterology and Motility original article from the Gemelli Hospital allergology, gastroenterology, nuclear medicine, and pulmonology consortium tests whether a low-nickel diet improves gastrointestinal symptoms in IBS patients with nickel sensitization, and characterizes the intestinal permeability profile of these patients using 51Cr-EDTA excretion. The study confirms that nickel-sensitive IBS patients have substantially elevated intestinal permeability versus controls (5.91 percent vs 2.20 percent 51Cr-EDTA excretion) and that all GI symptoms except vomiting improve significantly on a low-nickel diet. The finding positions IBS with nickel sensitization as a candidate subtype of SNAS amenable to dietary intervention.
Key numbers
| Measure | Ni-sensitive IBS | Controls |
|---|---|---|
| 51Cr-EDTA intestinal permeability (24h urinary excretion percent) | 5.91 | 2.20 |
On low-nickel diet, all GI symptoms except vomiting improved significantly in the Ni-sensitive IBS cohort. Compromised intestinal permeability was documented in all enrolled patients.
Methods (brief)
Single-site prospective study at Gemelli Hospital. Inclusion: IBS by Rome criteria + positive nickel patch test + symptom flare on oral Ni challenge. Intervention: structured low-nickel diet. Outcome: GI symptom response plus pre/post 51Cr-EDTA intestinal permeability quantification.
Implications
- Certification: Establishes the IBS-Ni-allergy-low-Ni-diet axis as a documented clinical subtype with quantitative permeability biomarker support. Mechanistically consistent with the Ni-driven gut-barrier disruption framework in Ghosh et al. 2024.
- Microbiome: Direct evidence that dietary nickel affects intestinal-barrier integrity in humans; the 5.91 percent vs 2.20 percent 51Cr-EDTA difference is a measurable biomarker of the leaky-gut consequence of Ni exposure.
- Courses: Standard reference for IBS-and-nickel clinical management.
Related evidence
Update history
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