Philadelphia-area physician Dr. Michael Stierstorfer has been helping patients with irritable bowel syndrome (IBS) find relief from their symptoms by testing them for type 4 food allergies that may be wreaking havoc on the inner lining of their gastrointestinal tract. He is now bringing his testing to the Bay Area at his IBS Test Center open in Albany, CA.
In the past, doctors have looked at type 1 allergies (the kind of allergy people have to peanuts, for example) as a potential cause of IBS but authoritative sources have since declared such allergies generally play no role. Stierstorfer suggests that testing for type 1 allergies is like “barking up the wrong tree.” Instead, he researched type 4 allergies, which are classified as “delayed hypersensitivity reactions” and can’t be diagnosed using the standard skin prick tests used to evaluate “immediate hypersensitivity” type 1 allergies.
To test for type 4 allergies, Stierstorfer uses skin patch testing, commonly used in dermatology to identify triggers of eczema. Using this method, he is often able to identify the foods or additives likely triggering an allergic response in the bowel and counsel patients on eliminating the allergen from their diet.
Though this innovative approach is still relatively new, Stierstorfer has seen promising results so far.
“More than half of the IBS patients we patch test benefit from the testing” says Stierstorfer, a dermatologist with offices in Albany, CA and Montgomery County, PA. “We work on eliminating the allergen from their diet and many experience moderate or complete relief. As the testing process becomes more accessible, I expect it to become a first line recommendation for IBS sufferers.”
For Stierstorfer, finding a precise underlying cause of IBS was personal. In otherwise perfect health sixteen years ago, he developed abdominal pain and other symptoms commonly associated with IBS. When his symptoms didn’t subside after months of discomfort, he sought the help of a gastroenterologist and joined the ranks of the 32 to 48 million Americans suffering from IBS.
“The symptoms were no fun and the doctor visits and testing very time-consuming and disruptive to my work and life in general,” Stierstorfer says. “I was eager to find out what was wrong.”
A wide range of tests revealed no underlying cause for his symptoms. It was only after eating at the same Indian restaurant twice within one week that he zeroed in on something that triggered his symptoms: garlic. After avoiding all garlic for a day or two, his IBS symptoms “completely disappeared.”
“At that point, I realized that a new allergy was the most likely explanation,” he says. “And as a dermatologist, I was perfectly positioned to investigate this.”
To test his hunch, Stierstorfer placed a slice of garlic on his skin, covered it with tape, and waited 48 hours. When he removed the patch, he found a small itchy red spot underneath, indicating a type 4 allergy, the same immune system response as occurs with poison ivy. Stierstorfer reasoned that if his skin reacted after being in contact with garlic, there was no reason the lining of his gastrointestinal tract couldn’t react the same way. “After all,” he says, “the immune system has as much access to the lining of the GI tract as it does to the surface of the skin—maybe more.”
After successfully eliminating his own IBS symptoms, Stierstorfer’s North Wales, PA dermatology practice conducted clinical studies for patients with IBS or IBS-like symptoms, testing up to 122 foods known to trigger type 4 allergies. A large majority of study participants had a positive patch test to at least one food and were instructed to avoid the food(s) in question. Over 50 percent of these people experienced improvement or resolution of their IBS symptoms, with their response maintained for the length of the studies, more than 4 months.
“Some people didn’t report relief from their IBS symptoms, but there are quite a few reasons for that,” Stierstorfer says. “Some of these foods and additives are very difficult to avoid in our Western diet—often we don’t even realize we’re eating them. It’s also possible that some people had allergies to other foods as well that weren’t among those used in the study and continued to eat them. And for others, food allergies may not be the cause.”
Satisfied that he had stumbled upon a major advance in the understanding and approach to IBS, Stierstorfer has had his results published in several prominent medical journals and began offering the testing at his dermatology practice. Since then, he’s self-published a print and audio book on his work and established The IBS Test Centers, PC, an IBS food allergy patch testing-exclusive practice in the Bay Area. Several other doctors on the East Coast and Southern California also offer the testing.
“People with IBS often go years with no sense of what’s causing their symptoms, and there are a host of complex diet plans and medications that attempt to combat the symptoms with varying degrees of success,” Stierstorfer says. “But this is unique: for a majority of patients, we can pinpoint an exact cause of IBS symptoms, and if they successfully eliminate those foods from their diet, their quality of life improves dramatically—almost overnight.”
