{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T02:13:41Z","timestamp":1792462421369,"version":"4.5.0"},"reference-count":81,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T00:00:00Z","timestamp":1751241600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Gastroenterol"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The underlying causes of irritable bowel syndrome (IBS) and functional dyspepsia (FD) have remained largely elusive, but emerging data suggest immune activation and loss of small intestinal homeostasis may explain a major subgroup. FD and IBS symptoms often overlap and may occur early in the post-prandial period, suggesting the origin of symptoms may be much higher in gastrointestinal tract than colon. There is strong evidence low-grade duodenal inflammation, comprising eosinophils and\/or mast cells associated with increased permeability, is present at least in a major subset with FD and IBS. This hypothesis is further supported by evidence of circulating increased small intestinal homing T cells and altered duodenal microbiota. We hypothesize a major etiologic pathway whereby interaction of food with intestinal bacteria switches on small intestinal immune activation in FD and IBS leading to presentation of antigens to the mucosa. While the low FODMAP diet provides symptom relief in both IBS and FD, this diet notably also reduces common food protein antigens (e.g., wheat, milk, soy) and urinary histamine levels. The obvious but often overlooked fact that food ingestion usually requires the act of eating adds nuance to determining whether food components or eating itself induces symptoms and that both need to be considered in DGBI in clinical practice. The exciting observations about subtle inflammation in DGBIs offer hope for new diagnostic biomarkers, and if considered in the context of altered dietary patterns and validated against symptom responses, will pave the way for novel DGBI treatment options.<\/jats:p>","DOI":"10.1007\/s00535-025-02268-2","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T10:33:52Z","timestamp":1751279632000},"page":"1211-1220","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Why are disorders of gut\u2013brain interaction (DGBI) often food-related? Duodenal eosinophils and mast cells, small intestinal bacteria, food allergy and altered food intake in functional dyspepsia and the irritable bowel syndrome: a new paradigm"],"prefix":"10.1007","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2537-3092","authenticated-orcid":false,"given":"Nicholas J.","family":"Talley","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kerith","family":"Duncanson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina M.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"2268_CR1","doi-asserted-by":"publisher","first-page":"1664","DOI":"10.1016\/S0140-6736(20)32115-2","volume":"396","author":"CJ Black","year":"2020","unstructured":"Black CJ, Drossman DA, Talley NJ, et al. Functional gastrointestinal disorders: advances in understanding and management. Lancet. 2020;396:1664\u201374.","journal-title":"Lancet"},{"key":"2268_CR2","doi-asserted-by":"publisher","first-page":"17081","DOI":"10.1038\/nrdp.2017.81","volume":"3","author":"P Enck","year":"2017","unstructured":"Enck P, Azpiroz F, Boeckxstaens G, et al. Functional dyspepsia. Nat Rev Dis Primers. 2017;3:17081.","journal-title":"Nat Rev Dis Primers"},{"key":"2268_CR3","doi-asserted-by":"publisher","first-page":"1689","DOI":"10.1016\/S0140-6736(20)30469-4","volume":"396","author":"AC Ford","year":"2020","unstructured":"Ford AC, Mahadeva S, Carbone MF, et al. Functional dyspepsia. Lancet. 2020;396:1689\u2013702.","journal-title":"Lancet"},{"key":"2268_CR4","doi-asserted-by":"publisher","first-page":"2660","DOI":"10.1016\/j.cgh.2023.01.017","volume":"21","author":"M Bosman","year":"2023","unstructured":"Bosman M, Weerts Z, Snijkers JTW, et al. The socioeconomic impact of irritable bowel syndrome: an analysis of direct and indirect health care costs. Clin Gastroenterol Hepatol. 2023;21:2660\u20139.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2268_CR5","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1111\/nmo.12626","volume":"27","author":"NA Koloski","year":"2015","unstructured":"Koloski NA, Jones M, Weltman M, et al. Identification of early environmental risk factors for irritable bowel syndrome and dyspepsia. Neurogastroenterol Motil. 2015;27:1317\u201325.","journal-title":"Neurogastroenterol Motil"},{"key":"2268_CR6","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13533","volume":"31","author":"AK Tuteja","year":"2019","unstructured":"Tuteja AK, Talley NJ, Stoddard GJ, et al. Risk factors for upper and lower functional gastrointestinal disorders in Persian Gulf War Veterans during and post-deployment. Neurogastroenterol Motil. 2019;31: e13533.","journal-title":"Neurogastroenterol Motil"},{"key":"2268_CR7","doi-asserted-by":"publisher","DOI":"10.3389\/fnins.2022.825246","volume":"16","author":"S Fowler","year":"2022","unstructured":"Fowler S, Hoedt EC, Talley NJ, et al. Circadian rhythms and melatonin metabolism in patients with disorders of gut\u2013brain interactions. Front Neurosci. 2022;16: 825246.","journal-title":"Front Neurosci"},{"key":"2268_CR8","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14109","volume":"33","author":"J Ronkainen","year":"2021","unstructured":"Ronkainen J, Aro P, Jones M, et al. Duodenal eosinophilia and the link to anxiety: a population-based endoscopic study. Neurogastroenterol Motil. 2021;33: e14109.","journal-title":"Neurogastroenterol Motil"},{"key":"2268_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2024.111834","volume":"183","author":"J Overs","year":"2024","unstructured":"Overs J, Morgan S, Apputhurai P, et al. Comparing the prevalence and association between anxiety, depression and gastrointestinal symptoms in gastroparesis versus functional dyspepsia: a systematic review and meta-analysis. J Psychosom Res. 2024;183: 111834.","journal-title":"J Psychosom Res"},{"key":"2268_CR10","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1016\/S2468-1253(23)00102-4","volume":"8","author":"T Fairlie","year":"2023","unstructured":"Fairlie T, Shah A, Talley NJ, et al. Overlap of disorders of gut-brain interaction: a systematic review and meta-analysis. Lancet Gastroenterol Hepatol. 2023;8:646\u201359.","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2268_CR11","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1111\/nmo.12510","volume":"27","author":"E Arsi\u00e8","year":"2015","unstructured":"Arsi\u00e8 E, Coletta M, Cesana BM, et al. Symptom-association probability between meal ingestion and abdominal pain in patients with irritable bowel syndrome. Does somatization play a role? Neurogastroenterol Motil. 2015;27:416\u201322.","journal-title":"Neurogastroenterol Motil"},{"key":"2268_CR12","doi-asserted-by":"crossref","unstructured":"MacIntosh A, Heenan PE, Wright-McNaughton M, et al. The relationship between fermentable carbohydrates and post-prandial bowel symptoms in patients with functional bowel disorders. Front Nutr. 2023; 2:10","DOI":"10.3389\/fnut.2023.1060928"},{"key":"2268_CR13","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1177\/2050640613501817","volume":"1","author":"I Posserud","year":"2013","unstructured":"Posserud I, Strid H, St\u00f6rsrud S, et al. Symptom pattern following a meal challenge test in patients with irritable bowel syndrome and healthy controls. United Eur Gastroenterol J. 2013;1:358\u201367.","journal-title":"United Eur Gastroenterol J"},{"key":"2268_CR14","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1097\/00042737-199805000-00011","volume":"10","author":"G Ragnarsson","year":"1998","unstructured":"Ragnarsson G, Bodemar G. Pain is temporally related to eating but not to defaecation in the irritable bowel syndrome (IBS). Patients\u2019 description of diarrhea, constipation and symptom variation during a prospective 6-week study. Eur J Gastroenterol Hepatol. 1998;10:415\u201321.","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"2268_CR15","doi-asserted-by":"publisher","first-page":"2522","DOI":"10.1007\/s10620-024-08457-y","volume":"69","author":"E Clevers","year":"2024","unstructured":"Clevers E, Launders D, Helme D, et al. Coffee, alcohol, and artificial sweeteners have temporal associations with gastrointestinal symptoms. Dig Dis Sci. 2024;69:2522\u20139.","journal-title":"Dig Dis Sci"},{"key":"2268_CR16","doi-asserted-by":"crossref","unstructured":"Scarlata K, Zickgraf HF, Satherley R-M, et al. A call to action: unraveling the nuance of adapted eating behaviors in individuals with gastrointestinal conditions. Clin Gastroenterol Hepatol. 2025; 23:6.","DOI":"10.1016\/j.cgh.2024.11.010"},{"key":"2268_CR17","doi-asserted-by":"publisher","first-page":"985","DOI":"10.14309\/ajg.0000000000001766","volume":"117","author":"HB Murray","year":"2022","unstructured":"Murray HB, Doerfler B, Harer KN, et al. Psychological considerations in the dietary management of patients with DGBI. Am J Gastroenterol. 2022;117:985\u201394.","journal-title":"Am J Gastroenterol"},{"key":"2268_CR18","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1111\/apt.12903","volume":"40","author":"AC Ford","year":"2014","unstructured":"Ford AC, Talley NJ, Walker MM, et al. Increased prevalence of autoimmune diseases in functional gastrointestinal disorders: case\u2013control study of 23471 primary care patients. Aliment Pharmacol Ther. 2014;40:827\u201334.","journal-title":"Aliment Pharmacol Ther"},{"key":"2268_CR19","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1111\/apt.12846","volume":"40","author":"MP Jones","year":"2014","unstructured":"Jones MP, Walker MM, Ford AC, et al. The overlap of atopy and functional gastrointestinal disorders among 23,471 patients in primary care. Aliment Pharmacol Ther. 2014;40:382\u201391.","journal-title":"Aliment Pharmacol Ther"},{"key":"2268_CR20","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1111\/apt.15120","volume":"49","author":"N Koloski","year":"2019","unstructured":"Koloski N, Jones M, Walker MM, et al. Population based study: atopy and autoimmune diseases are associated with functional dyspepsia and irritable bowel syndrome, independent of psychological distress. Aliment Pharmacol Ther. 2019;49:546\u201355.","journal-title":"Aliment Pharmacol Ther"},{"key":"2268_CR21","doi-asserted-by":"publisher","first-page":"1175","DOI":"10.1016\/j.cgh.2007.05.015","volume":"5","author":"NJ Talley","year":"2007","unstructured":"Talley NJ, Walker MM, Aro P, et al. Non-ulcer dyspepsia and duodenal eosinophilia: an adult endoscopic population-based case-control study. Clin Gastroenterol Hepatol. 2007;5:1175\u201383.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2268_CR22","doi-asserted-by":"crossref","unstructured":"Burns GL, Bruce JK, Minahan K, et al. Type 2 and type 17 effector cells are increased in the duodenal mucosa but not peripheral blood of patients with functional dyspepsia. Front Immunol. 2023; 6:13.","DOI":"10.3389\/fimmu.2022.1051632"},{"key":"2268_CR23","doi-asserted-by":"publisher","first-page":"2229","DOI":"10.1016\/j.cgh.2022.01.014","volume":"20","author":"A Shah","year":"2022","unstructured":"Shah A, Fairlie T, Brown G, et al. Duodenal eosinophils and mast cells in functional dyspepsia: a systematic review and meta-analysis of case\u2013control studies. Clin Gastroenterol Hepatol. 2022;20:2229-2242.e29.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2268_CR24","doi-asserted-by":"publisher","first-page":"1521","DOI":"10.1053\/j.gastro.2020.12.016","volume":"160","author":"L Wauters","year":"2021","unstructured":"Wauters L, Ceulemans M, Frings D, et al. proton pump inhibitors reduce duodenal eosinophilia, mast cells, and permeability in patients with functional dyspepsia. Gastroenterology. 2021;160:1521-1531.e9.","journal-title":"Gastroenterology"},{"key":"2268_CR25","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1002\/jpn3.12351","volume":"79","author":"S Dalal","year":"2024","unstructured":"Dalal S, Ajit D, Friesen CS, et al. Metabolomic comparison of postprandial distress syndrome patients with and without duodenal eosinophilia. J Pediatr Gastroenterol Nutr. 2024;79:991\u20139.","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2268_CR26","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1007\/s00535-011-0379-9","volume":"46","author":"AC Ford","year":"2011","unstructured":"Ford AC, Talley NJ. Mucosal inflammation as a potential etiological factor in irritable bowel syndrome: a systematic review. J Gastroenterol. 2011;46:421\u201331.","journal-title":"J Gastroenterol"},{"key":"2268_CR27","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1111\/j.1365-2036.2009.03937.x","volume":"29","author":"MM Walker","year":"2009","unstructured":"Walker MM, Talley NJ, Prabhakar M, et al. Duodenal mastocytosis, eosinophilia and intraepithelial lymphocytosis as possible disease markers in the irritable bowel syndrome and functional dyspepsia. Aliment Pharmacol Ther. 2009;29:765\u201373.","journal-title":"Aliment Pharmacol Ther"},{"key":"2268_CR28","doi-asserted-by":"publisher","DOI":"10.14309\/ctg.0000000000000725","volume":"15","author":"M Ceulemans","year":"2024","unstructured":"Ceulemans M, Huyghe P, De Hertogh G, et al. redefining histological cell counts using a standardized method: the Leuven Intestinal Counting Protocol. Clin Transl Gastroenterol. 2024;15: e00725.","journal-title":"Clin Transl Gastroenterol"},{"key":"2268_CR29","doi-asserted-by":"publisher","first-page":"1089","DOI":"10.1038\/ajg.2010.512","volume":"106","author":"T Liebregts","year":"2011","unstructured":"Liebregts T, Adam B, Bredack C, et al. Small bowel homing T cells are associated with symptoms and delayed gastric emptying in functional dyspepsia. Am J Gastroenterol. 2011;106:1089\u201398.","journal-title":"Am J Gastroenterol"},{"key":"2268_CR30","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1053\/j.gastro.2007.01.046","volume":"132","author":"T Liebregts","year":"2007","unstructured":"Liebregts T, Adam B, Bredack C, et al. Immune activation in patients with irritable bowel syndrome. Gastroenterology. 2007;132:913\u201320.","journal-title":"Gastroenterology"},{"key":"2268_CR31","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1111\/apt.13006","volume":"41","author":"S Futagami","year":"2015","unstructured":"Futagami S, Itoh T, Sakamoto C. Systematic review with meta-analysis: post-infectious functional dyspepsia. Aliment Pharmacol Ther. 2015;41:177\u201388.","journal-title":"Aliment Pharmacol Ther"},{"key":"2268_CR32","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1080\/00365521.2019.1607897","volume":"54","author":"AT Svendsen","year":"2019","unstructured":"Svendsen AT, Bytzer P, Engsbro AL. Systematic review with meta-analyses: does the pathogen matter in post-infectious irritable bowel syndrome? Scand J Gastroenterol. 2019;54:546\u201362.","journal-title":"Scand J Gastroenterol"},{"key":"2268_CR33","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1136\/gutjnl-2023-331835","volume":"73","author":"S Porcari","year":"2024","unstructured":"Porcari S, Ingrosso MR, Maida M, et al. Prevalence of irritable bowel syndrome and functional dyspepsia after acute gastroenteritis: systematic review and meta-analysis. Gut. 2024;73:1431\u201340.","journal-title":"Gut"},{"key":"2268_CR34","first-page":"1","volume":"85","author":"J Zhao","year":"2024","unstructured":"Zhao J, Dai Y, Tian J, et al. Impact of mechanical barrier damage and interleukin-17 on symptoms in patients with post-infectious irritable bowel syndrome. Br J Hosp Med (Lond). 2024;85:1\u201313.","journal-title":"Br J Hosp Med (Lond)"},{"key":"2268_CR35","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1038\/s41586-020-03118-2","volume":"590","author":"J Aguilera-Lizarraga","year":"2021","unstructured":"Aguilera-Lizarraga J, Florens MV, Viola MF, et al. Local immune response to food antigens drives meal-induced abdominal pain. Nature. 2021;590:151\u20136.","journal-title":"Nature"},{"key":"2268_CR36","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.bbi.2022.01.019","volume":"101","author":"JK Bruce","year":"2022","unstructured":"Bruce JK, Burns GL, Sinn Soh W, et al. Defects in NLRP6, autophagy and goblet cell homeostasis are associated with reduced duodenal CRH receptor 2 expression in patients with functional dyspepsia. Brain Behav Immun. 2022;101:335\u201345.","journal-title":"Brain Behav Immun"},{"key":"2268_CR37","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1111\/apt.16372","volume":"54","author":"NJ Talley","year":"2021","unstructured":"Talley NJ, Powell N, Walker MM, et al. Role of smoking in functional dyspepsia and irritable bowel syndrome: three random population-based studies. Aliment Pharmacol Ther. 2021;54:32\u201342.","journal-title":"Aliment Pharmacol Ther"},{"key":"2268_CR38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/s41395-018-0084-x","volume":"113","author":"AC Ford","year":"2018","unstructured":"Ford AC, Moayyedi P, Chey WD, et al. American College of gastroenterology monograph on management of irritable bowel syndrome. Am J Gastroenterol. 2018;113:1\u201318.","journal-title":"Am J Gastroenterol"},{"key":"2268_CR39","doi-asserted-by":"publisher","first-page":"1517","DOI":"10.1136\/gutjnl-2017-313750","volume":"66","author":"HM Staudacher","year":"2017","unstructured":"Staudacher HM, Whelan K. The low FODMAP diet: recent advances in understanding its mechanisms and efficacy in IBS. Gut. 2017;66:1517\u201327.","journal-title":"Gut"},{"key":"2268_CR40","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2022.856216","volume":"9","author":"AR Silva","year":"2022","unstructured":"Silva AR, Bernardo A, de Mesquita MF, et al. An anti-inflammatory and low fermentable oligo, di, and monosaccharides and polyols diet improved patient reported outcomes in fibromyalgia: a randomized controlled trial. Front Nutr. 2022;9: 856216.","journal-title":"Front Nutr"},{"key":"2268_CR41","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13154","volume":"30","author":"M O'Keeffe","year":"2018","unstructured":"O\u2019Keeffe M, Jansen C, Martin L, et al. Long-term impact of the low-FODMAP diet on gastrointestinal symptoms, dietary intake, patient acceptability, and healthcare utilization in irritable bowel syndrome. Neurogastroenterol Motil. 2018;30: e13154.","journal-title":"Neurogastroenterol Motil"},{"key":"2268_CR42","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1111\/jgh.15694","volume":"37","author":"O Goyal","year":"2022","unstructured":"Goyal O, Nohria S, Batta S, et al. Low fermentable oligosaccharides, disaccharides, monosaccharides, and polyols diet versus traditional dietary advice for functional dyspepsia: a randomized controlled trial. J Gastroenterol Hepatol. 2022;37:301\u20139.","journal-title":"J Gastroenterol Hepatol"},{"key":"2268_CR43","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14148","volume":"33","author":"HM Staudacher","year":"2021","unstructured":"Staudacher HM, Nevin AN, Duff C, et al. Epigastric symptom response to low FODMAP dietary advice compared with standard dietetic advice in individuals with functional dyspepsia. Neurogastroenterol Motil. 2021;33: e14148.","journal-title":"Neurogastroenterol Motil"},{"key":"2268_CR44","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.13167","volume":"30","author":"I Masuy","year":"2018","unstructured":"Masuy I, Van Oudenhove L, Tack J, et al. Effect of intragastric FODMAP infusion on upper gastrointestinal motility, gastrointestinal, and psychological symptoms in irritable bowel syndrome vs healthy controls. Neurogastroenterol Motil. 2018;30: e13167.","journal-title":"Neurogastroenterol Motil"},{"key":"2268_CR45","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1016\/j.ajg.2024.07.010","volume":"25","author":"A Akp\u0131nar","year":"2024","unstructured":"Akp\u0131nar A, Kochan K, Kiremitci S, et al. The efficacy of removal of animal milk from the diet in functional dyspepsia: a cross-sectional study. Arab J Gastroenterol. 2024;25:390\u20138.","journal-title":"Arab J Gastroenterol"},{"key":"2268_CR46","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1016\/S2468-1253(23)00012-2","volume":"8","author":"KL Kliewer","year":"2023","unstructured":"Kliewer KL, Gonsalves N, Dellon ES, et al. One-food versus six-food elimination diet therapy for the treatment of eosinophilic oesophagitis: a multicentre, randomised, open-label trial. Lancet Gastroenterol Hepatol. 2023;8:408\u201321.","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2268_CR47","doi-asserted-by":"publisher","first-page":"676","DOI":"10.1016\/j.jaci.2023.05.024","volume":"152","author":"N Gonsalves","year":"2023","unstructured":"Gonsalves N, Doerfler B, Zalewski A, et al. Prospective study of an amino acid-based elemental diet in an eosinophilic gastritis and gastroenteritis nutrition trial. J Allergy Clin Immunol. 2023;152:676\u201388.","journal-title":"J Allergy Clin Immunol"},{"key":"2268_CR48","doi-asserted-by":"publisher","first-page":"1459","DOI":"10.1136\/gut.2003.037697","volume":"53","author":"W Atkinson","year":"2004","unstructured":"Atkinson W, Sheldon TA, Shaath N, et al. Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial. Gut. 2004;53:1459\u201364.","journal-title":"Gut"},{"key":"2268_CR49","doi-asserted-by":"crossref","unstructured":"Singh P, Chey WD, Takakura W, et al. A novel, IBS-specific IgG ELISA-based elimination diet in irritable bowel syndrome: a randomized, sham-controlled trial. Gastroenterology. 2025; 68: 6.","DOI":"10.1053\/j.gastro.2025.01.223"},{"key":"2268_CR50","doi-asserted-by":"publisher","first-page":"E70","DOI":"10.1017\/S0029665124000880","volume":"83","author":"K Lynam","year":"2024","unstructured":"Lynam K, Trakman G, Biesiekierski J, et al. The relationship between the low food chemical diet and symptoms in irritable bowel syndrome: a cross-sectional survey. Proc Nutr Soc. 2024;83:E70.","journal-title":"Proc Nutr Soc"},{"key":"2268_CR51","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1111\/cea.14561","volume":"54","author":"Z Cooke","year":"2024","unstructured":"Cooke Z, Lynam K, Tuck C, et al. Naturally occurring food chemical components and extraintestinal and gastrointestinal symptoms in adults: a systematic review. Clin Exp Allergy. 2024;54:855\u201380.","journal-title":"Clin Exp Allergy"},{"key":"2268_CR52","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1053\/j.gastro.2019.03.046","volume":"157","author":"A Fritscher-Ravens","year":"2019","unstructured":"Fritscher-Ravens A, Pflaum T, M\u00f6singer M, et al. Many patients with irritable bowel syndrome have atypical food allergies not associated with immunoglobulin E. Gastroenterology. 2019;157:109-118.e5.","journal-title":"Gastroenterology"},{"key":"2268_CR53","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1053\/j.gastro.2014.07.046","volume":"147","author":"A Fritscher-Ravens","year":"2014","unstructured":"Fritscher-Ravens A, Schuppan D, Ellrichmann M, et al. Confocal endomicroscopy shows food-associated changes in the intestinal mucosa of patients with irritable bowel syndrome. Gastroenterology. 2014;147:1012-20.e4.","journal-title":"Gastroenterology"},{"key":"2268_CR54","doi-asserted-by":"publisher","first-page":"965","DOI":"10.14309\/ajg.0000000000001780","volume":"117","author":"J Tack","year":"2022","unstructured":"Tack J, Tornblom H, Tan V, et al. Evidence-based and emerging dietary approaches to upper disorders of gut\u2013brain interaction. Am J Gastroenterol. 2022;117:965\u201372.","journal-title":"Am J Gastroenterol"},{"key":"2268_CR55","doi-asserted-by":"publisher","unstructured":"Burns GL, Potter M, Mathe A, et al. TRAV26-2 T cell receptor expression is associated with mucosal lymphocyte response to wheat proteins in functional dyspepsia patients. Clin Transl Gastroenterol. https:\/\/doi.org\/10.14309\/ctg.0000000000000638.","DOI":"10.14309\/ctg.0000000000000638"},{"key":"2268_CR56","doi-asserted-by":"publisher","first-page":"2401","DOI":"10.1038\/s41598-020-59532-z","volume":"10","author":"B Shahbazkhani","year":"2020","unstructured":"Shahbazkhani B, Fanaeian MM, Farahvash MJ, et al. Prevalence of non-celiac gluten sensitivity in patients with refractory functional dyspepsia: a randomized double-blind placebo controlled trial. Sci Rep. 2020;10:2401.","journal-title":"Sci Rep"},{"key":"2268_CR57","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/S2468-1253(23)00317-5","volume":"9","author":"MCG de Graaf","year":"2024","unstructured":"de Graaf MCG, Lawton CL, Croden F, et al. The effect of expectancy versus actual gluten intake on gastrointestinal and extra-intestinal symptoms in non-coeliac gluten sensitivity: a randomised, double-blind, placebo-controlled, international, multicentre study. Lancet Gastroenterol Hepatol. 2024;9:110\u201323.","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"2268_CR58","doi-asserted-by":"publisher","first-page":"1901275","DOI":"10.1002\/mnfr.201901275","volume":"65","author":"M Ajamian","year":"2021","unstructured":"Ajamian M, Rosella G, Newnham ED, et al. Effect of gluten ingestion and FODMAP restriction on intestinal epithelial integrity in patients with irritable bowel syndrome and self-reported non-coeliac gluten sensitivity. Mol Nutr Food Res. 2021;65:1901275.","journal-title":"Mol Nutr Food Res"},{"key":"2268_CR59","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1016\/j.cgh.2022.12.035","volume":"21","author":"SK McGill","year":"2023","unstructured":"McGill SK, Hashash JG, Platts-Mills TA. AGA clinical practice update on alpha-gal syndrome for the GI clinician: commentary. Clin Gastroenterol Hepatol. 2023;21:891\u20136.","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2268_CR60","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14955","volume":"37","author":"G Tziatzios","year":"2025","unstructured":"Tziatzios G, Stylianakis E, Damoraki G, et al. Third generation sequencing analysis detects significant differences in duodenal microbiome composition between functional dyspepsia patients and control subjects. Neurogastroenterol Motil. 2025;37: e14955.","journal-title":"Neurogastroenterol Motil"},{"key":"2268_CR61","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1136\/gutjnl-2021-326158","volume":"72","author":"ER Shanahan","year":"2023","unstructured":"Shanahan ER, Kang S, Staudacher H, et al. Alterations to the duodenal microbiota are linked to gastric emptying and symptoms in functional dyspepsia. Gut. 2023;72:929\u201338.","journal-title":"Gut"},{"key":"2268_CR62","doi-asserted-by":"publisher","first-page":"2012","DOI":"10.1038\/s41467-019-09964-7","volume":"10","author":"GB Saffouri","year":"2019","unstructured":"Saffouri GB, Shields-Cutler RR, Chen J, et al. Small intestinal microbial dysbiosis underlies symptoms associated with functional gastrointestinal disorders. Nat Commun. 2019;10:2012.","journal-title":"Nat Commun"},{"key":"2268_CR63","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1111\/apt.13622","volume":"43","author":"ER Shanahan","year":"2016","unstructured":"Shanahan ER, Zhong L, Talley NJ, et al. Characterisation of the gastrointestinal mucosa-associated microbiota: a novel technique to prevent cross-contamination during endoscopic procedures. Aliment Pharmacol Ther. 2016;43:1186\u201396.","journal-title":"Aliment Pharmacol Ther"},{"key":"2268_CR64","doi-asserted-by":"publisher","first-page":"1168","DOI":"10.1136\/gutjnl-2016-312574","volume":"66","author":"L Zhong","year":"2017","unstructured":"Zhong L, Shanahan ER, Raj A, et al. Dyspepsia and the microbiome: time to focus on the small intestine. Gut. 2017;66:1168\u20139.","journal-title":"Gut"},{"key":"2268_CR65","doi-asserted-by":"publisher","DOI":"10.1128\/MRA.00758-21","volume":"10","author":"EC Hoedt","year":"2021","unstructured":"Hoedt EC, Shanahan ER, Keely S, et al. Draft genome sequence of Streptococcus salivarius AGIRA0003, isolated from functional gastrointestinal disorder duodenal tissue. Microbiol Resour Announc. 2021;10: e0075821.","journal-title":"Microbiol Resour Announc"},{"key":"2268_CR66","doi-asserted-by":"publisher","first-page":"2132078","DOI":"10.1080\/19490976.2022.2132078","volume":"14","author":"A Shah","year":"2022","unstructured":"Shah A, Kang S, Talley NJ, et al. The duodenal mucosa associated microbiome, visceral sensory function, immune activation and psychological comorbidities in functional gastrointestinal disorders with and without self-reported non-celiac wheat sensitivity. Gut Microbes. 2022;14:2132078.","journal-title":"Gut Microbes"},{"key":"2268_CR67","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1177\/1535370214564748","volume":"240","author":"M Berger","year":"2015","unstructured":"Berger M, Sarantopoulos C, Ongchangco D, et al. Rapid isolation of gluten-digesting bacteria from human stool and saliva by using gliadin-containing plates. Exp Biol Med (Maywood). 2015;240:917\u201324.","journal-title":"Exp Biol Med (Maywood)"},{"key":"2268_CR68","doi-asserted-by":"publisher","first-page":"3045","DOI":"10.1007\/s00253-021-11263-5","volume":"105","author":"V K\u00f5iv","year":"2021","unstructured":"K\u00f5iv V, Tenson T. Gluten-degrading bacteria: availability and applications. Appl Microbiol Biotechnol. 2021;105:3045\u201359.","journal-title":"Appl Microbiol Biotechnol"},{"key":"2268_CR69","doi-asserted-by":"publisher","first-page":"621","DOI":"10.5009\/gnl230130","volume":"18","author":"SH Kim","year":"2024","unstructured":"Kim SH, Choi Y, Oh J, et al. Associations among the duodenal ecosystem, gut microbiota, and nutrient intake in functional dyspepsia. Gut Liver. 2024;18:621\u201331.","journal-title":"Gut Liver"},{"key":"2268_CR70","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1002\/ueg2.12075","volume":"9","author":"UC Ghoshal","year":"2021","unstructured":"Ghoshal UC. Antibiotic treatment for small intestinal bacterial overgrowth: Is a cocktail better than a single? United Eur Gastroenterol J. 2021;9:643\u20134.","journal-title":"United Eur Gastroenterol J"},{"key":"2268_CR71","doi-asserted-by":"publisher","first-page":"eabj1895","DOI":"10.1126\/scitranslmed.abj1895","volume":"14","author":"G De Palma","year":"2022","unstructured":"De Palma G, Shimbori C, Reed DE, et al. Histamine production by the gut microbiota induces visceral hyperalgesia through histamine 4 receptor signaling in mice. Sci Transl Med. 2022;14:eabj1895.","journal-title":"Sci Transl Med"},{"key":"2268_CR72","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1067\/mai.2003.1585","volume":"112","author":"CA Akdis","year":"2003","unstructured":"Akdis CA, Blaser K. Histamine in the immune regulation of allergic inflammation. J Allergy Clin Immunol. 2003;112:15\u201322.","journal-title":"J Allergy Clin Immunol"},{"key":"2268_CR73","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1038\/s41587-020-0501-8","volume":"38","author":"DH Parks","year":"2020","unstructured":"Parks DH, Chuvochina M, Chaumeil PA, et al. A complete domain-to-species taxonomy for Bacteria and Archaea. Nat Biotechnol. 2020;38:1079\u201386.","journal-title":"Nat Biotechnol"},{"key":"2268_CR74","doi-asserted-by":"publisher","first-page":"634","DOI":"10.1038\/ajg.2013.105","volume":"108","author":"L B\u00f6hn","year":"2013","unstructured":"B\u00f6hn L, St\u00f6rsrud S, T\u00f6rnblom H, et al. Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life. Am J Gastroenterol. 2013;108:634\u201341.","journal-title":"Am J Gastroenterol"},{"key":"2268_CR75","doi-asserted-by":"publisher","first-page":"1241","DOI":"10.1136\/gutjnl-2015-311339","volume":"66","author":"K McIntosh","year":"2017","unstructured":"McIntosh K, Reed DE, Schneider T, et al. FODMAPs alter symptoms and the metabolome of patients with IBS: a randomised controlled trial. Gut. 2017;66:1241\u201351.","journal-title":"Gut"},{"key":"2268_CR76","first-page":"2022","volume":"13","author":"CJ Tuck","year":"2022","unstructured":"Tuck CJ, Abu Omar A, De Palma G, et al. Changes in signalling from faecal neuroactive metabolites following dietary modulation of IBS pain. Gut. 2022;13:2022\u2013327260.","journal-title":"Gut"},{"key":"2268_CR77","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1053\/j.gastro.2015.12.034","volume":"150","author":"MM Wouters","year":"2016","unstructured":"Wouters MM, Balemans D, Van Wanrooy S, et al. Histamine receptor H1-mediated sensitization of TRPV1 mediates visceral hypersensitivity and symptoms in patients with irritable bowel syndrome. Gastroenterology. 2016;150:875-87.e9.","journal-title":"Gastroenterology"},{"key":"2268_CR78","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1136\/gutjnl-2023-331634","volume":"73","author":"L Decraecker","year":"2024","unstructured":"Decraecker L, De Looze D, Hirsch DP, et al. Treatment of non-constipated irritable bowel syndrome with the histamine 1 receptor antagonist ebastine: a randomised, double-blind, placebo-controlled trial. Gut. 2024;73:459\u201369.","journal-title":"Gut"},{"key":"2268_CR79","doi-asserted-by":"publisher","first-page":"966","DOI":"10.1136\/gutjnl-2019-318412","volume":"69","author":"MDE Potter","year":"2020","unstructured":"Potter MDE, Goodsall TM, Walker MM, et al. Dual histamine blockade for the treatment of adult functional dyspepsia: a single centre experience. Gut. 2020;69:966.","journal-title":"Gut"},{"key":"2268_CR80","doi-asserted-by":"crossref","unstructured":"Biesiekierski JR, Yao CK, Tuck CJ, et al. Methodological advances in gastrointestinal tract physiology measurements: relevance to nutritional studies. Proc Nutr Soc. 2025; 84: 2.","DOI":"10.1017\/S0029665124007444"},{"key":"2268_CR81","doi-asserted-by":"publisher","first-page":"2350785","DOI":"10.1080\/19490976.2024.2350785","volume":"16","author":"K Duncanson","year":"2024","unstructured":"Duncanson K, Williams G, Hoedt EC, et al. Diet-microbiota associations in gastrointestinal research: a systematic review. Gut Microbes. 2024;16:2350785.","journal-title":"Gut Microbes"}],"container-title":["Journal of Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00535-025-02268-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00535-025-02268-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00535-025-02268-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T15:02:33Z","timestamp":1775055753000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00535-025-02268-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,30]]},"references-count":81,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["2268"],"URL":"https:\/\/doi.org\/10.1007\/s00535-025-02268-2","relation":{},"ISSN":["0944-1174","1435-5922"],"issn-type":[{"value":"0944-1174","type":"print"},{"value":"1435-5922","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,30]]},"assertion":[{"value":"17 March 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Nicholas J. Talley: Biocodex (FD diagnostic tool) (present), Comvita Manuka Honey (FD trial consulting). Outside the submitted work. In addition, Dr. Talley has a patent Nepean Dyspepsia Index (NDI) 1998, a patent Licensing Questionnaires Talley Bowel Disease Questionnaire licensed to Mayo\/Talley, \u201cDiagnostic marker for functional gastrointestinal disorders\u201d Australian Provisional Patent Application 2021901692,\u201dMethods and compositions for treating age-related neurodegenerative disease associated with dysbiosis\u201d US Patent Application No. 63\/537,725.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}