Histamine Intolerance and IBS
In a previous article, I described the condition called histamine intolerance (HIT) and how to treat it. It is important information for anyone continuing to struggle with digestive or other health problems. Histamine intolerance often occurs in people with IBS. Until recently, accepting HIT as a “real” issue has been controversial in the medical community. Recall, however, that 10 years ago, gluten/wheat was also seen as an imaginary player in health problems. Science has since proven them to be culprits in many disorders. Research may be a sign that the tides are also changing regarding HIT. These studies are suggesting there may be a correlation between HIT and IBS.
Common Symptoms of Histamine Intolerance (HIT)
- Flushing/Rash/Urticaria (hives)/eczema
- Arrhythmia ( irregular heartbeat)
- Low blood pressure due to vasodilation caused by the histamine
- Stomach/intestinal Pain
- Runny Nose/Watery eyes/wheezing
- Angioedema-swelling of face/hands/lips
- Heartburn-due to increased acid production
- Itching- typically of the skin
- PMS- Headaches around the menstrual cycle or painful cramps due to histamine-induced contractions about hormone levels
The low-FODMAP diet is the primary dietary treatment for IBS. Following a low FODMAP diet has also been shown to lower histamine levels eightfold. This connection may be explained further why some people with IBS feel better on the Low-FODMAP diet. If science continues to mount, the Low -FODMAP diet may be routinely recommended for people with HIT in the future.
Histamine Intolerance & Gluten
Looking at the list of symptoms for HIT, you may notice a similarity with the symptoms of non-celiac gluten/wheat sensitivity (NCGWS). In the future, we may find some symptoms of NCGWS to be mediated by histamine receptors. New research suggests this may be so. If this is true, eating gluten might cause histamine-type symptoms in some people. Most gluten is eaten in the form of baked goods and processed foods. These foods are often high in histamine or seasoned with histamine containing ingredients.
HIT and Visceral Hypersensitivity ( Gut Pain)
Visceral hypersensitivity is a term used to describe the gut pain seen in people with IBS. Research has found that receptors in the gut make people with IBS more sensitive to histamine. Does this mean if you have IBS and eat high histamine foods, symptoms ( including pain) occur? This is not seen in everyone with IBS but is something to consider. Anti-histamines are sometimes used to treat IBS and visceral hypersensitivity but not routinely at this time. If dietary changes improve symptoms, some people may choose dietary changes over medications.
Thoughts to Ponder
When histamine levels go up with seasonal allergies, are gastrointestinal symptoms triggered in people with IBS? If so, people with seasonal allergies and IBS would experience more GI symptoms during certain times of the year. Some of my patients have noted this. We may be getting closer to a reason why this occurs. This may also mean temporary low histamine dietary changes could help antihistamines aren’t completely relieving seasonal allergies. It will also be interesting to see more studies on how a low histamine diet can help relieve IBS symptoms and how a low HIT diet will compare to a low FODMAP diet concerning symptom relief in IBS.
Will we see more targeted drugs for lowering histamine levels in the gut? Will these become a more mainstream treatment of IBS? All food for thought-literally.
Recent Research On Histamine Intolerance
- Histamine Intolerance: The Current State Of Art : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463562/
- Comparing Histamine Intolerance And Mast Cell Disorder: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463562/
- Considering Histamine In Functional GI Disorders: https://pubmed.ncbi.nlm.nih.gov/32643952/
- Non-responsive Celiac Disease And Histamine Intolerance: https://pubmed.ncbi.nlm.nih.gov/33268003/
- Histamine Intolerance And Functional Gut Disorders-https://pubmed.ncbi.nlm.nih.gov/32643952/
THIS ARTICLE IS COPYRIGHTED BY AMY BURKHART, MD, RD.
Dr. Amy Burkhart is a doctor (M.D.), Registered Dietitian, R.D., and fellowship-trained in integrative medicine. She specializes in treating chronic digestive disorders from an integrative/functional medicine perspective.