Skip to main content

Thank you for visiting You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Nutrition and Health (including climate and ecological aspects)

Serum food specific IgG antibodies are associated with small bowel inflammation in patients with Crohn’s disease



Food antigens are thought to play a vital role in the initiation and perpetuation of Crohn’s disease (CD). The main purpose of this study was to evaluate the potential association of serum food specific IgG antibodies and small bowel (SB) inflammation in CD patients.


We conducted a prospective observational study with 96 CD patients. Demographic, disease-related data and inflammatory parameters were collected. Serum food IgG antibodies were measured using enzyme-linked immunosorbent assay (ELISA). Capsule endoscopy was performed to detect SB inflammation quantified by the Lewis Score.


Seventy-eight of (81.3%) CD patients were detected positive for at least one food-specific antibody. The five most prevalent food antibodies in CD patients were tomato, egg, corn, rice, and soybean. Patients with SB inflammation had a higher positive rate of food IgG antibodies (P = 0.010) and more IgG-positive food items (P = 0.010) than those without. Specifically, patients with SB inflammation were more likely to have positive food-specific IgG against egg (P = 0.014), corn (P = 0.014), and wheat (P = 0.048). Additionally, the number of positive food IgGs ≥ 3 and elevated ESR were independently associated with concurrent SB inflammation (P = 0.015 and P = 0.013, respectively).


Our study confirmed that CD patients with SB inflammation had a higher positive rate of food IgG antibodies and more IgG-positive food items. The number of food positive IgGs ≥ 3 and elevated ESR were independently associated with concurrent SB inflammation.

This is a preview of subscription content, access via your institution

Access options

Rent or buy this article

Prices vary by article type



Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Distribution of positive food antibodies in Crohn’s disease patients with and without small bowel inflammation.

Data availability

The data that support the findings of this study are available from the corresponding author Chengdang Wang ( upon reasonable request.


  1. Lazarev M, Huang CR, Bitton A, Cho JH, Duerr RH, McGovern DP, et al. Relationship between proximal Crohn’s disease location and disease behavior and surgery: a cross-sectional study of the IBD Genetics Consortium. Am J Gastroenterol. 2013;108:106–12.

    Article  CAS  PubMed  Google Scholar 

  2. Du J, Du HJ, Chen HT, Shen LY, Zhang BL, Xu WW, et al. Characteristics and prognosis of isolated small-bowel Crohn’s disease. Int J Colorectal Dis. 2020;35:69–75.

    Article  PubMed  Google Scholar 

  3. Peyrin-Biroulet L, Sandborn W, Sands BE, Reinisch W, Bemelman W, Bryant RV, et al. Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE): determining therapeutic goals for treat-to-target. Am J Gastroenterol. 2015;110:1324–38.

    Article  CAS  PubMed  Google Scholar 

  4. Peyrin-Biroulet L, Loftus EV, Colombel JF, Sandborn WJ. The natural history of adult Crohn’s disease in population-based cohorts. Am J Gastroenterol. 2010;105:289–97.

    Article  PubMed  Google Scholar 

  5. Iddan G, Meron G, Glukhovsky A, Swain P. Wireless capsule endoscopy. Nature. 2000;405:417.

    Article  CAS  PubMed  Google Scholar 

  6. Voderholzer WA, Beinhoelzl J, Rogalla P, Murrer S, Schachschal G, Lochs H, et al. Small bowel involvement in Crohn’s disease: a prospective comparison of wireless capsule endoscopy and computed tomography enteroclysis. Gut. 2005;54:369–73.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Jensen MD, Nathan T, Rafaelsen SR, Kjeldsen J. Diagnostic accuracy of capsule endoscopy for small bowel Crohn’s disease is superior to that of MR enterography or CT enterography. Clin Gastroenterol Hepatol. 2011;9:124–9.

    Article  PubMed  Google Scholar 

  8. O’Donnell S, Qasim A, Ryan BM, O’Connor HJ, Breslin N, CA OM. The role of capsule endoscopy in small bowel Crohn’s disease. J Crohns Colitis. 2009;3:282–6.

    Article  PubMed  Google Scholar 

  9. Santos-Antunes J, Cardoso H, Lopes S, Marques M, Nunes AC, Macedo G. Capsule enteroscopy is useful for the therapeutic management of Crohn’s disease. World J Gastroenterol. 2015;21:12660–66.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Ben-Horin S, Lahat A, Amitai MM, Klang E, Yablecovitch D, Neuman S, et al. Assessment of small bowel mucosal healing by video capsule endoscopy for the prediction of short-term and long-term risk of Crohn’s disease flare: a prospective cohort study. Lancet Gastroenterol Hepatol. 2019;4:519–28.

    Article  PubMed  Google Scholar 

  11. Wang Y-C, Pan J, Liu Y-W, Sun F-Y, Qian Y-Y, Jiang X, et al. Adverse events of video capsule endoscopy over the past two decades: a systematic review and proportion meta-analysis. BMC Gastroenterol. 2020;20.

  12. Cheifetz AS, Kornbluth AA, Legnani P, Schmelkin I, Brown A, Lichtiger S, et al. The risk of retention of the capsule endoscope in patients with known or suspected Crohn’s disease. Am J Gastroenterol. 2006;101:2218–22.

    Article  PubMed  Google Scholar 

  13. Solem CA, Loftus EV Jr, Tremaine WJ, Harmsen WS, Zinsmeister AR, Sandborn WJ. Correlation of C-reactive protein with clinical, endoscopic, histologic, and radiographic activity in inflammatory bowel disease. Inflamm Bowel Dis. 2005;11:707–12.

    Article  PubMed  Google Scholar 

  14. Mitselos IV, Katsanos KH, Tatsioni A, Skamnelos A, Eliakim R, Tsianos EV, et al. Association of clinical and inflammatory markers with small bowel capsule endoscopy findings in Crohn’s disease. Eur J Gastroenterol Hepatol. 2018;30:861–7.

    Article  CAS  PubMed  Google Scholar 

  15. Kopylov U, Yablecovitch D, Lahat A, Neuman S, Levhar N, Greener T, et al. Detection of small bowel mucosal healing and deep remission in patients with known small bowel Crohn’s disease using biomarkers, capsule endoscopy, and imaging. Am J Gastroenterol. 2015;110:1316–23.

    Article  CAS  PubMed  Google Scholar 

  16. Laharie D, Mesli S, El Hajbi F, Chabrun E, Chanteloup E, Capdepont M, et al. Prediction of Crohn’s disease relapse with faecal calprotectin in infliximab responders: a prospective study. Aliment Pharmacol Ther. 2011;34:462–9.

    Article  CAS  PubMed  Google Scholar 

  17. Koulaouzidis A, Douglas S, Rogers MA, Arnott ID, Plevris JN. Fecal calprotectin: a selection tool for small bowel capsule endoscopy in suspected IBD with prior negative bi-directional endoscopy. Scand J Gastroenterol. 2011;46:561–6.

    Article  CAS  PubMed  Google Scholar 

  18. Simon EG, Wardle R, Thi AA, Eldridge J, Samuel S, Moran GW. Does fecal calprotectin equally and accurately measure disease activity in small bowel and large bowel Crohn’s disease?: a systematic review. Intest Res. 2019;17:160–70.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Xiao N, Liu F, Zhou G, Sun M, Ai F, Liu Z. Food-specific IgGs are highly increased in the sera of patients with inflammatory bowel disease and are clinically relevant to the pathogenesis. Intern Med. 2018;57:2787–98.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Cai C, Shen J, Zhao D, Qiao Y, Xu A, Jin S, et al. Serological investigation of food specific immunoglobulin g antibodies in patients with inflammatory bowel diseases. PLOS ONE. 2014;9:e112154.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Wang HY, Li Y, Li JJ, Jiao CH, Zhao XJ, Li XT, et al. Serological investigation of IgG and IgE antibodies against food antigens in patients with inflammatory bowel disease. World J Clin Cases. 2019;7:2189–203.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Van Assche G, Dignass A, Panes J, Beaugerie L, Karagiannis J, Allez M, et al. The second European evidence-based Consensus on the diagnosis and management of Crohn’s disease: definitions and diagnosis. J Crohns Colitis. 2010;4:7–27.

    Article  PubMed  Google Scholar 

  23. Best WR, Becktel JM, Singleton JW, Kern F, Jr. Development of a Crohn’s disease activity index. National Cooperative Crohn’s disease study. Gastroenterology. 1976;70:439–44.

  24. Gralnek IM, Defranchis R, Seidman E, Leighton JA, Legnani P, Lewis BS. Development of a capsule endoscopy scoring index for small bowel mucosal inflammatory change. Aliment Pharm Ther. 2008;27:146–54.

    Article  CAS  Google Scholar 

  25. Wang G, Ren J, Li G, Hu Q, Gu G, Ren H, et al. The utility of food antigen test in the diagnosis of Crohn’s disease and remission maintenance after exclusive enteral nutrition. Clin Res Hepatol Gastroenterol. 2018;42:145–52.

    Article  PubMed  Google Scholar 

  26. Mishkin B, Yalovsky M, Mishkin S. Increased prevalence of lactose malabsorption in Crohn’s disease patients at low risk for lactose malabsorption based on ethnic origin. Am J Gastroenterol. 1997;92:1148–53.

    CAS  PubMed  Google Scholar 

  27. Szilagyi A, Galiatsatos P, Xue X. Systematic review and meta-analysis of lactose digestion, its impact on intolerance and nutritional effects of dairy food restriction in inflammatory bowel diseases. Nutr J. 2016;15:67.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references


We acknowledge Ye XU and Qing Song LIN for their help in the statistical analysis and thank Wei Wei ZHENG and Yi Juan LIU at First Affiliated Hospital of Fujian Medical University for capsule endoscopy examination and scoring.


This study was partly funded by Natural Science Fundation of Fujian Province (No. 2021J02037 and 2022J01231) and Fujian Provincial Health Technology Project (No. 2020QNA050).

Author information

Authors and Affiliations



JTC and HNC designed the study, conceived the survey, analyzed the data and wrote the manuscript. YNH and HCX assessed the participants and collected clinical data. SLL analyzed the data. CDW designed and supervised the study, and revised the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Chengdang Wang.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethics approval and consent to participate

Each patient signed an informed consent, and the study protocol was approved by the Ethics Committee of the First Affiliated Hospital of Fujian Medical University, China (MRCTA, ECFAH of FMU [2016] 332), in accordance with the Declaration of Helsinki.

Consent for publication

All authors have read and agree to the published version of the manuscript.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chen, J., Chen, H., Huang, Y. et al. Serum food specific IgG antibodies are associated with small bowel inflammation in patients with Crohn’s disease. Eur J Clin Nutr (2023).

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI:


Quick links