Why can eating a familiar food cause abdominal pain in someone with irritable bowel syndrome (IBS)? At IBS Days, Guy Boeckxstaens of KU Leuven explains how mast cells may alter pain signalling through IgE dependent responses to food antigens and activation of the MRGPRX2 receptor. 

His team’s research suggests that intestinal infection or bacterial toxins can disrupt tolerance to food antigens. In experimental models, later exposure to those foods activates mast cells and heightens visceral pain; studies in patients with IBS have also observed local mast cell responses to food antigens. These findings point to mast cells and the substances they release as potential treatment targets, although their clinical role still needs to be established