DISCUSSION
IBS
FOOD INTOLERANCE, COLD
All subjects enrolled in this study were from Harbin, the coldest provincial capital city in China. Local residents are accustomed to uncooked, cold, spicy, fried, and alcoholic foods in their daily diet. Many clinical IBS patients complain of abdominal symptoms induced by certain foods or certain properties of foods, which is similar to previous studies of patients in other areas.Many studies have investigated a role for the intestinal microbiota in IBS.In summary, these are the conclusions of this study. First, both the CSF res diet and the IgG res diet improved specific‐food IgG positive IBS‐D patient symptoms. Second, the IgG res diet was an important means by which to accurately eliminate certain foods. When intolerant foods cannot be eliminated, avoiding uncooked, cold, spicy, fried, and alcoholic foods is a good choice. Third, the effect of IgG food elimination combined with a probiotic is the best choice. Improvement in gastrointestinal symptoms by Bifidobacteria may be through a non‐IgG pathway.Hidalgo‐Cantabrana et al.There are limitations to this study. First, in the two parts of the study, 45% and 35% of patients were food IgG negative, respectively. Future research needs to expand specific IgG testing of more foods. Second, some studies have shown that the IgG4 subtype is closely related to IBS food intolerance and that specific subtype was not evaluated. It is worth nothing that the prevalence of positivity for IgG/IgA AGA in IBS patients has been reported to be 5%–17%Restricted diets influence nutritional status, therefore the more accurate the determination of the food that requires restriction, the better the patient benefit and the more effective the patient's treatment. Further, understanding the means by which to use probiotics to improve bacterial imbalance caused by food restriction will also benefit patients. Therefore, in the future, we will guide patients through more accurate detection methods, precise restricted diets, and accurate probiotic intake, as our specific future direction.