Moderated Poster

Poster, Podium & Video Sessions

MP29-13: Histamine intolerance and microbiota changes in patients with Painful Bladder Syndrome / Interstitial Cystitis

Saturday, May 13
9:30 AM - 11:30 AM
Location: BCEC: Room 151

Presentation Authors: Elke Hessdorfer*, Berlin, Germany

Introduction: The cause of Painful Bladder Syndrome / Interstitial Cystitis is currently unknown.Histamine seems to play a major role in IC as neurogenic inflammation is one of the hypothesis of IC.Antihistamines are part of the guideline recommendations, foods high in histamine (e.g. Shorter-Moldwin Food Sensitivity Questionnaire) aggravate IC symptoms.
Objective: Within this retrospective study the role of histamine overload in the gut and vagina is highlighted.


Methods: Between September 2012 and October 2016 a total of 80 women (range 19 to 75 years, mean age 47) were surveyed.Histamine in fecal samples was measured with a commercially available ELISA kit (LDN Labor Diagnostika Nord GmbH &Co. KG, Nordhorn, Germany).The results were compared to an age-matched cohort of 57 healthy women.Additionally, vaginal swabs were analysed for histamine producing bacteria of the Enterococcus and Enterobacteriaceae family. Furthermore a complete gut microbiota analysis was done in all women.


Results: Stool results:
In 55 of the 80 analysed women elevated histamine levels were found in fecal samples compared to a control-group of 57 healthy women.Moreover in most of the patients the protective anaerobic indicator microbiota (mainly lactobacilli and bifidobacteria) was also diminished.
Vaginal swab results:
In 39 out of the 55 women with the elevated histamine level the presence of Enterococcus ssp. and / or Enterobacteriaceae in vaginal swabs was also detected. In 12 women only the presence of Enterococcus ssp. and / or Enterobacteriaceae was found. 4 women did neither show elevated histamine levels nor the presence of histamine producing bacteria in vaginal swabs.



Conclusions: There are paralleles between IC and histamine intolerance: 1% of the population affected, 80% female and middle aged, symptom improvement in pregnancy because of a 500 fold higher level of the diamine oxidase (histamine eliminating enzyme).Histamine intolerance is a poorly described disease which can present with a variety of symptoms also found as comorbidities in IC patients like e.g. migraine, irritable bowel syndrome and urticaria.Histamine can increase intestinal permeability causing a leaky gut which prompts the body to initiate immune reactions causing autoimmune diseases and can also lead to pain through a toll-like receptor (TLR)-4 inflammatory response.That TLR-4 plays a role in pain has recently been demonstrated in IC patients by the MAPP research group.Moreover histamine alone as shown in mice can also cause pelvic pain.

Source Of Funding: none

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