## 3 Results
### Mucosal Alterations and Food Allergy in IBS: Insights from Confocal Laser Endomicroscopy  
The differences between the mucosal alteration diagnosed with CLE between patients with and without food allergy (FA) were investigated in one full-text journal article: both groups reported gastrointestinal symptoms, with the former associated with food intake and the latter not [36]. FA patients were diagnosed using a combination of clinical symptoms, food-specific IgE serological tests, and oral food challenges. These patients exhibited a higher frequency of intestinal barrier alterations detected through CLE performed in three sites: terminal ileum, cecum, and rectosigmoid junction. Fluorescein leakage, cell shedding, and micro erosions, interpreted as lamina propria exposure were compared to patients classified as non-FA. In the 96% of FA patients, a barrier dysfunction was observed in the terminal ileum, micro erosions were observed in 92.6% of FA patients. Barrier dysfunction in the terminal ileum was detected in 96% of patients with food allergy, with microorganisms present in 92.6% of these cases, suggesting that CLE could serve as an effective screening test to rule out FA (Table 1). \begin{table}
\begin{tabular}{c c c c c c} \hline \hline
**Quator** & **Population** & **Methods** & **CLE Results** & \begin{tabular}{c} **Dietary** \\ **Intervention** \\ \end{tabular} \\ \hline \multirow{4}{*}{\begin{tabular}{c} [PERSON] \\ et al., 2013 \\ [37] \\ \end{tabular} } & \multirow{4}{*}{35 patients. 17 IBS} & CLE captured images & IBS patients had & \\  & & post-fluorescein & significantly higher & \\  & & injection to examine & epithelial gap density & no \\  & & epithelial gaps between & compared to controls & \\  & & & villi & \\ \hline \multirow{4}{*}{\begin{tabular}{c} [PERSON]- \\ [PERSON] \\ [38] \\ \end{tabular} } & \multirow{4}{*}{36 IBS and 10 HC} & \multirow{4}{*}{36 IBS and 10 HC} & 61.1\% of IBS patients were & \\  & & & CLE+. IELs increased from & \\  & & & 18.7 \(\pm\) 0.9 to 24.7 \(\pm\) 1.4 & \\  & & & (\(p\) = 0.0001). Not confirmed & \\  & & HS patients. Observed & histologically. Epithelial & \\  & & & breaks increased from & CLE-positive \\  & & epithelial breaks, and & 5.5 \(\pm\) 0.6 to 11.9 \(\pm\) 1.5 per & patients experienced \\  & & & 1000 epithelial cells & symptom reduction \\  & & & (\(p\) < 0.001). Intervillous & over 12 months \\  & & & space widened from & \\  & & & 8.1 \(\pm\) 3.5 \(\mu\)m to & \\  & & & 41.1 \(\pm\) 2.5 \(\mu\)m (\(p\) = 0.0001) & \\ \hline \multirow{4}{*}{\begin{tabular}{c} [PERSON] \\ [PERSON] \\ et al., 2019 \\ [39] \\ \end{tabular} } & \multirow{4}{*}{155 IBS patients and 10 healthy controls} & \multirow{4}{*}{10 healthy controls} & CLE was used for FCT & \multirow{4}{*}{70\% of IBS patients were } \\  & & in IBS and HC by & \\  & & evaluating immune & CLE positive, showing \\  & & activation, epithelial & increased intraepithelial & \\  & & integrity, and barrier & lymphocytes (\(p\) = 0.001) and & \\  & & tion. Duodenal & tight junction alterations, \\  & & & analyzed for claud-2, & \\  & & & concludin, ECP, trypatase & \\  & & and intraepithelial & \\  & & lymphocytes. & & \\ \hline \multirow{4}{*}{\
\begin{tabular}{c} [PERSON] et al., \\ 2021 [36] \\ \end{tabular} } & \multirow{4}{*}{35 with FA and 27 non FA with GI} & \multirow{4}{*}{
\begin{tabular}{c} Patients with and \\ without FA, both \\ experiencing \\ gastrointestinal \\ symptoms \\ \end{tabular} } & Barrier dysfunction in the & \\  & & & terminal ileum detected in \\  & & without FA, both & 96\% of FA patients vs. 33\% \\  & & experiencing & of non-FA patients \\  & & gastrointestinal & (\(p\) < 0.0001). Microerosions \\  & & symptoms triggered by & significantly more frequent \\  & & food intake. CLE & in FA (92.6\% vs. 24.2\%, \\  & & observations included & \(p\) < 0.0001). Crypt \\  & & fluorescein leakage, cell & architecture showed no \\  & & shedding, and & differences. CLE proved \\  & & microerosions & highly effective in ruling \\  & & out FA & \\ \hline \hline \end{tabular}
\end{table}