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The recent study published in Gut by Klooker and coworkers1 reported very interesting and important findings, but with some contradictions. The authors investigated the effects of treatment with the mast cell stabiliser ketotifen in irritable bowel syndrome (IBS) with three key findings. First, treatment (but not placebo) increased the threshold for discomfort in patients with IBS with documented visceral hypersensitivity. Second, and importantly, ketotifen therapy significantly decreased abdominal pain and other IBS symptoms—an effect that appeared to be reversible on withdrawal of the drug. Third, the mast cell stabiliser did not alter mast cell numbers or mediator release in the rectal biopsy tissue investigated …
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