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. 2023 Jan 19;72(4):787–798. doi: 10.1136/gutjnl-2020-320633

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© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Food–microbiota interaction in visceral hypersensitivity. Bacterial histidine decarboxylase (HDC) in high-histamine producing species such as Klebsiella aerogenes metabolises dietary histidine into histamine which is stimulated by high intake of fermentable carbohydrates. Higher abundance of Lactobacilli reduces histamine production by lowering luminal pH through production of lactic acid. Bacteria-derived histamine can subsequently activate H4R on mast cells contributing to visceral hypersensitivity. FODMAPs, Fermentable Oligo-, Di-, Monosaccharides and Polyols; H1R, histamine 1 receptor; H4R, histamine 4 receptor; HDC, histidine decarboxylase; MC, mast cell; SCFA, short-chain fatty acids.