Several gastrointestinal disorders
Posted by admin on June 8th, 2009
Several gastrointestinal immune-mediated disorders have been described. Food-induced enterocolitis, generally associated with ingestion of cow milk or soy-based formula, has its onset between 1 week and 3 months of age, with vomiting and diarrhea severe enough to produce dehydration. Stools contain gross or occult blood and often are watery and positive for carbohydrate (reducing substances). When diarrhea contains gross or occult blood only and pathology is limited to the distal bowel, the condition is defined as food-induced colitis. Both syndromes improve within 72 hours of eliminating the allergen. Malabsorption syndromes have been described secondary to ingestion of cow milk, soy-based products, egg, and wheat. These patients have patchy intestinal villous atrophy when biopsied. The more extensive malabsorption enteropathy with total villous atrophy (often called celiac syndrome) is associated with sensitivity to gliadin, a component of gluten. Allergic eosinophilic gastroenteropathy syndrome can affect children and presents with postprandial nausea, vomiting, abdominal pain, diarrhea, and steatorrhea. Affected patients may have elevated serum IgE levels, positive skin tests, peripheral eosinophilia, iron deficiency anemia, hypoalbuminemia, and a specific food allergy.
The natural history of food allergy in children varies from patient to patient, and food allergies are not always life-long. Studies have shown loss of gastrointestinal food allergy in 1 to 3 years among one third of children, even though results of skin tests and RASTs may not change. The likelihood of losing a food allergy depends on the food that provokes the symptoms and the degree to which the patient maintains the allergen elimination diet. Allergy to peanuts, tree nuts, and fish and seafood appear to be more long-lasting than allergy to milk,soy, and egg.
Tags: allergy, food allergy