Gastrointestinal allergy symptoms from food or drugs more commonly represent nonspecific intolerance or are secondary to digestive enzyme defects ( as in celiac disease and disacharidase deficiency) and hypersensitivity to food allergens is more commonly manifested as utricaria or angiodema.
Gastrointestinal Allergy Symptoms
The severe, but rare, acute reaction to food is characterized by nausea, vomiting, diarrhea, and violent abdominal pains associated with the other symptoms of anaphylaxis. Less severe reactions -chronic crampy pain, and often uticaria. Most patients prone to severe reactions can detect traces of the offending food in their mouths by the rapid onset of mucosal burning or itching.
Occasionally, cheilitis, aphthae, pylorospasm, spastic constipation, irritable colon, pruritus ani, and perianal eczema have been attributed to food allergy, but the association is difficult to prove.
Severe food allergy is usual obvious to the patient. When it is not, diagnosis is difficult and the condition must be differentiated from functional gastrointestinal problems. Skin tests are of limited value. A detailed history, physical examination and elimination diets will assist in establishing a diagnosis. The regular occurrence of symptoms after ingestion of a particular food is usually the only pratical diagnostic clue.
Except for elimination of the offending foods, there is no specific treatment. When only a few foods are involved, abstinence is preferred. Sensitivity to one or more foods may disappear spontaneously. Heating certain foods may reduce their antigenicity by protein denaturation. Antihistamin are of little value except in acute general reactions with urticaria and angiodema. Prolonged corticosteroid treatment is not indicated except in eosinophilic enteropathy.
