Chapter 22. Gastrointestinal Food Allergy and Intolerance

  1. Nicholas J. Talley MD, PhD Pro Vice Chancellor Professor of Medicine Faculty of Health2,3,4,5,6,
  2. Sunanda V. Kane MD, MSPH Professor of Medicine Consultant7,8 and
  3. Michael B. Wallace MD, MPH Professor Chair Consultant9,10
  1. Sheila E. Crowe MD Professor of Medicine

Published Online: 31 AUG 2010

DOI: 10.1002/9781444328417.ch22

Practical Gastroenterology and Hepatology: Small and Large Intestine and Pancreas

Practical Gastroenterology and Hepatology: Small and Large Intestine and Pancreas

How to Cite

Crowe, S. E. (2010) Gastrointestinal Food Allergy and Intolerance, in Practical Gastroenterology and Hepatology: Small and Large Intestine and Pancreas (eds N. J. Talley, S. V. Kane and M. B. Wallace), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444328417.ch22

Editor Information

  1. 2

    University of Newcastle, NSW, Australia

  2. 3

    College of Medicine, Mayo Clinic, Rochester, MN, USA

  3. 4

    College of Medicine, Mayo Clinic, Jacksonville, FL, USA

  4. 5

    Karolinska Institute, Stockholm, Sweden

  5. 6

    University of North Carolina, USA

  6. 7

    College of Medicine, Mayo Clinic, USA

  7. 8

    Miles and Shirley Fitterman Division of Gastroenterology and Hepatology, College of Medicine, Mayo Clinic, Rochester, MN, USA

  8. 9

    Division of Gastroenterology and Hepatology, College of Medicine, Mayo Clinic, USA

  9. 10

    Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, FL, USA

Author Information

  1. Division of Gastroenterology and Hepatology, Department of Medicine, University of Virginia, Charlottesville, VA, USA

Publication History

  1. Published Online: 31 AUG 2010
  2. Published Print: 17 SEP 2010

ISBN Information

Print ISBN: 9781405182744

Online ISBN: 9781444328417

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Keywords:

  • food allergy;
  • food intolerance;
  • food hypersensitivity;
  • lactose intolerance;
  • oral allergy syndrome;
  • latex–food allergy syndrome;
  • anaphylaxis;
  • eosinophilic gastrointestinal diseases

Summary

Adverse reactions to food (ARF) affect at least 20% of populations in developed countries. ARF are categorized as immune-mediated (food allergy (FA) or food hypersensitivity) or non-immunological (food intolerance). FA occurs in 4-8% of children and 1-4% of adults in the US. Common food allergens in children include cow's milk, wheat, eggs, peanuts, soy products and in adults, peanuts, tree nuts, seafood and fish are most common. Most FA involves systems outside the GI tract but ∼50% of presentations include GI complaints such as nausea, vomiting, abdominal cramping or pain, and diarrhea. Diagnosis of FA is based on clinical presentation, food diaries, response to elimination diets, and certain diagnostic tests (skin testing, RAST). Management of FA centers on avoidance of the food(s) identified as causing symptoms although medications can play a role in minimizing reactions of inadvertent exposure to the antigen or modulating the immune response to foods.