Gastrointestinal reactions

Gastrointestinal reactions to foods are very common and not all are associated with positive results on standard tests. A severe feature of food allergy in childhood is called eosinophilic enterocolitis, where the lining of the bowel is filled with cells called eosinophils, which are major factors in local allergic inflammation and reactivity. Patients, usually less than two years old, have severe abdominal pain and bloody diarrhoea, usually made worse by several foods. The treatment of this is the same as for food-related anaphylaxis, i.e. allergen exclusion. In many cases multiple allergens may need to be excluded, and enterocolitis can be a very difficult problem to treat.33

Diarrhoeal reactions to foods are common. Isolated gastrointestinal symptoms are a rare manifestation of allergy20,21 but are a common feature of intolerance reactions. Wheat is a common cause of diarrhoeal reactions and benign wheat intolerance must be distinguished from coeliac disease. In coeliac disease a different class of antibodies (IgA, not IgE) is generated.

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