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Collections under which this article appears: Allergy & Dermatology

PEDIATRICS Vol. 111 No. 6 June 2003, pp. 1609-1616

 

Clinical Aspects of Gastrointestinal Food Allergy in Childhood

Scott H. Sicherer, MD

From the Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Mount Sinai School of Medicine, New York, New York

Gastrointestinal food allergies are a spectrum of disorders that result from adverse immune responses to dietary antigens. The named disorders include immediate gastrointestinal hypersensitivity (anaphylaxis), oral allergy syndrome, allergic eosinophilic esophagitis, gastritis, and gastroenterocolitis; dietary protein enterocolitis, proctitis, and enteropathy; and celiac disease. Additional disorders sometimes attributed to food allergy include colic, gastroesophageal reflux, and constipation. The pediatrician faces several challenges in dealing with these disorders because diagnosis requires differentiating allergic disorders from many other causes of similar symptoms, and therapy requires identification of causal foods, application of therapeutic diets and/or medications, and monitoring for resolution of these disorders. This review catalogs the spectrum of gastrointestinal food allergies that affect children and provides a framework for a rational approach to diagnosis and management.

Key Words: gastrointestinal allergy • food allergy • food hypersensitivity • oral tolerance • mucosal immunology

Abbreviations: IgE, immunoglobulin E • RAST, radioallergosorbent test • GER, gastroesophageal reflux • CMA, cow milk allergy

Received for publication Sep 11, 2002; accepted Oct 30, 2002.

Copyright © 2003 by the American Academy of Pediatrics. [Disclaimer]