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Food Allergies and Alpha-gal Syndrome for the Gastroenterologist

  • Neurogastroenterology and Motility Disorders of the Gastrointestinal Tract (S Rao and A Sharma, Section Editors)
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Abstract

Purpose of Review

Food allergies are typically not considered as a cause of gastrointestinal (GI) distress without additional allergic symptoms, apart from celiac disease and eosinophilic esophagitis. However, recent reports of patients with alpha-gal syndrome who presented with GI-only symptoms like abdominal pain, vomiting, and diarrhea challenge this paradigm. Alpha-gal syndrome is an IgE-mediated allergy characterized by delayed reactions after eating mammalian meat or mammalian-derived products that contain galactose-alpha-1,3-galactose (alpha-gal). The purpose of this review is to discuss our current understanding of food allergies, GI illness, and the GI manifestations of alpha-gal syndrome.

Recent Findings

Among Southeastern U.S. GI clinic patients who screened positive for serum alpha-gal IgE, a majority of patients reported significant symptom improvement on an alpha-gal-avoidant diet, suggesting that the allergy had played a role in their GI symptoms. Diagnosis of alpha-gal syndrome is typically made with concerning allergic symptoms, elevated alpha-gal specific IgE in the serum, and symptom improvement on an alpha-gal avoidant diet.

Summary

Alpha-gal syndrome can cause a delayed allergic response that is increasingly recognized worldwide, including among patients with predominant GI symptoms.

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Abbreviations

GI:

Gastrointestinal

Ig:

Immunoglobulin

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Lee, C.J., McGill, S.K. Food Allergies and Alpha-gal Syndrome for the Gastroenterologist. Curr Gastroenterol Rep 25, 21–30 (2023). https://doi.org/10.1007/s11894-022-00860-7

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