Gastrointestinal Allergy and Food Hypersensitivity

  • Martin H. Floch
Part of the Topics in Gastroenterology book series (TGEN)

Abstract

Allergy has been simply defined as altered reactivity, but to many it implies an adverse reaction that occurs due to the interaction of an antigen with antibody or lymphoid cells.l,la Although there is tremendous interest, the clinical significance of gastrointestinal allergy and food hypersensitivity is uncertain, as the science of the field is in its infancy. The allergists have been inundated by patients who claim all sorts of symptoms from food intake and the art of allergy has responded with intermittent success, but the science of proving food hypersensitivity has been limited. The only clinical situations that have been established as disease entities due to food hypersensitivity are cow's milk intolerance and gluten enteropathy. Although eosinophilic gastroenteritis is suspected of being related to food and hypersensitivity, the association has not been proven. There is no question humans must have numerous intolerances and hypersensitivities to foods, but much research has to evolve before the subject is understood in more detail. The following facts appear certain and may be of help in management of suspected gastrointestinal allergy or food hypersensitivity. It is important to make the distinction that gastrointestinal allergy refers to allergic responses that are manifest within the gastrointestinal tract, whereas food hypersensitivity may be a hypersensitivity state caused by the ingestion of food with symptoms occurring in the gastrointestinal tract, or at other target organs.

Keywords

Sugar Fatigue Corticosteroid Aspirin Diarrhea 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Editorial: Food allergy. Lancet 1: 249, 1979.Google Scholar
  2. la. Gleich GJ: IgE, allergy, and the gut. Dig Dis Sci 25: 321, 1980.CrossRefGoogle Scholar
  3. 2.
    Freir S: Paediatric gastrointestinal allergy.Clin Allergy 3: 597, 1973.Google Scholar
  4. 3.
    Ishizaka K, Ishizaka T: Identification of gamma E antibodies as a carrier of reaginic activity. J Immunol 99: 1187, 1967.Google Scholar
  5. 4.
    Ishizaka K, Ishizaka T, Hornbrook MM: Physiochemical properties of reaginic antibody. V. Correlation of reaginic activity with E-globulin antibody.J Immunol 97: 840, 1966.Google Scholar
  6. 5.
    Heiner DC, Rose B: Elevated levels of gamma E (IgE) in conditions other than classical allergy. J Allergy 45: 31, 1970.Google Scholar
  7. 6.
    Coombs RRA, Hunter A, Jones WE, et al: Detection of IgE (IgND) specific antibody (probably ragin) to castor bean allergen by the red-cell-linked antigen—antiglobulin reaction. Lancet i: 1115, 1968.Google Scholar
  8. 7.
    Kletter B Gery I, Freier S, et al: Immunoglobulin E antibodies to milk proteins.Clin Allergy 1:249, 1971.Google Scholar
  9. 8.
    Tada T, Ishizaka K: Distribution of IgE forming cells in lymphoid tissues of the human and monkey.Jlmmunol 104: 377, 1970.Google Scholar
  10. 9.
    Ferguson A: Models of intestinal hypersensitivity.Clin Gastroenterol 5: 271, 1976.Google Scholar
  11. 10.
    Editorial: Antigen absorption by the gut. Lancet 2: 715, 1978.Google Scholar
  12. 11.
    Walker WA, Isselbacher KJ: Uptake and transport of macromolecules by the intestine. Gastroenterology 67: 531, 1974.Google Scholar
  13. 12.
    Hemmings WA:Antigen Absorption by the Gut. Lancaster: MTP Press, 1978, pp 170, 181.Google Scholar
  14. 13.
    Owen RL, Jones AL: Epithelial cell specialization within human Peyer’s patches. An ultra-structural study of intestinal lymphoid follicles. Gastroenterology 66: 189, 1974.Google Scholar
  15. 14.
    Hemmings WA, Williams EW: Transport of large breakdown products of dietary protein through the gut wall. Gut 19: 715, 1978.CrossRefGoogle Scholar
  16. 15.
    Warshan AL, Walker WA, Isselbacher KJ: Protein uptake by the intestine: Evidence for absorption of intact macromolecules. Gastroenterology 66: 987, 1974.Google Scholar
  17. 16.
    Falchuk KR, Isselbacher KJ: Circulating antibodies to bovine albumin in ulcerative colitis and Crohn’s disease. Gastroenterology 70: 5, 1976.Google Scholar
  18. 17.
    May CD, Bock SA: Adverse reactions to food due to hypersensitivity, in Middleton E, Reed CE, Ellis CF (eds):Allergy, Principles and Practice. St Louis: CV Mosby, 1978, p 1159.Google Scholar
  19. 18.
    Goldstein GB, Heimer DC: Clinical and immunological perspectives in food sensitivity: A review.J Allergy 46: 270, 1970.Google Scholar
  20. 19.
    Bock SA, Buckley J, Holst A, et al: Proper use of skin tests with food extracts in diagnosis of hypersensitivity to food in children. Clin Allergy 7: 375, 1975.Google Scholar
  21. 20.
    May CD: Objective clinical and laboratory studies of immediate hypersensitivity reactions to food in children. J Allergy Clin Immunol 58: 500, 1976.CrossRefGoogle Scholar
  22. 21.
    Rowe AH:Food Allergy. Springfield, III: Charles C Thomas, 1972.Google Scholar
  23. 22.
    Biondi R: Personal communication.Google Scholar
  24. 23.
    Speen F:Food Allergy. Littleton, Mass: PSG Publishing, 1978.Google Scholar
  25. 24.
    Galant SP, Franz ML, Walker P,et al: A potential diagnostic method for food allergy: Clinical application and immunogenicity evaluation of an elemental diet.Am J Clin Nutr 30: 512, 1977.Google Scholar
  26. 25.
    Zlotlow MJ, Settipane GA: Allergic potential of food additives: A report of a case of tartrazine sensitivity without aspirin.Am J Clin Nutr 30: 1023, 1977.Google Scholar
  27. 26.
    Freier S, Berger H: Disodium cromoglycate in gastrointestinal protein intolerance. Lancet 2: 916, 1973.Google Scholar
  28. 27.
    Vaz GA, Tan L, Gerrard JW: Oral cromoglycate in treatment of adverse reactions to foods. Lancet 1: 1066, 1978.CrossRefGoogle Scholar
  29. 28.
    Brostoff J, Carini C, Wraith DG, et al: Production of IgE complexes by allergen challenge in atopic patients and the effect of sodium cromoglycate. Lancet 1: 1268, 1979.CrossRefGoogle Scholar
  30. 29.
    Paganelli R, Levinsky RJ, Brostoff J, et al: Immune complexes containing food proteins in normal and atopic subjects after oral challenge and effect of sodium cromoglycate on antigen absorption. Lancet 1: 1270, 1979.CrossRefGoogle Scholar
  31. 30.
    Kocoshis S, Gryboski JD: Use of cromolyn in combined gastrointestinal allergy. JAMA 242: 1169, 1979.CrossRefGoogle Scholar
  32. 31.
    Eastham EJ, Walker WA: Adverse effects of milk formula ingestion on the gastrointestinal tract. Gastroenterology 76: 365, 1979.Google Scholar
  33. 32.
    Parish WE: Detection of reaginic and short-term sensitizing anaphylactic or anaphylactoid antibodies to milk in sera of allergic and normal persons. Clin Allergy 1: 369, 1971.CrossRefGoogle Scholar
  34. 33.
    Jakobsson I, Lindberg T: Cow’s milk as a cause of infantile colic in breast-fed infants. Lancet 2: 438, 1978.Google Scholar
  35. 34.
    Grybowski JD: Gastrointestinal milk allergy in infants. Pediatrics 40: 354, 1967.Google Scholar
  36. 35.
    Kuitinen P, Visakorpi JK, Savilahti E, et al: Malabsorption syndrome with cow’s milk intolerance. Arch Dis Child 50: 351, 1975.CrossRefGoogle Scholar
  37. 36.
    Freier S, Kletter B, Gery I, et al: Intolerance to milk protein. Pediatrics 75: 623, 1969.CrossRefGoogle Scholar
  38. 37.
    Lubos MC, Gerrard JW, Buchan DJ: Disaccharidase activities in milk-sensitive and celiac patients. J Pediatr 70: 325, 1967.CrossRefGoogle Scholar
  39. 38.
    Baker AL, Rosenberg IH: Refractory sprue: Recovery after removal of nongluten dietary proteins. Ann Intern Med 89: 505, 1978.Google Scholar
  40. 39.
    Ureles AL, Alscibaja T, Lodico D, et al: Idiopathic eosinophilic infiltration of the gastrointestinal tract: diffuse and circumscribed. Am J Med 30: 899, 1961.CrossRefGoogle Scholar
  41. 40.
    Klein N, Hargove R, Sleisenger AM, et al: Eosinophilic gastroenteritis. Medicine 49: 299, 1970.CrossRefGoogle Scholar
  42. 41.
    Pitchumoni CS, Dearani AC, Burke AF, et al: Eosinophilic granuloma of the gastrointestinal tract. JAMA 211: 1180, 1970.CrossRefGoogle Scholar
  43. 42.
    Katz AJ, Goldman H, Grand RJ: Gastric mucosal biopsy in eosinophilic (allergic) gastroenteritis. Gastroenterology 73: 705, 1977.Google Scholar
  44. 43.
    Leinbach GE, Rubin CE: Eosinophilic gastroenteritis: A sample reaction to food allergens? Gastroenterology 59: 874, 1970.Google Scholar
  45. 44.
    Caldwell JH, Sharma HM, Hurtubise PE, et al: Eosinophilic gastroenteritis in extreme allergy. Gastroenterology 77: 560, 1979.Google Scholar

Copyright information

© Plenum Publishing Corporation 1981

Authors and Affiliations

  • Martin H. Floch
    • 1
    • 2
  1. 1.Yale University School of MedicineUSA
  2. 2.Department of Medicine, Section of Gastroenterology and NutritionNorwalk HospitalUSA

Personalised recommendations