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Allergy and Neurogastroenterology

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Pediatric Neurogastroenterology

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Abstract

Most symptoms in patients presenting to neurogastroenterology clinics can be manifestations of undiagnosed food allergies. Allergy may mimic or coexist with primary gastroesophageal reflux disease, functional constipation, irritable bowel syndrome, and even pseudo-obstruction. Detection and management of allergy can resolve previously intractable symptoms, including in children with conditions such as Hirschsprung’s disease, esophageal atresia, or short bowel syndrome. Precise identification of the cause and pathophysiology of symptoms is essential for optimal management. Diagnosis of allergy at intake to gastroenterology services has the potential to avoid unnecessary and ineffective treatments, invasive investigations, and unwarranted surgery. Most gastrointestinal food allergies are non-immunoglobulin E (IgE)-mediated. Diagnosis requires an allergy-focused history and dietary elimination with challenge. A personal or family history of atopy or food reactions is an important indicator. This chapter presents the many ways allergens can trigger dysmotility. It describes the classical gastrointestinal food allergy syndromes and reviews the evidence for the role of allergy in common gastrointestinal symptoms and motility disorders. An awareness of the role of food allergy in patients with dysmotility provides an enormous opportunity to improve patient outcomes, as well as to enhance service delivery, by diverting children away from unnecessary appointments, investigations, and procedures.

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Acknowledgments

The author wishes to acknowledge the invaluable assistance of Dr. Bridget Simpson in sourcing permissions to reproduce images, and Dr. Licia Pensabene for contributing to section “Gastroesophageal Reflux (GERD)”.

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Authors and Affiliations

  1. Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children’s Hospital, South Brisbane, QLD, Australia

    Frances Connor

  2. Mayne Academy of Paediatrics, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia

    Frances Connor

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  1. Frances Connor
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Correspondence to Frances Connor .

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Editors and Affiliations

  1. Division of Gastroenterology, Department of Pediatrics, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, QC, Canada

    Christophe Faure

  2. Department of Gastroenterology, Hepatology and Liver Transplant, Queensland Children’s Hospital School of Medicine University of Queensland, Brisbane, QLD, Australia

    Nikhil Thapar

  3. Division of Pediatric Gastroenterology, Nationwide Children’s Hospital, Columbus, OH, USA

    Carlo Di Lorenzo

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Connor, F. (2022). Allergy and Neurogastroenterology. In: Faure, C., Thapar, N., Di Lorenzo, C. (eds) Pediatric Neurogastroenterology. Springer, Cham. https://doi.org/10.1007/978-3-031-15229-0_20

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