AGA technical review on the evaluation of food allergy in gastrointestinal disorders

Fecal Assays Detect Hypersensitivity to Cow's Milk Protein and Gluten in Adults With Irritable Bowel Syndrome

“…Furthermore, none of the available in vivo and in vitro allergy tests (ie, skin prick test and serum total IgE and specific IgE assays) have a good diagnostic reliability. 29 In this study we evaluated a large group of IBS patients and, using a rigorous diagnostic approach-based on elimination diet and DBPC challenge-identified those suffering from FH. Forty IBS patients were positive on DBPC challenge with cow's milk and/or wheat proteins and consequently a high percentage (40/160, 25%) of cases were diagnosed as FH.…”

Food Hypersensitivity as a Cause of Rectal Bleeding in Adults

“…The diagnosis of FH in the patients included in the prospective study was based on rigorous criteria 16 : a DBPC challenge with cow's milk and wheat. The clinical history of the allergic patients showed that abdominal pain and bowel habit disturbances very often accompanied the rectal bleeding.…”

Multiple food hypersensitivity as a cause of refractory chronic constipation in adults

“…Furthermore, several other foods caused constipation and abdominal pain, as confirmed by open challenges and several episodes of involuntary food consumption. As food hypersensitivity diagnosis is based on the clinical observation of the relationship between food ingestion and symptom onset on DBPC challenge and the subsequent disappearance of symptoms on returning to an elimination diet [18], we can reasonably affirm that chronic constipation may be a manifestation of food hypersensitivity in adults, as has been shown in children [8,9,19 Á/21]. Moreover, the hypothesis that the resolution of the chronic constipation could be related to an unspecific property of the hypoallergenic diet is excluded by the evidence that this diet did not modify stool frequency, consistency and form in another 13 patients who underwent this dietary treatment.…”

“…However, it is known that most of the gastrointestinal symptoms due to food allergy are not linked to an IgE reaction [18] and we have described cases of anaphylactic shock a few minutes after rice ingestion, without any evidence of an IgE-mediated mechanism [26]. Two patients with wheat hypersensitivity were positive for IgG AGA, a result in keeping with the useful role of the IgG food antibodies in addressing an elimination diet in patients with suspected food intolerance [27,28].…”