Food Hypersensitivity as a Cause of Rectal Bleeding in Adults

Carroccio, Antonio; Iacono, Giuseppe; Prima, Lidia Di; Ravelli, A; Pirrone, Giuseppe; Cefalù, Angelo B.; Florena, Ada Maria; Rini, Giovan Battista; Fede, Gaetana Di

doi:10.1016/j.cgh.2008.07.029

Cited by 11 publications

(8 citation statements)

References 19 publications

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“…The clinical improvement frequently found in our case series might indicate the spontaneous resolution of symptoms and consequently the benign nature of LNH as isolated finding in childhood. As previously reported , the majority of children with LNH had rectal bleeding and abdominal pain, with or without a change in bowel movements, which are the most common indications for colonoscopy. A hypothetical explanation for rectal bleeding in patients with LNH is that ulcerations may occur over the follicles , but LNH can be found also in asymptomatic children.…”

Section: Discussionsupporting

confidence: 61%

Intestinal lymphoid nodular hyperplasia in children: The relationship to food allergy

Lucarelli

Lastrucci

Nardo

et al. 2015

Pediatric Allergy Immunology

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Section: Discussionsupporting

confidence: 61%

Intestinal lymphoid nodular hyperplasia in children: The relationship to food allergy

Lucarelli

Lastrucci

Nardo

et al. 2015

Pediatric Allergy Immunology

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“…It is also interesting that in 70 of 206 (35 % ) patients with NCWS and CM protein hypersensitivity, we found the presence of lymphoid hyperplasia in the colon mucosa ( 7 ). This histology characteristic has been reported in adult patients ( 49 ) and children ( 50 ) with rectal bleeding due to food allergy. In clinical practice, the eosinophil infiltrate and / or the presence of lymphoid hyperplasia in the colon or duodenal mucosa cannot be considered an accurate diagnostic marker of NCWS.…”

Section: Non-celiac Wheat Sensitivity and Food Allergymentioning

confidence: 59%

Non-Celiac Wheat Sensitivity as an Allergic Condition: Personal Experience and Narrative Review

Carroccio

Mansueto

D’Alcamo

et al. 2013

American Journal of Gastroenterology

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OBJECTIVES:Non-celiac wheat sensitivity (NCWS) is a newly described clinical entity characterized by symptoms, which can involve the gastrointestinal tract, the nervous system, the skin, and other organs. There is little data on the pathogenesis of NCWS and it is probable that different pathogenic mechanisms are involved in the different clinical manifestations of the disease. The only common denominator of NCWS " syndrome " is wheat consumption: the symptoms disappear on exclusion of wheat from the diet, and reappear on wheat consumption. The objective of this study was to review our prior data regarding NCWS and to review relevant medical literature regarding NCWS, with particular attention to the hypothesis that NCWS patients could suffer from non-immunoglobulin E (IgE)-mediated wheat allergy. METHODS:We reviewed our data on 276 patients diagnosed with NCWS by means of double-blind placebocontrolled (DBPC) wheat challenge. The data indicating a possible wheat allergy diagnosis were examined and other data in the literature were reviewed; we review the role of serum immunoglobulin G antibodies and the basophil activation assay in food allergy, and the histology fi ndings in the food allergy diagnosis. RESULTS:The comparison between patients suffering from NCWS and presenting with irritable bowel syndrome (IBS) and controls with IBS not due to NCWS showed that NCWS was characterized by: a personal history of food allergy in the pediatric age (0.01), coexistent atopic diseases (0.0001), positive serum anti-gliadin (0.0001) and anti-betalactoglobulin (0.001) antibodies, positive cytofl uorimetric assay revealing in vitro basophil activation by food antigens (0.0001), and a presence of eosinophils in the intestinal mucosa biopsies (0.0001).CONCLUSIONS: Patients with NCWS and multiple food sensitivity show several clinical, laboratory, and histological characteristics that suggest they might be suffering from non-IgE-mediated food allergy. However, other pathogenic mechanisms need to be considered.

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“…As in Anisakis infections, it can be hypothesized that other infectious agents causing chronic infections of the upper gastrointestinal tract such as Helicobacter pylori , or food hypersensitivity [46], may also modify the risk of UGIB in NSAID consumers. In the present study, the observed synergism between NSAID consumption and prior Anisakis infections on the risk of UGIB were obtained from data adjusted by seroprevalence to H. pylori , thus discounting any possible bias caused by this confounding variable.…”

Section: Discussionmentioning

confidence: 99%

Synergism between Prior Anisakis simplex Infections and Intake of NSAIDs, on the Risk of Upper Digestive Bleeding: A Case-Control Study

et al. 2011

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BackgroundThe aim of this study was to investigate the relationship between prior Anisakis infections and upper gastrointestinal bleeding (UGIB), and its interaction with non-steroidal anti-inflammatory drug (NSAID) intake.Methods/Principal FindingsWe conducted a hospital-based case-control study covering 215 UGIB cases and 650 controls. Odds ratios (ORs) with their confidence intervals (95% CIs) were calculated, as well as the ratio of the combined effects to the sum of the separate effects of Anisakis allergic sensitization and NSAIDs intake. Prior Anisakis infections were revealed by the presence of anti-Anisakis IgE antibodies specific to the recombinant Ani s 1 and Ani s 7 allergens used as the targets in indirect ELISA. Prior Anisakis infections (OR 1.74 [95% CI: 1.10 to 2.75]) and the intake of NSAIDs (OR 6.63 [95% CI: 4.21 to 10.43]) increased the risk of bleeding. Simultaneous NSAIDs intake and Anisakis allergic sensitization increased the risk of UGIB 14-fold (OR = 14.46 [95% CI: 6.08 to 34.40]). This interaction was additive, with a synergistic index of 3.01 (95% CI: 1.18–7.71).ConclusionsPrior Anisakis infection is an independent risk factor for UGIB, and the joint effect with NSAIDs is 3 times higher than the sum of their individual effects.

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Food Hypersensitivity as a Cause of Rectal Bleeding in Adults

Cited by 11 publications

References 19 publications

Intestinal lymphoid nodular hyperplasia in children: The relationship to food allergy

Intestinal lymphoid nodular hyperplasia in children: The relationship to food allergy

Non-Celiac Wheat Sensitivity as an Allergic Condition: Personal Experience and Narrative Review

Synergism between Prior Anisakis simplex Infections and Intake of NSAIDs, on the Risk of Upper Digestive Bleeding: A Case-Control Study

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