A review on the diagnosis and management of food-induced gastrointestinal allergies : review articles

The prevalence of food allergy in children between 0 and 3 years of age ranges between 2.1% and 4.2%. Food allergies are caused by cow's milk, hen's egg, soya bean, wheat, peanut, tree nuts, fish and shellfish in 90% of cases. Food-induced gastrointestinal allergies according to current classifications are either non-immunoglobulin E (IgE)-mediated or mixed IgE and non-IgE-mediated. Because of the continually evolving knowledge on the pathophysiology of gastrointestinal food allergies, this condition continues to pose significant diagnostic and management dilemmas, as there are no specific diagnostic tests and there is paucity of data on diagnostic elimination diets. The most common involved allergens in food-induced gastrointestinal allergies include cow's milk, soya, egg and wheat. However, in some cases other allergens including beef, rice, chicken and nuts have been implicated. In the absence of breast milk and maternal dietary exclusion, the correct choice of hypoallergenic formula is an integral part of optimal dietary management and should be considered carefully. However, dietary elimination in many cases does not lead to complete symptom resolution and may require the targeted introduction of medication. Further research is required to allow for a more targeted dietary exclusion, as well as guiding the medical management.