Gastrointestinal Food Allergies and Intolerances

Gastroenterol Clin North Am. 2021 Mar;50(1):41-57. doi: 10.1016/j.gtc.2020.10.006.

Abstract

Adverse reactions to food include immune-mediated food allergies, celiac disease, and nonimmune-mediated food intolerances. Differentiating between these many disorders is important to guide us toward appropriate testing and management. Double-blind placebo-controlled food challenges are the gold standard for food allergy diagnosis but are difficult and time-consuming. In place of this, strong clinical history, other supportive tests, and oral food challenges are helpful. Some commonly available tests for food allergy and intolerances lack sufficient evidence for efficacy. Food intolerance diagnosis is largely based on history and supported by symptom improvement with appropriate dietary manipulation.

Keywords: Allergy testing; Anaphylaxis; Food allergy; Food intolerance; Food protein-induced enterocolitis syndrome; Immunoglobulin G testing; Irritable bowel syndrome; Oral allergy syndrome.

Publication types

  • Review

MeSH terms

  • Celiac Disease* / diagnosis
  • Diagnosis, Differential
  • Food
  • Food Hypersensitivity* / diagnosis
  • Humans
  • Randomized Controlled Trials as Topic