Gastrointestinal Tract Diseases Related With Food Allergy

Yıl 2017, Cilt: 9 Sayı: 5, 21 - 32, 10.09.2017

Doç. Dr. Mustafa Arga

Öz

Abstract

Gastrointestinal (GI) food allergy has become an important global health problem with its rapidly increasing prevalence across the world. Although it is more common in early childhood, it may occur in all age groups. Food allergy related gastrointestinal system (GIS) diseases can affect the digestive tract from mouth to anus butnone of the GI involvements were pathognomonic. The common feature of these diseases is that pathological inflammatory changes occur in the GIS as a result of an immune response to a specific food protein. Clinical progression of the disease may be benign; however, some cases may develop life-long and significant complicationsthat can be life-threatening. Skin prick testing, specificIgE measurement and/or patch testing can be helpful inthe identification of allergen(s) that causes sensitizationin the GI tract. With regard to the suspected disease and clinical manifestations, endoscopic examination and histopathological evaluation may be required for the diagnostic work-up. Dietary elimination is the primary modality for the treatment of such diseases. In cases wherethis intervention is inadequate, anti-inflammatory treatment may need to be used.  Further more, dietary elimination can lead to nutritional deficiencies in patients withfood allergy. It is necessary to regulate the nutrient content of foods consumed by the patients who were on dietary elimination, to meet the needs of calories, proteins,minerals and vitamins. A multidisciplinary approach,which includes the interaction of the pediatric allergists,dieticians and pediatric gastroenterologists is highlyimportant in the management of the GI food allergy.

Anahtar Kelimeler

Food allergy, child, gastroin-testinal system, diagnosis, treatment

Besin Alerjisi İle İlişkili Gastrointestinal Sistem Hastalıkları

Öz

Öz

Günümüzde önemli bir sağlık sorunu haline gelen besin alerjisi ile ilişkili gastrointestinal sistem hastalıkların sıklığı her geçen gün artış göstermektedir. Genellikle erken çocukluk döneminde sık görülmelerine karşın tüm yaş gruplarında ortaya çıkabilirler. Besin alerjisi ile ilişkili gastrointestinal hastalıklar ağızdan anüse kadar heryerde semptom ve bulgulara neden olabilirken, bunların hiçbirisi kendileri için spesifik değildir. Bu hastalıkların ortak noktası immün sistemin özgün bir besin proteinine cevap vermesi sonucunda GİS’de patolojik inflamatuvar değişikliklerin oluşmasıdır. Klinik bazılarında iyi seyirli olabilirken, bazıların da hayat boyu devam edebilir ve hayatı tehdit edebilecek önemli komplikasyonlar gelişebilir. Altta yatan immün mekanizmaya göre klinik ile ilişki besin(ler)in tespitinde deri prick testi, spesifik IgE ölçümü ve/veya yama (patch) testi yardımcı olur. Şüphelenilen hastalığa ve klinik özelliklere göre tanısal değerlendirme için endoskopik inceleme ve histopatolojik değerlendirme gerekebilir. Diyet eliminasyonu bu hastalıkların tedavisinin esasını oluşturur. Bu tedavinin yetersiz kaldığı durumlarda antiinflamatuvar tedavilerin kullanılması gerekebilir. Diyet eliminasyonu hastalarda beslenme yetersizliklerine yol açabilir. Özellikle çoklu besin eliminasyonu yapılan her hastanın kalori, protein, mineral ve vitamin ihtiyacını karşılayacak şekilde beslenme içeriğinin düzenlenmesi gereklidir. Bu hastalıkların yönetiminde çocuk alerji, gastroenteroloji ve beslenme uzmanlarının mültidisipliner yaklaşımları oldukça önemlidir.

Anahtar Kelimeler

Besin alerjisi, çocuk, gastroin-testinal sistem, tanı, tedavi

Kaynakça

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