Food allergy

Food allergy. Etiology, pathogenesis. Allergic lesions of the digestive system are of food, medicinal, bacterial and other origin. Food allergy is observed when eating certain, often seasonal foods: some vegetables, fruits, berries, mushrooms, rare marine and fish products. Allergies can also develop after taking medications (and ingesting other chemicals) that have high sensitizing properties (antibiotics, sulfanilamide preparations, hydrazines, atophane, pyrazolone derivatives, etc.). Allergic damage to the digestive system is possible due to inhalation of some allergens: pollen of flowers, dust and vapors of some chemicals. Allergens can also be protein antigens, formed during the decay of bacteria parasitizing the gastrointestinal tract of protozoa, helminths. Allergic reactions can be provoked by the mental state of the patient, meteorological factors, in women, exacerbation of symptoms can be associated with the menstrual cycle. Allergic lesions of the digestive system can be acute and chronic, occur paroxysmally with more or less long intervals of complete absence of symptoms.

Allergic lesions of the gastrointestinal tract can be manifested by regional edema (such as Quincke's edema), areas of mucosal hyperemia, petechiae and larger hemorrhages; There may be an increase in the lymph nodes of the abdominal cavity. Allergic liver damage occurs in the form of cholestatic, less often parenchymal hepatitis and fatty liver, in especially severe cases - with multiple massive necrosis of the hepatic parenchyma; Sometimes there is a granulomatous hepatitis.

Symptoms that are typical for the defeat of the digestive organs, quite rarely come to the fore in the overall clinical picture of an allergic reaction.

When the esophagus is affected, dysphagia and retrosternal pain are observed, usually with swallowing. The lesion of the gastrointestinal tract is manifested by abdominal pain, sometimes by sharp abdominal crises simulating acute surgical diseases of the abdominal cavity. Gastrointestinal bleeding may occur. The defeat of the liver is manifested by its increase, jaundice, changes in functional biochemical indicators (bromsulfaleinovoy reaction, aminotransferases, protein fractions, protein sediment samples, etc.).

Severe cases - with massive necrosis of the hepatic parenchyma - are very acute and result in hepatic insufficiency and death of the patient in a few days.

The diagnosis is established on the basis of other allergic manifestations and a clear connection in many cases with a certain factor that makes one suspect the allergic nature of the disease (taking certain medicines, eating foods such as strawberries, oranges, caviar, crabs, etc.). Significant eosinophilia of the blood also suggests the allergic nature of the disease.

Treatment. It is necessary to eliminate the allergen, to appoint a sparing diet (table № 1-1а with lesions of the gastrointestinal tract and № 5а-5 with liver damage). Conduct desensitizing therapy. In severe cases, not amenable to conventional therapy, appoint glucocorticoid drugs.