Recently, one of our allergy-immunology colleagues, Dr. Kiran Patel, from Emory presented an update on GI Diseases from an allergist viewpoint at one of our GI clinical education meetings. With his permission, many of the slides are noted below.  The slides present a good deal of information, though a lot of nuance and further details were provided by Dr. Patel.

Next few slides discuss typical GI food allergies.  It is not surprising that a lot of allergies manifest with GI symptoms given the amount of immune cells in the intestines and frequent interactions with foods and antigens.

This next slide points out that four of the most common food allergens (cow’s milk, egg, soy, and wheat) are frequently outgrown, whereas with peanuts, tree nuts, fish, and shellfish, it is uncommon to outgrow these allergies..

The next slide discusses potential evaluation.  While the slide states that the positive predictive value of skin prick tests and serum-based IgE tests may be as high as 50%; in fact, when broad panels of allergy tests are ordered, the positive predictive value can be quite low.

Related blog posts:

• What’s Wrong with ‘I want my kid tested for food allergies” (part 2)
• What’s Wrong with “I Want My Kid Tested for Food Allergies,
• Save a Life with Free Allergy Education

Dr. Patel did discuss the LEAP study and the LEAP-ON study which overall indicate that early antigen introduction is likely to reduce food allergies. Related blog posts:

• LEAP-ON Study
• The Peanut Story -From NEJM Blog | gutsandgrowth
• The “EAT” Study | gutsandgrowth
• Peanut Allergy Prevention Guidelines | gutsandgrowth

The next few slides review Food Protein-Induced Enterocolitis Syndrome. Related blog posts:

• FPIES Guidelines
• SEED Journal Club: FPIES

The next few slides discuss eosinophilic esophagitis (EoE).  Allergy testing has not been very helpful in most patients with EoE. Related blog posts:

• What is the role of allergy testing in EoE?
• Systemic Review of Dietary Treatments for Eosinophilic …
• Picking the right diet for EoE | gutsandgrowth
• SFED works for EoE! | gutsandgrowth
• Guidelines for Eosinophilic Esophagitis

The last part of Dr. Patel’s talk focused on GI disease (eg. inflammatory bowel disease presentation) of primary immune deficiencies.  In the bottom slide, the diseases that often present with GI symptoms are boxed.

Disclaimer: These blog posts are for educational purposes only. Specific dosing of medications (along with potential adverse effects) and changes in diet should be confirmed by prescribing physician.  This content is not a substitute for medical advice, diagnosis or treatment provided by a qualified healthcare provider. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a condition.