Food intolerances —a diagnostic challenge

AbstractBackgroundFood-associated complaints in the gastrointestinal tract can be signs of an intolerance of different etiology, which is reported by almost a  quarter of the population. Due to the unspecific symptoms, a whole range of different triggers and immune reactions can be considered for the differential diagnosis, which cannot always be determined unambiguously and quickly.Differentiation and diagnosis of disease entityThe time course in connection with the clinical picture already allows a  rough estimation of the underlying pathomechanism and points the diagnostic way. Thus, immune-mediated clinical pictures such as allergy must be distinguished from nonimmune-mediated intolerances. An allergic reaction can be IgE-mediated or cellularly induced. Secondary food allergies are triggere d by other allergens than primary allergies, differ in their sensitization routes and course of disease. Non-immunological intolerance reactions also play a not insignificant role, including carbohydrate utilization disorders and histamine intolerance in addition to toxic reactions. Often difficult to identify are also those food components which trigger a nonspecific mast cell activation. Due to their particular clinical relevance, wheat intolerances of different pathogenesis are also discussed. As a consequence of their complexity with regards to disease-causing proteins, target organ man ifestations, pathomechanisms and diagnostic clarification, these require a particularly d...
Source: Allergo Journal International - Category: Allergy & Immunology Source Type: research