Food Allergy

Food Allergies

Food Allergies

Peanuts can leave you breathless. Cat dander can lead to itchy eyes, a stuffy nose, coughing and sneezing. And most of us have suffered through those seasonal allergies with horrible pollen counts. Learn more...

Get My Free Ebook

Food Allergies

Considering that the gut microflora is an important factor in regulating both the intestinal and systemic immune system, probiotics are used to promote endogenous barrier mechanisms, reduce gut permeability and alleviate intestinal inflammation in patients with atopic dermatitis and food allergy (Majamaa & Isolauri 1997). A 1 -month study of 10 breastfed infants who had atopic eczema and cow's milk allergy found that L GG reduced certain faecal inflammatory markers. More specifically, the hygiene hypothesis suggests that improved hygienic conditions and vaccinations, which reduce early-life exposure to microbes, are associated with a heightened risk of allergic disease and other immune disorders. This is because reduced exposure may result in reduced stimulation of the immune system. As a result, lymphocytes that would normally differentiate to become Th1 type, differentiate to Th2-type cells and produce inflammatory cytokines in the allergic response in much greater quantities. As...

Brief Review Of The Intestinal Microbiota

From birth to death, the gut is colonized by a diverse, complex, and dynamic bacterial ecosystem that constitutes the intestinal microbiota. In newborns, it develops sequentially according to the maturation of intestinal mucosa and dietary diversification. In healthy conditions, the human baby's intestine is sterile at birth but, within 48 hours, 108 to 109 bacteria can be found in 1 g of feces (9-11). The bacteria colonizing the baby's intestine come from the environment, where maternal vaginal and fecal microbes represent the most important source of bacterial contamination. However, the infant conducts an initial selection, since, out of all the bacteria present, only the facultative anaerobic bacteria such as Escherichia coli and Streptococcus will be able to colonize the intestinal tract, whatever the diet. Conditions under which this initial selection is operated have yet to be fully elucidated. They are related to endogenous factors, such as maturation of intestinal mucosa,...

Introduction to Diarrhea in Children

The answer to this seeming paradox has only been elucidated in the past 30 years with improvements in our understanding of the microbiology of gastrointestinal infections. In 1970, only a few organisms such as Salmonella, Shigella, Vibrio cholerae O1, Entamoeba histolytica, and Giardia lamblia, were recognized to cause diarrhea and with the diagnostics available, fewer than 10 of all diarrheal diseases could be linked to a known infectious agent. The remainder were attributed to conditions such as weaning, malnutrition, or food allergy and the largest single diagnostic group was called idiopathic, a term indicating that no cause could be identified. Since 1970, a scientific explosion has occurred with the discovery of more than 25 different pathogens that can cause diarrhea in children - novel bacteria, viruses and parasites. The field has become so rich with new agents and so diag-nostically complicated that outside of a research setting, few laboratories or groups are capable of...

Biomedical Importance

Carbohydrates are widely distributed in plants and animals they have important structural and metabolic roles. In plants, glucose is synthesized from carbon dioxide and water by photosynthesis and stored as starch or used to synthesize cellulose of the plant framework. Animals can synthesize carbohydrate from lipid glycerol and amino acids, but most animal carbohydrate is derived ultimately from plants. Glucose is the most important carbohydrate most dietary carbohydrate is absorbed into the bloodstream as glucose, and other sugars are converted into glucose in the liver. Glucose is the major metabolic fuel of mammals (except ruminants) and a universal fuel of the fetus. It is the precursor for synthesis of all the other carbohydrates in the body, including glycogen for storage ri-bose and deoxyribose in nucleic acids and galactose in lactose of milk, in glycolipids, and in combination with protein in glycoproteins and proteoglycans. Diseases associated with carbohydrate metabolism...

Studies by Molecular Methods

Somewhat contrasting results to those presented by plate culture methods have also been reported. In a study of 6-month-old exclusively breast-fed infants the mean bifidobacterial numbers were not found to be lower in the feces of infants with early onset atopic eczema (n 15) compared to controls (n 10), with the exception of a small subgroup of allergic infants (n 5) that additionally had gastrointestinal symptoms. Moreover, as opposed to studies by Bjorksten and co-workers, Bacteroides numbers were higher in a subgroup of allergic infants (n 6) who were later confirmed to have cow milk allergy by challenge (44). Bacteroides numbers were also associated with cow milk allergy in a later study where the high counts correlated directly with serum total IgE concentration in a subgroup of infants intolerant to extensively hydrolyzed whey formula (n 7) (18).

Reflection of Environmental Factors

Amongst the best examples of factors which have been clearly shown to influence the development of the gut microbiota and have also been implicated in allergic diseases include the mode of delivery and breast-feeding (116-123). Indeed, it is plausible that the characteristics of fecal microbiota associated with atopic eczema and allergic sensitization may partly reflect dietary factors. It is well known that changes in diet may dramatically affect the microbial composition of the gut. Then again, in allergic infants the diet can reflect the child's health status due to food restrictions. In 39-63 of all infants and young children, atopic eczema is triggered by one or more challenge-confirmed food allergies (124-126). Moreover, the development of manifestations of allergic diseases in children correlates with differences in the composition and immunological characteristics of breast-milk, which on the other hand are affected by maternal gut microbiota and atopy (127-133). For example,...

Studies by Traditional Plate Culture Methods

The first reports associating allergy with characteristic microbial composition in the gut appear to be from studies in the former Soviet Union in the early1980s (38-40). One of these studies, reported also in English, involved an assessment of 60 under one-year-old infants with food allergy and atopic eczema. It was claimed that the severity of the disease was in direct correlation with the stage of aberrancy in the fecal microbiota. This aberrancy was characterized as low prevalence of bifidobacteria and lactobacilli and high prevalence of Enterobactericeae, pathogenic species of staplylococci and streptococci as well as Candida species (39). Indication that such differences may persist beyond infancy was provided a few years later by Ionescu and co-workers (1986) who studied 10- to 45-year-old subjects. Subjects with atopic eczema (n 58) were shown to have lower prevalence of lactobacilli, bifidobacteria, and enterococci species than the healthy subjects (n 21) but higher...

Secretions of the Small Intestine

Epithelial Cell Small Intestine

Many adults do not produce sufficient lactase to adequately digest lactose, or milk sugar. In this lactose intolerance, lactose remains undigested, increasing osmotic pressure of the intestinal contents and drawing water into the intestines. At the same time, intestinal bacteria metabolize undigested sugar, producing organic acids and gases. The overall result of lactose intolerance is bloating, intestinal cramps, and diarrhea. To avoid these unpleasant symptoms, people with lactose intolerance can take lactase in pill form before eating dairy products. Infants with lactose intolerance can drink formula based on soybeans rather than milk.

Regulation of the Immune Responses

It is interesting to compare these experimental results to those described in human neonates by Lodinova-Zadnikova and coworkers (85). In their study, they colonized the digestive tract of babies just after birth with a given strain of E. coli. In these conditions E. coli is able to establish durably in the digestive tract of newborns as described previously (86). After 10 years (preterm infants) and 20 years (full-term infants), differences in occurrence of food allergies between colonized and control subjects were statistically significant 21 versus 53 , and 36 versus 51 respectively. Furthermore, recent clinical trials using ingestion of a strain of probiotic, Lactobacillus rhamnosus GG, during the last month of pregnancy to women and after birth to babies during 6 months, reduced the incidence of atopic eczema in at-risk children during the first 4 years of life (87). However, in this case, IgE levels were not decreased in the treated group as compared with the placebo group. The...


Important presentation overlapping with GERD, particularly in infants, is cow's milk allergy studies report the two conditions co-existing in 42-58 children 48 , 49 . Generally, in all children with the aforementioned symptoms, other causes of esoph-agitis, such as eosinophilic or infectious esoph-agitis, and esophageal motility disorders, warrant consideration.

Other Conditions

Glutamine is a popular supplement in naturopathic practice and sometimes used for conditions that may be associated with compromised intestinal permeability such as food allergies, leaky gut syndrome and malabsorption syndromes, including diarrhoea. It may also be used for conditions such as dermatitis and general fatigue based on the theory that compromised intestinal permeability provides the opportunity for undigested food particles (especially proteins) to enter the systemic circulation and gives rise to an unwanted immune response that manifests as a skin reaction or lethargy.


In patients with massive diarrhea, the priority is to treat dehydration and loss of electrolytes. Other causes such as gastrointestinal infections or lactose intolerance should be excluded. Difficult to digest foodstuffs (particularly those rich in fats or glucose) should be avoided and those that are easy to digest (e.g. potatoes, rice, noodles), eaten instead. It makes sense to remember approved homespun remedies (see table 1).

Native Americans

In the eyes of the federal government, Native American have a different status than other minorities. They are viewed as a conquered people, poor unfortunates who must be protected, rather than independent citizens. They suffer from a variety of health problems, among which are high blood pressure, obesity, diabetes, lactose intolerance, alcoholism, cirrhosis of the liver, and tuberculosis. Although Native Americans have a lower than average risk for the three major killers of Americans heart disease, cancer, and stroke the high rate of other diseases and accidents during young and middle adulthood results in the shortest life span of all minority groups. Compared with a 70 rate for other Americans, only 42 of Native Americans reach age 65 (Singh et al., 1996).

Soy Infant Formula

Soy has been used as an alternative for cow's milk in infant feeding for more than 30 years and may account for as much as 25 of infant formula (Mendez et al 2002). Soy formula is commonly used for infants with cow's milk allergy and there is evidence to suggest that soy milk may be effective in reducing infant colic (Garrison & Christakis 2000). There are few studies, however, examining the effects of phyto-oestrogens in infants. Although infants consuming soy formula may be exposed to 6-11 mg kg day of phyto-oestrogens and have plasma levels of isoflavones an order of magnitude higher than adults consuming soy foods (Setchell & Cassidy 1999), there is no obvious evidence to suggest any negative effects (Mendez et al 2002, Setchell & Cassidy 1999).


Our knowledge of food allergies is far from complete. It is still unclear, for example, why only certain individuals are affected and why, even among them, the problem is often restricted to childhood. It is also not clear why the allergies caused by various nuts and aquatic animals tend to persist and be lifelong. Milk, egg, soy, and wheat are the major causes of food allergies in children, whereas peanut, tree nuts, shellfish, and fish are the most prevalent causes for allergies in adults.

Chapter Overview

This chapter addresses concepts used as a foundation for bowel management in patients with cancer. Because cancer treatment can be very noxious and disrupt bowel function, a preventive approach is an important part of bowel management for patients with cancer. The 6 steps to good bowel management are assessment and diagnosis of bowel dysfunction, normalization of the bowel, establishment of expectations for bowel-movement frequency, development of a bowel management program, assessment of outcomes, and adjustment of the bowel management program through problem-solving. New and innovative approaches to management of bowel dysfunction covered in this chapter are (1) differentiation between low and high impactions in the treatment of impactions (2) administration of milk-and-molasses enemas (3) use of a bowel training program for patients with constipation or diarrhea or frequent stooling and (4) use of a proven, nontraditional fiber regimen for patients with frequent stooling after...


History of the Present Illness Biliary colic (constant right upper quadrant pain, 30-90 minutes after meals, lasting several hours). Radiation to epigastrium, scapula or back nausea, vomiting, anorexia, low-grade fever fatty food intolerance, dark urine, clay colored stools bloating, jaundice, early satiety, flatulence, obesity.