SC Irritable bowel syndrome (IBS) is a chronic functional gastrointestinal disorder characterized by abdominal pain or discomfort and alterations in bowel habits. The pathophysiology of the disease remains unknown, but various factors are thought to play a role, including visceral hypersensitivity, gut dysmotility, mucosal inflammation, and changes in the makeup of the intestinal microbiota. Limited data are available on the relationship between food and IBS, but it appears that an adverse reaction to a particular food (or foods) may be associated with symptom onset or exacerbation. A study on IBS patients in England used food-specific immunoglobulin (Ig) G testing with borderline positive tests. Although protein reactions are rare in IBS, intolerance to poorly absorbed carbohydrates, such as fructose, lactose, sorbitol, and other fermentable sugars and starches, is related to worsening symptoms in patients with IBS.
A food intolerance is a nonimmune-mediated adverse reaction to food that can be caused by any (nonprotein) food component, and is much more common than food allergy. Some individuals have intolerance to lactose and may have decreased levels or an absence of lactase, whereas others may exhibit sensitivity to triacylglycerol, or the fat that is present in milk. In contrast, an individual who is allergic to cow milk protein (more common in infants and young children) will have an immune reaction after ingesting food containing cow milk.
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SC The prevalence of food allergy among patients with IBS tends to overlap with that among the general US population, which is 1% to 4% in adults and approximately 6% in children, although these percentages are rising. Most food allergies are seen in early childhood; however, approximately 15% of food allergies are diagnosed in adults. Celiac disease affects approximately 1% of the population in developed and developing nations where wheat ingestion is common. Research has suggested that patients with IBS are 4 times more likely to have celiac disease than those in the general population, although the accuracy of the diagnostic tests for celiac disease has been questioned. Between 20% and 25% of the world population reports having a food intolerance. However, the wide range of associated symptoms makes it challenging to diagnose food intolerance.
SC Patients with a food allergy or food intolerance often report worsened IBS symptoms after eating certain foods. The most common complaints are of abdominal pain, bloating, cramping, diarrhea, dyspepsia, and nausea. Patients with intolerance to lactose and fermentable carbohydrates typically experience symptoms similar to those of IBS, with the addition of distension and flatulence. Patients with a food allergy may experience immediate reactions of itching, hives, or asthma.
SC Milk, wheat, soy, egg, peanuts/tree nuts, fish/shellfish, and corn account for 90% of all IgE-mediated food allergies. Geography and diet play a role in allergies as well; peanut allergy is common in the United States, whereas sesame allergy is a growing concern in the Middle East. Foods high in sucrose or fructose, such as cookies, cakes, soft drinks, breads, crackers, bananas, and breakfast cereals (ie, fermentable carbohydrates), tend to trigger symptoms related to food intolerance, as these foods ferment in the microbiome.
SC Alterations in diet can be very beneficial for patients with IBS. Randomized, blinded studies have shown that the low-FODMAP diet effectively reduced gastrointestinal symptoms in patients with IBS, including lessening the severity of abdominal pain, bloating, and flatulence. However, dietary approaches are not recommended for long-term use, and the lasting effects of these diets on the gut microbiota are unknown. Patients should work with a qualified dietitian, as elimination diets can be restrictive, complex, and costly. Diets are not recommended in patients without confirmed food allergy, as patients may risk unnecessary deficiencies.
SC There is still a lot that is unknown about the relationship between food, diet, and IBS. Current and ongoing research has focused on certain foods and their effects on the microbiome. Studies are needed to elucidate whether individuals have different colonizing bugs and to further investigate precision medicine. It would be helpful to utilize precision medicine to understand which kind of bugs are in the gut and which foods patients should eat or avoid for better health and for reduced symptoms.
If you have a food allergy, please let us know and Fill out the Food Allergy Advisory Form now. By doing so, our Dining Services Nutritionist will reach out to you to set up an appointment to meet your student dining needs across campus.
Make it easier for your patients with food allergies or food intolerances to stick to a diet by offering these comprehensive handouts. Each downloadable handout includes useful information, featuring how to read food labels, a thorough list of acceptable choices, nutritionally equal substitutions, foods to avoid, types of products that may contain the allergen and more.
Handouts are also available on conditions that have been linked to reactions to food, including eczema, oral allergy syndrome, hyperactivity and autism. Examples of covered dietary issues include milk allergies, fish allergies, nickel allergies, salicylate sensitivity, and nitrate and nitrite intolerances. Help patients to better understand how to live with a food allergy or intolerance with these authoritative, user-friendly handouts.
Although the prevalence of allergic diseases, including food allergies, has increased over recent decades, relevant information on this topic is still lacking, particularly in younger children living in small cities.
A total of 412 questionnaires were returned, of which, 47 presented a positive response to food allergies and only 29 (7.04%) identified a particular food. The most frequently reported food items were shrimp, mollusks, pork, fruit and milk. Of the 29 who identified foods, 22 responded to the detailed questionnaire, resulting in only 4 (0.97%) positive responses. Of these, two were later discarded through clinical examinations and an open oral provocation test, resulting in a final prevalence of 0.48% of confirmed food allergies.
The prevalence of reported food allergies was lower than that described in previous studies. The most commonly mentioned foods were shrimp, mollusks and pork, with more reports of multiple food allergies, even in children who had never been previously exposed to these possible allergens, which highlights the relevance of perception in reported food allergy studies.
The prevalence of food allergies has increased worldwide, over the past decades [1]. However, there is a divergence in data registered in each region. This fact may be due to, among other issues, geographical differences and regional cultural habits, the difficulty of diagnosis, and methodological inconsistencies across studies. This, therefore, makes it difficult to assess the true dimension of the food allergy problem, whether for comparative purposes, for knowledge, or for planning government actions. Several previous studies [2, 3] have shown that there is an inconsistency between family perception and expert assessment of food allergies, which may lead either to under-diagnoses or excessive diagnoses and unnecessary dietary restrictions [4]. Moreover, besides possible genetic influences, other factors such as specific eating and cultural habits of each assessed region, different perceptions of health problems by studied populations, and even the health and illness process itself may underlie divergences in the prevalence of food allergies among different urban centers, namely between larger and smaller cities.
The increased risk of serious and potentially fatal allergic reactions, in addition to the unfavorable nutritional impact and the high socioeconomic cost resulting from the use of restrictive diets are also negatively associated factors [5,6,7]. Children mainly develop food allergies within the first years of life, a crucial period for growth and development. Several of the most common food allergens are those that comprise the largest portion of the nutrients in children's diets. Studies comparing the growth of children with and without food allergies have reported a smaller stature among those with an allergy to cow's milk protein perceived from the second year of life [8].
There is a lack of data regarding the prevalence of food allergies and its clinical findings in children from the preschool age group, particularly in small towns [5]. It should be noted that other factors compete with food allergies, especially in populations with low socioeconomic conditions, such as food restrictions and improprieties, in addition to infectious diseases [9].
Thus, the objectives of the present study were to study the prevalence of food allergies in a small town in an underdeveloped country, due to its importance for planning, providing resources, managing and assessing health in these locations, based on the singularities [10]. Furthermore, this understanding could also shed light onto an analysis of how cultural aspects may influence the perception of families regarding food allergies. The city in which this study was carried out is located in the Northeast region of Brazil, 72 kms from the shore, has an estimated population of 56.149 inhabitants and a medium Human Development Index. In 2019, its GDP (gross domestic product) per capita was US$ 2.641,14 [11].
There were no statistically significant differences in the prevalence of reported food allergies according to sex, age or birth order, between the groups with positive and negative results in the screening questionnaire, as presented in Table 2.
Only 29 participants, who identified one or more foods, were invited to participate in an interview to complete the second, confirmatory, questionnaire (Q2). Of these, 22 (75.86%) agreed to participate in this stage of the study, with Q2 being applied 1 month after Q1. 2ff7e9595c
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