Heine Ralf G
Department of Allergy, Royal Children's Hospital, Parkville, Victoria, Australia.
Curr Opin Allergy Clin Immunol. 2006 Jun;6(3):220-5. doi: 10.1097/01.all.0000225164.06016.5d.
This review assesses the role of food allergy in the pathophysiology of gastroesophageal reflux disease, colic and constipation in infancy.
Frequent regurgitation, persistent crying and constipation are common clinical problems in infancy. A subgroup of infants with these conditions may respond to hypoallergenic diets, but only few randomized clinical trials have been conducted. Skin prick testing and food-specific antibody levels are usually not elevated in these infants, whereas atopy patch testing may diagnostic. The mechanisms by which cow's milk and other food allergens induce gastrointestinal motility disorders are not understood. Apart from cell-mediated reactions, non-immunological effects of food constituents on gastrointestinal motility and gut microbiota may be involved in the pathogenesis. In the absence of reliable diagnostic tests, dietary elimination and re-challenge are usually required to confirm food allergy. A trial of amino acid-based formula or an oligoantigenic maternal elimination diet may be indicated in infants who have failed conventional medical treatment.
Food allergy may contribute to gastroesophageal reflux disease, colic or constipation in infancy. Infants with these conditions often respond to hypoallergenic formula or a maternal elimination diet. Further research is needed to define the mechanisms and clinical markers of gastrointestinal food allergy in infancy.
本综述评估食物过敏在婴儿胃食管反流病、腹绞痛和便秘病理生理学中的作用。
频繁反流、持续哭闹和便秘是婴儿期常见的临床问题。患有这些病症的婴儿亚组可能对低敏饮食有反应，但仅进行了少数随机临床试验。这些婴儿的皮肤点刺试验和食物特异性抗体水平通常不升高，而异位性皮炎斑贴试验可能具有诊断价值。牛奶和其他食物过敏原诱发胃肠动力障碍的机制尚不清楚。除细胞介导的反应外，食物成分对胃肠动力和肠道微生物群的非免疫作用可能参与发病机制。在缺乏可靠诊断试验的情况下，通常需要进行饮食排除和再激发试验以确诊食物过敏。对于常规治疗无效的婴儿，可能需要试用氨基酸配方奶粉或低抗原性的母体排除饮食。
食物过敏可能导致婴儿期胃食管反流病、腹绞痛或便秘。患有这些病症的婴儿通常对低敏配方奶粉或母体排除饮食有反应。需要进一步研究来确定婴儿期胃肠道食物过敏的机制和临床标志物。
