Hon Emily, Gupta Sandeep K
Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Riley Hospital for Children at IU Health, ROC 4210, 705 Riley Hospital Drive, Indianapolis, IN 46202, USA.
Community Health Network, 6626 E 75th Street, Suite 400, Indianapolis, IN 46250, USA; Section of Pediatric Gastroenterology, Hepatology, Nutrition, Riley Hospital for Children at IU Health, Indiana University School of Medicine, ROC 4210, 705 Riley Hospital Drive, Indianapolis, IN 46202, USA.
Gastroenterol Clin North Am. 2021 Mar;50(1):41-57. doi: 10.1016/j.gtc.2020.10.006.
Adverse reactions to food include immune-mediated food allergies, celiac disease, and nonimmune-mediated food intolerances. Differentiating between these many disorders is important to guide us toward appropriate testing and management. Double-blind placebo-controlled food challenges are the gold standard for food allergy diagnosis but are difficult and time-consuming. In place of this, strong clinical history, other supportive tests, and oral food challenges are helpful. Some commonly available tests for food allergy and intolerances lack sufficient evidence for efficacy. Food intolerance diagnosis is largely based on history and supported by symptom improvement with appropriate dietary manipulation.
食物不良反应包括免疫介导的食物过敏、乳糜泻和非免疫介导的食物不耐受。区分这些众多病症对于指导我们进行适当的检测和管理很重要。双盲安慰剂对照食物激发试验是食物过敏诊断的金标准，但操作困难且耗时。取而代之的是，详细的临床病史、其他支持性检测和口服食物激发试验会有所帮助。一些常见的食物过敏和不耐受检测方法缺乏足够的疗效证据。食物不耐受的诊断很大程度上基于病史，并通过适当饮食调整后症状改善来支持。
