Adverse reactions to food: allergies and intolerances.
All the anomalous reactions secondary to food ingestion are defined as 'adverse reactions to food'. In 1995 the European Academy of Allergology and Clinical Immunology suggested a classification on the basis of the responsible pathogenetic mechanism; according to this classification, non-toxic reactions can be divided into 'food allergies' when they recognize immunological mechanisms, and 'food intolerances' when there are no immunological implications. The diagnostic approach to adverse reactions to food is based on accurate clinical history and objective examination, and further execution of specific tests when allergy or intolerance is suspected. The therapy for food allergies is the elimination of the food to which hypersensibility has been found; this strategy can lead, especially in pediatric age, to tolerance. If elimination diets cannot be completely performed, or if it is not possible to identify the food to eliminate, some drugs (e.g. antihistaminics, steroids, etc.) can be administered. Specific allergen immunotherapy has been recently introduced. Fundamental is food allergy prevention, especially in high-risk subjects. The therapeutic approach to secondary food intolerances is based principally on primitive disease resolution; on the other hand, some specific treatments (e.g. beta-galactosidases in lactose malabsorption) are available in case of primary intolerance.
Montalto
Massimo
M
Institute of Internal Medicine, Catholic University, Rome, Italy. mmontalto@rm.unicatt.it
Santoro
Luca
L
D'Onofrio
Ferruccio
F
Curigliano
Valentina
V
Gallo
Antonella
A
Visca
Dina
D
Cammarota
Giovanni
G
Gasbarrini
Antonio
A
Gasbarrini
Giovanni
G
D002239:Carbohydrate Metabolism, Inborn Errors / Q000503:physiopathology; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D006801:Humans