Pollen-Food Allergy Syndrome (PFAS) Can Cause Diarrhea and/or Abdominal Pain and Simulate Irritable Bowel Syndrome (IBS)
Notice bibliographique
Résumé
Purpose: Pollen-food allergy syndrome (PFAS) is a food-related type of allergy that is commonly seen in adult populations. Patients with the disease most often experience localized oropharyngeal symptoms such as itchiness and swelling of the mouth and throat. Gastrointestinal (GI) issues such as pain and diarrhea are rarely present in PFAS. We want to find out if there is a cause-effect relationship between PFAS and GI problems. Here we present the results of four PFAS patients with GI problems including abdominal pain and diarrhea. We suggest a strong causal relationship between PFAS and these gastrointestinal issues resembling those found in IBS. Methods: We thoroughly reviewed medical histories of four pollen-food allergy syndrome patients who displayed gastrointestinal symptoms of abdominal pain and diarrhea. We recorded, compiled and analyzed our findings from various test results in order to establish the relationships between abdominal pain/diarrhea and PFAS. Results: We recognized four patients (three female and one male, ages 55, 39, 28, and 29 years, with abdominal pain and/or diarrhea). In two patients, diarrhea was associated with urgency and near incontinence. The patients had investigations including gastroscopy, colonoscopy, CT enteroclysis, and blood work, as appropriate, which were all negative. One patient had coincident eosinophilic esophagitis from biopsy results. All patients recognized what they interpreted as allergies to foods such as cantaloupes (two patients), saltfish, carrots, trees, cats, and dogs. Two patients had anaphylactic allergic reactions to azithromycin, mangoes, and melons. The patients were presented with lists of cross-reacting foods and recognized specific foods that they ate regularly. They were advised to eliminate these specific foods that they did not previously recognize causing a problem such as celery, various nuts, cantaloupe, and carrots. Their symptoms of diarrhea and/or pain resolved afterwards. Interestingly, all the patients were on proton pump inhibitors (PPI) which may predispose to gastrointestinal manifestations due to decreased gastric degradation of the allergen. All patients had positive skin tests to birch, ragweed, hazelnut, dust, and mugwort. The cross-reactions between environmental and food allergens may also be related to the cause of these GI tract symptoms. Two patients who received IgE testing also showed elevated IgE content. Conclusion: PFAS can cause GI symptoms that can be mistaken for IBS. A history of allergy, an elevated IgE, and positive skin testing can help to recognize food allergies that can cause significant symptoms and are amenable to dietary alteration.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».