Pollen-Food Allergy Syndrome (PFAS) Can Cause Diarrhea and/or Abdominal Pain and Simulate Irritable Bowel Syndrome (IBS)
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".