Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0017168 (gastroesophageal reflux disease)
 11,783 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cow's milk allergy affects approximately 2% of infants under 2 years of age. This review summarizes the recent advances in understanding its pathophysiology and immunological mechanisms. Apart from IgE-mediated atopic manifestations, T cell-mediated reactions have been demonstrated in infants with cow's milk allergy. The clinical spectrum ranges from immediate-type reactions, presenting with urticaria and angioedema to intermediate and late-onset reactions, including atopic dermatitis, infantile colic, gastro-oesophageal reflux, oesophagitis, infantile proctocolitis, food-associated enterocolitis and constipation. The exact mechanisms of these disorders are still poorly understood. Double-blind, placebo controlled food challenge, the definitive diagnostic test for cow's milk allergy, is increasingly being replaced by the measurement of food-specific antibodies, in combination with skin-prick or atopy patch testing. The treatment of cow's milk allergy relies on allergen avoidance and hypoallergenic formulae, or maternal elimination diets in breast-fed infants.
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PMID:Cow's milk allergy in infancy. 1204 18

Approximately 7% to 8% of children are affected by food allergies, the most common being cow's milk allergy (CMA), and egg and peanut allergies. The occurrence of CMA decreases with age, but it is often replaced by other allergic manifestations. CMA affects mainly the skin and gastrointestinal tract, and reactions mediated via immunoglobulin E manifest differently to those that are not. Gastroesophageal reflux disease is frequently present in the first year of life and may be associated with CMA. Eosinophilic oesophagitis is related to food allergy and aeroallergens, less common than gastroesophageal reflux disease, and generally occurs in older children. Eosinophilic oesophagitis manifests as classic symptoms of reflux plus dysphagia. Treatment includes allergen avoidance and local steroid treatment. Other manifestations of CMA include eosinophilic gastroenteritis and proctocolitis. Accurate diagnosis of food allergy and the causative food is important because the condition is present in only about one third of patients with suspected food allergy, may be due to foods other than those originally suspected, and elimination diets may be detrimental to the child's health. Differential diagnosis is important to rule out upper and/or lower gastrointestinal disorders. Food allergy is generally treated with a hypoallergenic diet; antihistamines and leukotriene receptor antagonists may be used in specific conditions.
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PMID:Food allergy as seen by a paediatric gastroenterologist. 1893 1

Cow's milk protein allergy (CMPA) affect many organs, from mouth to gut, with, immediate and delayed reactions, including infantile colic, food protein induced enterocolitis syndrome, enteropathy, eosinophilic disorders, among which infantile proctocolitis, and "dysmotility" disturbances, gastro-esophageal reflux and constipation. Diagnosis follows usual steps, careful history taking and medical examination, before starting an elimination diet, for diagnosis and treatment. Beyond, laboratory tests may help, but definitive conclusion will arise from the oral food challenge. The double-blind-placebo-controlled-food challenge, the "gold standard", is needed in clinical research. The food challenge includes the progressive at-home reintroduction of milk, all the more needed since most cases of CMPA in infants are delayed: in clinical practice, diagnosing CMPA is more than saying if the child reacts to cow's milk. One has to define the syndrome the child is suffering from, the risk implied, the best replacement formula. When tolerance develops, a second diagnostic procedure allows seeing if the child has outgrown his disease and, if not, what is the expected outcome and which type of food is best adapted: small amounts of milk, or transformed forms, such as baked milk. Primary care practice is adapted to non-IgE mediated CMPA. When CMPA is part of multiple food allergies or of an eosinophilic disorder, referral centers will perform multiple allergy testing, endoscopic procedures and complex dietary guidance.
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PMID:Diagnosis of cow's milk allergy in children: determining the gold standard? 2441 May 39

Non-IgE-mediated gastrointestinal food allergic disorders (non-IgE-GI-FA) including food protein-induced enterocolitis syndrome (FPIES), food protein-induced enteropathy (FPE), and food protein-induced allergic proctocolitis (FPIAP) are relatively uncommon in infants and young children, but are likely under-diagnosed. Non-IgE-GI-FA have a favorable prognosis, with majority resolving by age 3-5 years. Diagnosis relies on the recognition of symptoms pattern in FPIAP and FPIES and biopsy in FPE. Further studies are needed for a better understanding of the pathomechanism, which will lead eventually to the development of diagnostic tests and treatments. Limited evidence supports the role of food allergens in subsets of constipation, gastroesophageal reflux disease, irritable bowel syndrome, and colic. The immunologic pathomechanism is not fully understood and empiric prolonged avoidance of food allergens should be limited to minimize nutrient deficiency and feeding disorders/food aversions in infants.
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PMID:Non-IgE-mediated gastrointestinal food allergies in children. 2763 72