What are Gastrointestinal Disorders that allergists manage?

Some disorders may produce symptoms that are similar to those of food allergies. However, some related digestive diseases are conditions that do not involve IgE (immunoglobulin E), the antibody that causes potentially life-threatening reactions in people with food allergies. 

Allergy-related gastrointestinal disorders stem from the body’s immune system reacting adversely to certain foods or substances, leading to a variety of symptoms that can impact the gastrointestinal tract. The most common are:

Eosinophilic Esophagitis (EOE)

Oral Allergy Syndrome (OAS)

Food Protein-Induced Enterocolitis Syndrome (FPIES)

Allergic Proctocolitis

Why See an Allergist for GI Symptoms?

Doctor listening to patient explaining conditions.

Why See an Allergist for GI Symptoms?

Some disorders may produce symptoms that are similar to those of food allergies. However, some related digestive diseases are conditions that do not involve IgE (immunoglobulin E), the antibody that causes potentially life-threatening reactions in people with food allergies.

Types of gastrointestinal disorders

Gastrointestinal disorders, encompassing a broad spectrum of conditions, vary widely in their presentation and impact on the digestive tract.

Gastrointestinal disorders significantly impact individuals’ lives, ranging from mild discomfort to severe, life-altering conditions.understanding and addressing gastrointestinal disorders is vital for improving the quality of life for those affected, emphasizing the importance of personalized medical care and intervention.

Female doctor checking the throat of a patient

Eosinophilic Esophagitis (EoE)

Eosinophilic esophagitis (EoE) is an inflammatory condition that targets the esophagus, leading to feeding difficulties, food impaction, and esophageal strictures. At the core of EoE’s pathology is an overactive immune response to certain foods and environmental triggers, including a diverse range of airborne allergens.

This connection between EoE and allergens brings an interesting aspect into focus: the correlation between common pollens and the foods that might exacerbate symptoms in affected individuals.

Managing EoE effectively thus requires not only a careful consideration of diet but also an understanding of how certain pollen types can influence food reactivity, paving the way for targeted dietary adjustments and treatments.

Once EoE is diagnosed, food allergy testing is conducted to identify the trigger. American Partnership for Eosinophilic Disorders has more about EoE.

Composition with common food allergens including egg, milk, soya, peanuts, hazelnut, fish, seafood and wheat flour

Food Protein-induced Enterocolitis Syndrome (FPIES)

One of the more common allergy-related diseases we treat is milk protein allergy, which typically affects infants after the first few weeks of life. Food protein-induced enterocolitis syndrome is a serious, non-IgE-mediated type of food allergy.

FPIES is usually triggered by cow’s milk or soy, though some cereal grains, especially rice and oat, and other foods may cause it. The symptoms typically include severe vomiting and diarrhea. Reactions are often delayed by 2-3 hours after the trigger food is eaten.

Standard food allergy tests are not used for diagnosing FPIES. The primary test used to diagnose this disease is an oral food challenge with the suspected trigger food. In most cases, FPIES is resolved by the age of three. More information about FPIES is available from the FPIES Foundation and the International Association for Food Protein Enterocolitis.

woman coughing and holding her throat while working.

Oral Allergy Syndrome (OAS)

Oral allergy syndrome (OAS), also known as pollen-food syndrome, is a term used to describe itchy or scratchy mouth symptoms caused by raw fruits or vegetables in people who also have hay fever. Symptoms are typically limited to the mouth.

This reaction is caused by an allergic response to the pollen that crosses over to similar proteins in the foods. Because these proteins are sensitive to heating, most people affected by OAS can eat cooked fruits or vegetables.

Symptoms usually resolve within minutes after the food is swallowed or removed from the mouth, and treatment generally is not necessary. OAS typically presents in older children, teens or young adults. Often, patients have been eating the offending foods without problems for many years.

Common Pollen-Food Associations:

  • Apple
  • Carrot
  • Pear
  • Peach
  • Plum
  • Cherry
  • Almond
  • Hazelnut
  • Tomato
  • Melons
  • Zucchini
  • Cucumber
  • Kiwi
  • Banana

Food Intolerance

With the exception of celiac disease (see below), food intolerances do not involve the immune system. Although food intolerances may cause some of the same symptoms as a true food allergy, they cannot trigger anaphylaxis, a potentially life-threatening reaction. Common intolerances include:

Lactose Intolerance

Celiac Disease