Gastrointestinal Disorders

This condition involves eosinophils, a type of white blood cell, accumulating in the esophagus, leading to inflammation, food impaction, and difficulty swallowing.

Often occurs in people who have a pollen allergy. It is triggered by certain raw fruits, vegetables, or nuts; this syndrome causes immediate reactions in the mouth and throat upon consumption. Symptoms can range from itching and swelling to more severe reactions, depending on the individual’s sensitivity.

A severe food reaction affecting the gastrointestinal tract, FPIES can cause vomiting, diarrhea, dehydration, and lethargy, often in response to the ingestion of specific foods, including dairy or soy products. Symptoms are delayed by several hours after food consumption.

Mostly seen in infants, this disorder is characterized by bloody stools in babies who are otherwise healthy, resulting from an allergic response to proteins in breast milk or formula. However, other foods have also been implicated, such as eggs, soy, corn, and others.

Lactose intolerance occurs when a person’s small intestine does not produce enough of the lactase enzyme. As a result, affected individuals are not able to digest lactose, a type of sugar found in dairy products. The symptoms of lactose intolerance typically occur within 30 minutes to two hours after ingesting dairy products. Large doses of dairy may cause increased symptoms.

An adverse reaction to gluten is known as celiac disease or “celiac sprue.” This chronic digestive disease requires a lifelong restriction of gluten, which is found in wheat, rye, barley, and perhaps oats. People with celiac disease must strictly avoid these grains and their by-products. When people with celiac disease eat gluten, they experience an immune reaction in the small intestine.

IgE, the antibody responsible for life-threatening reactions (anaphylaxis) does not play a role in this disorder. However, the immune response in celiac disease may damage the lining of the small intestine, preventing proper absorption of the nutrients in food. Over time, patients may become malnourished.

Celiac disease can cause many symptoms, including bloating and gas, diarrhea, constipation, headaches, itchy skin rash, and pale mouth sores, to name a few. The symptoms may vary among affected individuals. More information about celiac disease is available from the Celiac Disease Foundation and Beyond Celiac.

Gastroesophageal Reflux Disease (GERD) is a digestive disorder that occurs when acidic stomach juices, or food and fluids back up from the stomach into the esophagus. GERD affects people of all ages—from infants to older adults.

People with asthma are at higher risk of developing GERD. Asthma flare-ups can cause the lower esophageal sphincter to relax, allowing stomach contents to flow back, or reflux, into the esophagus. Some asthma medications (especially theophylline) may worsen reflux symptoms. Acid reflux can also make asthma symptoms worse by irritating the airways and lungs. This, in turn, can lead to progressively more serious asthma. Also, this irritation can trigger allergic reactions and make the airways more sensitive to environmental conditions such as smoke or cold air.

SYMPTOMS

Everyone has experienced gastroesophageal reflux. It happens when you burp, have an acid taste in your mouth or have heartburn. However, if these symptoms interfere with your daily life it is time to see your physician. Other symptoms that occur less frequently but can indicate that you could have GERD are:

• acid regurgitation (retasting your food after eating)
• difficulty or pain when swallowing
• sudden excess of saliva
• chronic sore throat
• laryngitis or hoarseness
• inflammation of the gums
• cavities
• bad breath
• chest pain (seek immediate medical help)

DIAGNOSIS

Several tests may be used to diagnose GERD including: x-ray of the upper digestive system, endoscopy (examines the inside of the esophagus), ambulatory acid (pH) test (monitors the amount of acid in the esophagus), esophageal impedance test (measures the movement of substances in the esophagus).

TREATMENT

If you have both GERD and asthma, managing your GERD will help control your asthma symptoms. Studies have shown that people with asthma and GERD saw a decrease in asthma symptoms and asthma medication use after treating their reflux disease.

Lifestyle changes to treat GERD include: elevate the head of the bed 6-8 inches, lose weight, stop smoking, decrease alcohol intake, limit meal size and avoid heavy evening meals, do not lie down within two to three hours of eating, decrease caffeine intake, avoid theophylline (if possible).

Your physician may also recommend medications to treat reflux or relieve symptoms. Over-the-counter antacids and H2 blockers may help decrease the effects of stomach acid. Proton pump inhibitors block acid production and also may be effective. In severe and medication intolerant cases, surgery may be recommended.