GI Disorders and ARF Functional Disorders

It is human nature for patients with GI disorders to believe that something in their diet has caused their condition even in the absence of a history of food intolerance. A significant number of GI conditions are associated with ARF but food plays a causal role in only some of these disorders. For patients with GERD, nonulcer dyspepsia, IBS, and other functional conditions, nonspecific physiological reactions to food can provoke symptoms. It is generally advisable to instruct these patients to avoid foods that cause symptoms, but nondietary measures are usually also necessary to manage their complaints. However, food protein intolerance or allergy may play a role in infants with GERD symptoms. There is no generalized role for hypoallergenic diets in IBS, although a few studies report benefit from such diets (reviewed by Spanier et al, 2003) and, in some instances, instituting a rigorous diet is helpful in convincing patients that specific dietary factors are not the sole cause of their illness.

Inflammatory Bowel Disease

There are many studies that have examined the role of diet in inflammatory bowel disease (IBD) but there is no evidence that specific immune-mediated reactions to food play a role in the majority of patients with either CD or ulcerative colitis. Elemental enteral feeding and parenteral nutrition can assist in the management of IBD patients with benefits that appear related to improved nutrition and bowel rest (and decreased fecal flow) rather than removal of specific allergens from the diet. Patients in remission should be encouraged to eat a nutritionally balanced diet without restrictions unless they experience intolerance to specific foods. It is typical for IBD patients to be instructed to avoid dairy products but this is unnecessary in most cases. Apart from those with symptomatic lactose intolerance (in which case they should still be able to eat most cheeses and yogurts) or rare instances of cow's milk protein allergy, IBD patients should be encouraged to consume dairy products because they are excellent sources of biologically available calcium in a population at increased risk of osteoporosis.

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Allergic To Everything

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