Nonimmune Adverse Reactions to Food

The vast majority of ARF are not immunologic in origin (see Table 57-1) and by virtue of their prevalence, are important considerations in the examination of patients complaining of ARF. Food toxicity or food poisoning results from microbial contamination of food causing primarily GI manifestations due to preformed toxins (eg, staphylococcal enterotoxin) or replication of enteric pathogens (Campylobacter, Salmonella, Shigella, Escherichia coli). These reactions can be distinguished from other ARF because they usually do not recur and have fairly characteristic presentations. Occasionally, a self-limited infection may result in a postinfectious irritable bowel syndrome (IBS). This is discussed in the chapter on IBS (see Chapter 39, "Irritable Bowel Syndrome") and the chapter on traveler's diarrhea (see Chapter 50, "Traveler's Diarrhea").

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Breaking Bulimia

Breaking Bulimia

We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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