food allergy acute gastroenteritis

Acute gastroenteritis caused by food allergy is completely different in nature from acute gastroenteritis caused by ordinary bacteria/viruses. The core trigger is the immune system's misjudgment and attack on specific proteins in food, rather than pathogenic infection. Misuse of antibiotics is not only ineffective but may also disrupt the intestinal flora and aggravate immune disorders. Avoiding allergens as soon as possible during an attack and mitigating allergic reactions in a targeted manner are the highest priority treatment principles.

I came across a typical case when I was on duty in the allergy department last week: a 19-year-old sophomore boy went to a popular crawfish restaurant with his roommate for the first time and had ice beer. He started vomiting and diarrhea just 20 minutes after eating, and a red rash appeared on his arms and neck. His roommate thought it was because the shrimps in the store were not clean, so he quickly gave him two pills of norfloxacin. As a result, he had to go to the toilet three times until his legs became weak, the rashes became more and more numerous, and his lips were swollen, so he rushed to the emergency room in a panic. A blood test revealed that the IgE index had soared. There was no indication of bacterial infection at all. He was allergic to the tropomyosin in crayfish. The cold beer only aggravated the stress response of the gastrointestinal tract. He was given an injection of antihistamines and some rehydration salts, and he recovered within two hours.

There are actually different tendencies in the current clinical treatment of this type of disease. When many grassroots general practitioners encounter patients with vomiting and diarrhea, their first reaction is to prescribe intestinal mucosal protective agents + antibiotics. The logic is also very practical: many patients are unable to provide a clear dietary history immediately when the attack occurs, and they cannot conduct immediate allergen testing. In case of bacterial infection, the symptoms should be suppressed first to avoid critical conditions such as electrolyte imbalance and sepsis, and it is too late to slowly investigate the cause later. But the clinical data of our allergy department is completely different: more than 80% of patients with acute gastroenteritis induced by food allergy are not infected by pathogens. The hasty use of antibiotics will destroy the intestinal flora barrier, which is equivalent to making the already chaotic immune system worse. Follow-up data shows that patients who misuse antibiotics have a 37% higher probability of subsequent recurrence of similar allergies than patients who are treated correctly.

To be honest, ordinary people can actually make a preliminary judgment at home, and don't have to rush to take anti-inflammatory drugs whenever they have diarrhea. If you have eaten novel food that you have never touched before, or have had a stomachache after eating a small amount before, and the onset time is within half an hour to two hours after eating, and it is also accompanied by itchy skin, numb and swollen lips, and a tight throat, which have nothing to do with the gastrointestinal symptoms, then it is most likely caused by allergies. Throw away the uneaten food first, and expel the leftovers in the stomach if it can induce vomiting. This is much more effective than taking antidiarrheal drugs blindly. If the attack occurs six or seven hours after eating, and the person who eats with the same person also suffers from vomiting and diarrhea, it is basically a common gastroenteritis due to contaminated food, and it can be treated according to conventional methods.

I met a 4-year-old patient two months ago. My mother said that the child had been suffering from chronic diarrhea for almost half a year. He had taken numerous probiotics and spleen-strengthening Chinese patent medicines, but none of them worked. The old man always said that the child had a weak intestines and stomach and that he could just take care of it. Finally, I checked the allergens and found out that I was allergic to milk protein. The fresh milk I drank every day was the "culprit". After switching to deeply hydrolyzed milk powder for half a month, the diarrhea was completely gone. To put it bluntly, it’s like your home’s anti-theft system mistook a visiting relative as a thief. Instead of turning off the alarm first, you were busy wiping the broken vase on the floor. No matter how diligently you wiped it, it was useless.

Of course, this does not mean that allergy-induced gastroenteritis does not require gastrointestinal issues to be taken care of at all. If you only have mild diarrhea, no difficulty breathing, or dizziness or inability to stand, take a second-generation antihistamine and drink some warm rehydration salt to avoid dehydration. You can basically recover after resting for a long time. In the next three to five days, avoid spicy and irritating things to give your stomach time to recover. But if you are dehydrated, or have begun to be out of breath or panic, don’t force yourself to go to the emergency room. Shock caused by a severe allergic reaction is really not an alarmist.

In fact, many people's current understanding of food allergies is still that "rashes and difficulty breathing are allergies." But in fact, the digestive tract is the first barrier for the human body to come into contact with allergens. The first symptom of many allergies is acute gastroenteritis. Pay more attention to it at ordinary times. If you always have stomach upset for no reason, don't just stare at the gastrointestinal endoscopy, but also check for food allergens. Maybe finding the root cause is more useful than taking supplements.