Sheila E Crowe MD FRCPC
Adverse reactions to food (ARF) are common, with up to 50% of some populations reporting ARF (Table 57-1). The majority of ARF are nonimmunologic in origin, but true food allergies are thought to affect up to 6 to 8% of children under the age of 10 years and 1 to 2% of the adult population (Sampson, 2003), a frequency which should result in most medical practitioners seeing cases of food allergy on a regular basis. The major difficulty in managing patients with food allergy lies in making a diagnosis of food allergy, particularly when the symptoms are primarily gastrointestinal (GI). Over 50 years ago Ingelfinger and colleagues (1949) wrote "gastrointestinal allergy is a diagnosis frequently entertained, occasionally evaluated, and rarely established" and even today this is an apt description of the problem confronting clinicians considering a diagnosis of GI food allergy. However, substantial developments have been made in our understanding of the basic biology of food allergy with implications for improved diagnostic and therapeutic strategies in the future.
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