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Celiac Disease, Allergic Esophagitis, Lactose Intolerance and Other Food-Related Sensitivities or Allergies

A number of gastrointestinal conditions involve allergic reactions or intolerances to various foods  that pass through and along the surface of the digestive tract. These conditions can be mild or can pose serious problems for those millions who suffer from them, as their manifestations can mean more than just discomfort and inconvenience.

These reactions may be a mild irritant or severe enough to compromise quality of life. The inflammation  that can take place along the lining of the GI tract, as the primary symptom of these sensitivities, can cause pain, bloating, gas, cramping, diarrhea, difficulty swallowing, airway problems, nausea, vomiting, itching, hives, fatigue and malnutrition. Broadly, the cause of all of these conditions is an inherited or genetic predisposition. Ethnicity and aging play roles in the occurrence and course of these conditions.

Virtua’s GI service is highly focused on a range of digestive-tract conditions that involve reactivity to food substances. The staff takes pride in its expertise in these types of disorders, in sorting through the basis of such problems for each patient and finding solutions.
Range of Conditions

Virtua’s’ GI specialists are highly training in sorting through the signs of these problems, eliminating other possible causes and identifying the type and source of these allergic reactions. They take a careful history, perform physical examination and initiate a series of steps that may involve lab testing to identify the basis of these reactions. Information gathered may include having the patient maintain a log of diet and symptoms.

Testing can include  endoscopic examination  of the GI tract, fecal testing, skin testing, blood or saliva testing and dietary challenge or adjustment, as well as biopsy of the affected area and imaging studies. The types of allergic digestive sensitivities that the Virtua service cares for most often are:

  • lactose intolerance. As many as one in 10 individuals lacks, or has a deficiency in, the enzyme in their gut required to digest lactose, the sugar contained in cow’s milk and cow’s-milk based dairy products. Normally, the small intestine produces lactase to perform this function. When the digestive tract lacks this enzyme and thus retains the lactose sugar, bacteria begin to metabolize the sugar and multiply, causing gas and irritation. Doctors may use a hydrogen breath test or blood sugar test to determine if an individual is digesting lactose normally. Treatment for lactase deficiency  can involve permanently avoiding dairy foods, slowly adapting to these foods, adding enzyme supplements to dairy foods or using lactose-free dairy products.
  • celiac disease (also called celiac sprue or gluten enteropathy). “Celiac” is a general term referring to the abdominal cavity, and celiac disease is a condition caused by sensitivity to gluten, a protein contained in various grains, especially wheat, and thus present in most flour-based products and many other types of food. An immune reaction in the small intestine of these individuals damages the intestinal villi, tiny projections along the surface this portion of the GI tract that are necessary for proper digestion of food. Because of this distortion and destruction of the inner lining of the small intestine, individuals with celiac disease have difficulty absorbing essential components of food and can become malnourished as a result. Doctors may use antibody or DNA testing to help confirm the diagnosis. Treatment usually involves permanently avoiding gluten-containing foods, in which case the villi can heal.
  • eosinophilic esophagitis. Uncommonly, an individual may have an allergic reaction to foods in the lining of the esophagus, causing severe sensitivity to passage of foods through this portion of the digestive tract. The rapid inflammation and spastic reaction that can occur in an episode with this condition can make eating or even breathing difficult. Infiltration into the lining of the esophagus of a large number of white blood cells called eosinophils characterizes the disorder. The condition is sometimes referred to as asthma of the esophagus.”  Virtua gastroenterologists have special experience in medically and endoscopically treating this condition.  Learn about the case of a patient treated at Virtua for inflammatory esophagitis.
  • other food allergies. Virtually any type of food can cause allergic reactions for a person with a specific sensitivity, usually as a result of a specific protein in the food. The list of foods that can and do cause an allergy are as varied as the individuals who suffer from these sensitivities. Allergic responses can be to fruits, vegetables, legumes, herbs, spices or animal products. The conditions include better-known allergies such as those to peanuts, tree nuts, shellfish, as well as rare allergies to unexpected types of foods. These allergies must be taken especially seriously for those who experience respiratory problems when having a reaction. Virtua gastroenterologists use history of symptoms and food intake, systematic dietary adjustments and referral for specific allergy testing to identify the culprit foods and head off problems. This includes helping youngsters to manage food allergies in the school setting.
Finding a Plan that Works

While there are no cures for these conditions, gastroenterologists at Virtua use the very latest know-how and care techniques to help manage and control them for their patients. Nonsteroidal or steroidal medications, antihistamines and a range of other medications that target or block various aspects of allergic reactions can help some patients, including during acute symptom outbreak. Coaching in emergency injection of epinephrine with an easy-to-carry “EpiPen” is part of the care for patients with strong allergic reactions.

Virtua’s service for these conditions provides long-term counseling to continue and refine a regimen of medical treatment and nutrition to allow patients to live with and function with allergic sensitivities. The GI team may work in coordination with allergists as needed with many patients, not just for testing but also for such treatments as desensitization therapies for food allergies.

1-888-Virtua (568-7337)

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