Q&A: Pediatric Food Allergies and GI Issues

Friday, August 01, 2014 3:19 PM comments (0)

tummy acheAre stomachaches and messy potty breaks frequent occurrences for little ones in your home? “Stomach problems” happen to everyone, and children are no exception. Sometimes an upset tummy is just an upset tummy, but children, just like adults, can suffer from food allergies and sensitivities, and just like adults these allergies and sensitivities can and should be addressed.

Vincent Biank, MD, Pediatric Gastroenterology at NorthShore, answers some common questions about GI food allergies and sensitivities in children: 

 Is there an easy, relatively non-invasive test to see which foods a child is allergic or sensitive to?
There are several simple blood tests for allergies but unfortunately we do not have simple tests for sensitivities that are accurate in children; therefore, we will commonly have to do an elimination diet.  We will remove one food item at a time for two weeks and then replace that food item after those two weeks, carefully documenting any changes in the symptoms. The two most common sensitivities are lactose and gluten. I would not recommend removing gluten from a child’s diet until they have been properly tested for Celiac disease otherwise you will just need to add it back in for one to two months before it can be accurately checked in the blood.

What foods are typically off-limits for child with soy and dairy allergies? Is it possible to eliminate these foods entirely from a child’s diet?
Soy and diary are in almost everything, so eliminating them is difficult. For this reason, we will have our pediatric dieticians work with families to make sure no soy or dairy in getting into a patient’s diet. Until then, check labels! Anything that has soy, soy protein, milk, milk protein, casein or whey in its label should be avoided.

Are children with GI food allergies more likely to develop other GI-related issues as young adults and adults? 
Unfortunately we don't have enough data to answer this question at this time. Although food allergy with typical symptoms of anaphylaxis, hives, trouble breathing etc. has been diagnosed and treated for many years, the majority of the GI manifestations of food allergy are recent in their discovery. For example it wasn't until 1995 that Eosinophilic Esophagitis was even considered a diagnosis and now we are diagnosing it one to two times per week. The result is we still don't have a clear idea of the natural history of GI food allergies over time.

Should children with stomach “issues” be given probiotics, as well as brought in for testing? 
The short answer is to go ahead and try probiotics prior to the visit. The long answer is that unfortunately we are only at the beginning of our understanding of what probiotics do, such as which varieties are best, how much to give and how long they should be taken.

What are some of the warning signs of GI issues in toddlers/children? Should a parent be concerned about frequent loose stools?
The biggest sign of GI issues is poor weight gain. Diarrhea can be a symptom of an underlying GI disorder but not always. We frequently see toddlers with loose stools with no additional systemic signs of disease, like poor weight gain; therefore, we will typically rule out some common GI-related problems. If tests are negative, we will then discuss how to thicken the stool.

Are the foods known to cause GI allergic reactions in kids the same as those that cause skin or more severe allergic reactions? What are the common foods for GI allergies?
Yes, for some individuals the foods that cause GI allergic symptoms could also cause skin and the typically more severe allergic reaction; however, this is not the case for everyone. Some individuals will only have GI symptoms and others will only have skin or respiratory symptoms. The most common foods for GI allergies are the “Big Six:” milk, soy, wheat, eggs, nuts and fish.

Does your child have a food allergy or sensitive that results in GI issues?

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