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Stomach Problems: Food Allergies & GI Issues in Kids

June 23, 2014 1:59 PM with Dr. Vincent Biank

Food allergies in children often manifest themselves as “stomach problems,” from abdominal pain and diarrhea to more severe, life-threatening gastrointestinal anaphylaxis. Vincent Biank, MD, Gastroenterologist at NorthShore, will answer questions on how food allergies can present in the GI tract from infants to adolescence. He will discuss the signs and symptoms parents should watch for, as well as describe what can be done to help the affected children whether the allergies are mild or severe. Submit questions early.

Brenna (Moderator) - 1:51 PM:
Our chat "Stomach Problems:" GI Food Allergies in Children will begin at 2 PM. You can submit questions now or at any point during the chat. Thank you for joining us today.

  Patricia (Munster, IN) - 2:03 PM:
My daughter (21 months) was recently diagnosed with FPIES (food protein induced enterocolitis syndrome). Current known triggers are eggs and milk. We have had several very alarming instances and are looking for a specialist in FPIES in the Chicagoland area to guide us. Do you know of a specialist or any resources for the syndrome?
Dr. Vincent Biank (NorthShore)
Great question. There are several specialists in the Chicago land area who treat children with FPIES including myself. The problem is differentiating FPIES from other allergic conditions such as Eosinophilic Esophagitis or Eosinophilic Gastroenteritis. To do this, endoscopy is required to make an acurate diagnosis.

  Jane (Deerfield, IL) - 2:10 PM:
My 6-year-old son complains often that his stomach hurts, and spends a lot of time in the bathroom. I believe he has some sensitivity to certain foods, but am worried that the first step to discovering what they are is to cut out everything, which seems almost impossible. Is there an easy, relatively non-invasive test to see which foods he may have allergies or sensitivities to?
Dr. Vincent Biank (NorthShore)
I'm sorry to hear about your son. I take care of numerous children with similar complaints and commonly it is not an allergy or sensitivity at all. 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 you remove one food item at a time for 2 weeks and then replace that food item after the 2 weeks carefully documenting for any changes in the symptoms. The 2 most common sensitivities are lactose and gluten. I would not recommend removing gluten from a childs diet until they have been properly tested for Celiac disease otherwise you will just need to add it back in for 1-2 months before it can be accurately check in the blood.

  Ebony (Roselle il) - 2:19 PM:
What foods are off limits. My daughter is 1yrs old and is on medication. For severe acid reflux and she is allgeric to soy and dairy. What is the foods she can eat.
Dr. Vincent Biank (NorthShore)
Unfortunately this question is very difficult to answer via a web chat as I would really need more specifics regarding you daughters history. However, as you are probably aware by now, soy and diary are in almost everything. As such we will typically have our pediatric dieticians work with families to make sure no soy or dairy in getting into the patients diet. In summary though, anything that has soy, soy protein, milk, milk protein, casein or whey in it's label should be avoided.

  Krista - 2:28 PM:
Are children with GI food allergies that resolve themselves as they grow older more likely to develop other GI-related issues as young adults and adults?
Dr. Vincent Biank (NorthShore)
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 diagnoses 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 1-2 time per week. The result is we still don't have a clear idea of the natural history of GI food allergies over time.

  Jane (Deerfield, IL) - 2:39 PM:
I have made an appointment to bring my son in for a consultation/testing. In the meantime, I was going to start giving him children's probiotics. Should I wait until after the visit to start these?
Dr. Vincent Biank (NorthShore)
Great question. The short answer is to go ahead and try the probiotics prior to the visit. The long answer is that unfortunately we are only at the beginning of our understanding of what probiotics do, which ones are best for what individuals, how much to give and how long they should be taken for.

  Julie (Buffalo Grove, IL) - 2:47 PM:
My son was diagnosed with Eosinophilic Esophagitis due to multiple mulitple food allergies at age 17. He is currently 21 years old and is treated with a steroid inhaler and endoscopies every year. Is there any mode other than endoscopy to monitor his progress?
Dr. Vincent Biank (NorthShore)
Unfortunately in 2014 there is no other way to monitor his progress. At the last national meeting there was a presentation about a string test where the patient swallows a string and then the string is analyzed to determine if it correlated with the endoscopy findings. Unfortunately there was no correlation with any of the chemicals identified on the string. So we are working on it but we have not come up with a solution at this point in time.

  Louise (Evanston) - 2:50 PM:
What are some of the warning signs of GI issues in toddlers/children? My son frequently has very loose stools, is this something to be concerned about?
Dr. Vincent Biank (NorthShore)
The biggest sign of GI issues is poor weight gain. Diarrhea can be a symptoms of an underlying GI disorder but not always. As such we frequently see toddlers with loose stools and as long as there are no additional systemtic signs of disease such as poor weigh gain. Therefore, we will typically rule out some common GI related problems and if negative discuss how to thicken the stool.

Brenna (Moderator) - 2:51 PM:
There are 10 minutes left in the chat. Please submit your final questions.

  Vicki - 2:56 PM:
Are the foods known to cause GI allergic reactions in kids the same as those that cause other skin or more severe allergic reactions? What are the common foods for GI allergies?
Dr. Vincent Biank (NorthShore)
Yes for some individuals the foods that cause GI allergic symptoms will also cause skin and the typical 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 alleriges are whats called the big 6: Milk, soy, wheat, eggs, nuts and fish

Brenna (Moderator) - 3:00 PM:
This will be the final questions of our chat today. Thank you everyone for your participation. A transcript of this chat will be made available later today.

Dr. Vincent Biank (NorthShore) - 3:02 PM:
Thanks everyone for participating. All the questions were wonderful. If you have any additional question or would like to schedule an appointment please do not hesitate to contact us at 847-570-1795. Thanks again, Vince

This chat has ended.

Thank you very much for your participation.