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Food Allergies and Alpha-gal Syndrome for the Gastroenterologist

  • Neurogastroenterology and Motility Disorders of the Gastrointestinal Tract (S Rao and A Sharma, Section Editors)
  • Published:
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Abstract

Purpose of Review

Food allergies are typically not considered as a cause of gastrointestinal (GI) distress without additional allergic symptoms, apart from celiac disease and eosinophilic esophagitis. However, recent reports of patients with alpha-gal syndrome who presented with GI-only symptoms like abdominal pain, vomiting, and diarrhea challenge this paradigm. Alpha-gal syndrome is an IgE-mediated allergy characterized by delayed reactions after eating mammalian meat or mammalian-derived products that contain galactose-alpha-1,3-galactose (alpha-gal). The purpose of this review is to discuss our current understanding of food allergies, GI illness, and the GI manifestations of alpha-gal syndrome.

Recent Findings

Among Southeastern U.S. GI clinic patients who screened positive for serum alpha-gal IgE, a majority of patients reported significant symptom improvement on an alpha-gal-avoidant diet, suggesting that the allergy had played a role in their GI symptoms. Diagnosis of alpha-gal syndrome is typically made with concerning allergic symptoms, elevated alpha-gal specific IgE in the serum, and symptom improvement on an alpha-gal avoidant diet.

Summary

Alpha-gal syndrome can cause a delayed allergic response that is increasingly recognized worldwide, including among patients with predominant GI symptoms.

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Abbreviations

GI:

Gastrointestinal

Ig:

Immunoglobulin

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  1. Department of Internal Medicine, University of North Carolina at Chapel Hill, 130 Mason Farm Road, Chapel Hill, NC, 27514, USA

    Christopher J. Lee

  2. Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of North Carolina at Chapel Hill, 130 Mason Farm Road, Chapel Hill, NC, 27514, USA

    Sarah K. McGill

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Lee, C.J., McGill, S.K. Food Allergies and Alpha-gal Syndrome for the Gastroenterologist. Curr Gastroenterol Rep 25, 21–30 (2023). https://doi.org/10.1007/s11894-022-00860-7

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