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Allergic Gastroenteritis – Causes, Symptoms and Treatment

Gastroenteritis

SYMPTOMS & SIGNS:

  • Allergic gastroenteritis is equally distributed for all sexes in all ages.
  • Symptoms vary with the type of organ that is affected.
  • Mainly it affects the gastrointestinal disorders only leading to various gastrointestinal disorders.
  • The symptoms of gastrointestinal disorder are vomiting, flatulence, diarrhea, cramps, epigastic pain, heart burns associated with class 2 type of allergy.
  • Other symptoms include family history of hematemesis, cholecystitis, pyloric obstruction and choleolithiasis.
  • More than 50% of allergic gastroenteritis is mainly due to allergical heredity.


CAUSES:

  • Causes are scientifically unknown.
  • Allergic mechanism is classified into two categories namely class 1 and class 2.
  • Class 1 is the diffused type and class 2 is of circumscribed types which include the local inciting agents.
  • Classes 1 and 2 are no way related to each other.

Class 1:

Class 1 is diffused types that include three categories polyenteric, monoenteric and regional.

Polyenteric:

In polyenteric type, many portions of intestine are involved wherein the antrum of stomach gets affected due to extension of jejunum and ileum. The affected areas become stiff with edematous appearance. The mesentery and omentum may become inflamed or fibrotic. The pylons become narrowed. Diffuse inflammatory infiltration from sub mucosa by mature eosinophils along with rare macrophages and giant cells. Hyalinization or necrosis of muscles. Mucosa free of involvement.

Monoenteric:

In case of monoenteric similar patterns of lesions are limited to the stomach.

Regional:

Same pattern develops which involves only a limited region. Pyloric and prepyloric have borders that are well defined.

Class 2:

Class 2 is circumscribed type including two categories.

Regional:

Mucosa may be ulcerated. Pseudotumours located at different site of gastrointestinal tract. Lesions are of granuloma types that have rich reticular fibrillar and fibroblastic elements. The number of blood vessels and inflammatory cells changes. Scarce eosinophilic infiltration. Rare histiocytes.

Polypoid peduculated polyps:

These are microscopically are of the same pattern as that of the regional type.

DIAGNOSIS:

Various diagnostic procedures of this disease includes-

  • X-ray.
  • Various findings based upon the location and extension of lesions.

Class 1:

  • Signs of pyloric obstruction along with bowel movements.
  • Smooth concentric narrowing of antrum.
  • Absence of peristalsis in the affected area.
  • Narrowing of tubular segments that alternate with dilated loops.
  • Blood eosinophilia test (about 60%).
  • Bone marrow test.
  • Percentage of eosinophils may be more.
  • Biopsy of lesion.

TREATMENT:

  • Conservative treatment using ACTH cardenocorticotropic and corticosteroids usually provides a prompt control of symptoms and eosinophilia.
  • If this disease is detected, exploratory laparotomy and biopsy tests must be carried out.
  • Surgical intervention will be decided based upon the location and extension of the lesions.
  • Gastro-enterostomy is adequate.
  • For peculiar cases, subtotal gastrectomy and total gastrectomy may be performed.
  • Recent researches have proved that surgery is necessary only to control bleeding.

EFFECTS:

Lesions do not recur after resection, but if they recur even after conservative treatment, then response to successive steroid administrations is prompt.

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