[Food Intolerance].

Mauricio Colella, Claudio Alberto Salvador Parisi
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Abstract

The term food intolerance has been used non-specifically to define a wide range of disorders related to food intake. Recently, the use of the term "non-immunological adverse reactions to foods" (RANIAs) was recommended as a more correct clinical definition. The pathophysiological mechanisms can be diverse, sometimes unknown, and there are no validated diagnostic tests, making it difficult to obtain accurate data. The clinical manifestations of non-immunological adverse reactions to foods affect more than one organ or system; and gastrointestinal symptoms (pain, abdominal distension, flatulence, and diarrhea) are the most common. Non-immunological adverse reactions to foods are divided into independent and dependent on host factors. Foods may contain chemicals with pharmacological activity and be present naturally, such as vasoactive amines (histamine) and salicylates, or added for preservation, to improve appearance or flavor (monosodium glutamate, tartrazine, sulfites, and benzoates). In some cases, these types of reactions may be like to hypersensitivity reactions. Concomitant alcohol consumption may worsen symptoms by inhibiting histamine breakdown and increasing intestinal permeability. In patients diagnosed with non-immunological adverse reactions to foods, it is important to rule out some psychological problems: aversions or eating disorders.

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[食物不耐受]。
食物不耐受一词一直被用来定义与食物摄入有关的各种疾病,但并不具体。最近,有人建议使用 "非免疫性食物不良反应"(RANIAs)一词作为更正确的临床定义。非免疫性食物不良反应的病理生理机制可能多种多样,有时甚至是未知的,而且没有经过验证的诊断测试,因此很难获得准确的数据。食物非免疫性不良反应的临床表现影响不止一个器官或系统,而胃肠道症状(疼痛、腹胀、胀气和腹泻)最为常见。食物非免疫性不良反应分为独立因素和依赖宿主因素。食物中可能含有天然存在的具有药理活性的化学物质,如血管活性胺(组胺)和水杨酸盐,或为防腐、改善外观或风味而添加的化学物质(味精、酒石酸、亚硫酸盐和苯甲酸盐)。在某些情况下,这类反应可能类似于超敏反应。同时饮酒可能会抑制组胺分解并增加肠道渗透性,从而加重症状。对于被诊断出对食物有非免疫性不良反应的患者,重要的是要排除一些心理问题:厌恶或饮食失调。
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