饮食失调和食物过敏

D.-A. Moneret-Vautrin, M. Morisset, O. Sans
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引用次数: 6

摘要

在食物过敏实践中观察到许多饮食失调。常见的情况是,患者避免食用许多食物,因为他们对交叉反应知之甚少,而这些交叉反应与临床无关。对于孩子来说,父母的焦虑可能会增加不合理的回避。虽然这种情况很少见,但应考虑代诊 nchausen综合征。儿童不正常的饮食行为可能与厌恶的巴甫洛夫反应、焦虑或抑郁、与母亲的关系不稳定或仅仅是由于对新食物的厌恶有关。在成年人中,食物回避与对阳性实验室检测结果的不良解释有关,这些检测结果表明交叉反应与临床无关。肠易激综合征导致食物回避,即使在食物过敏记录不足的地方。纤维肌痛也会导致不必要的避免饮食。可能出现真正的神经症(强迫症和焦虑性神经症)。服用替代药物或属于某些教派的患者经常遵循异常的避免饮食。所有病人都应接受营养评估。心理学家、精神病学家和营养师也应该参与治疗。过敏症专家不应该局限于简单地消除对特定食物过敏的食物过敏,而应该让病人意识到问题是“不”吃不同的食物引起的。准确的测试,详细的信息和仔细的监测建议的饮食变化应该导致更合理的饮食习惯。已经确立的神经症不会得到改善,因为病人否认这些疾病,精神科医生对它们知之甚少。
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Troubles des conduites alimentaires et allergies alimentaires

Many eating disorders are observed in food allergy practice. It is common to see patients avoiding many foods because they have been poorly informed of cross-reactions that are not clinically relevant. For children, parental anxiety may multiply irrational avoidance. The diagnosis of Münchausen syndrome by proxy should be envisaged, although it is rare. Abnormal eating behavior in children can be related to a Pavlovian reaction of disgust, to anxiety or depression, a perturbed relationship with the mother or simply due to an aversion to new foods. In adults, food avoidance is linked to poor interpretation of positive laboratory tests indicating cross-reactions that are clinically irrelevant. Irritable bowel syndrome results in food avoidance even where food allergy is poorly documented. Fibromyalgia also leads to unnecessary avoidance diets. True neurosis (obsession and anxiety neurosis) may occur. Patients taking alternative medicines or belonging to certain sects often follow aberrant avoidance diets. All patients should undergo a nutritional evaluation. Psychologists, psychiatrists and dieticians should also be involved in treatment. Allergists should not limit themselves to simply eliminating food allergy to a given food allergy, but should make patients aware that problems arise from “not” eating different foods. Accurate tests, detailed information and careful monitoring of proposed changes in diet should result in more rational eating habits. Established neurosis will not improve, since patients are in denial about these disorders, psychiatrists know little about them.

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Editorial Board Page tournée et nouveaux rendez-vous L’enseignement de l’allergologie pendant les études médicales en France Toux chronique de l’adulte et reflux gastro-œsophagien Les frontières du bilan allergologique en allergo-anesthésie
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