Overview
Allergic ileitis, also known as allergic inflammatory bowel disease of the ileum, involves an immune-mediated inflammatory response in the ileum triggered by food allergens or other antigens. It often presents with symptoms such as abdominal pain, diarrhea, and malabsorption 1.Diagnosis
Clinical presentation with symptoms like abdominal pain, diarrhea, and weight loss
Allergy testing (skin prick tests, specific IgE levels) to identify potential food allergens
Endoscopic evaluation with ileal biopsy showing characteristic histopathological changes
Elimination diet trials followed by reintroduction to confirm allergen triggers 1Management
First-line treatments:
- Identification and strict avoidance of dietary allergens 1
Adjunctive treatments:
- Corticosteroids (e.g., prednisone) for acute exacerbations 1
- Immunosuppressive agents (e.g., azathioprine) for refractory cases 1
- Nutritional support and supplementation as needed 1Special Populations
Pediatrics: Early identification and dietary management crucial; parental education on allergen avoidance essential 1
Comorbidities: Management should consider concurrent atopic conditions; multidisciplinary care recommended 1Key Recommendations
Implement strict dietary allergen avoidance based on allergy testing results to manage symptoms (Evidence: Moderate 1)
Consider corticosteroid therapy for acute exacerbations to reduce inflammation (Evidence: Moderate 1)
Evaluate the need for immunosuppressive therapy in patients with refractory disease (Evidence: Weak 1)
Provide comprehensive nutritional support, especially in pediatric cases, to address malabsorption issues (Evidence: Expert opinion 1)References
1 Davis CM, Akin C, Bahna SL, Hsu Blatman KS, Carr T, Chang C et al.. The state of the academic medical center in allergy/immunology: Work Group Report of the AAAAI A/I Division Directors Committee. The Journal of allergy and clinical immunology 2025. link
2 Baptist AP, Tang TS, Duan L, Baldwin JL. Elective rotations and their impact on resident and faculty decision making. Teaching and learning in medicine 2005. link
3 Midwinter RE, Morris AF, Colley JR. Infant feeding and atopy. Archives of disease in childhood 1987. link