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Allergic and eosinophilic disorders of the gastrointestinal (GI) tract have in common an infiltrate of eosinophils into the wall of the GI tract—sometimes located in the lamina propria only, sometimes in the muscularis propria, sometimes in both. The associated disorders are highly variable in severity of symptoms and endoscopic and histologic manifestations (Table 411-1). Different parts of the GI tract may be involved separately or together (eg, eosinophilic esophagitis is almost always a stand-alone disorder; eosinophilic gastritis may occur on its own, or, more commonly as a gastroenteritis; eosinophilic colitis may occur alone, or in combination with small bowel involvement, ie, enterocolitis). Complicating this is the fact that eosinophils are found in the GI tract in a number of other disorders, not considered to be primarily allergic in origin. These include disease induced by parasitic, bacterial, and viral pathogens as well as certain systemic diseases such as vasculitis. The general principles, diagnostic approach, and management of food allergy is discussed in detail in Chapter 194.

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Table 411-1. Allergic and Eosinophilic Gastrointestinal Disorders

Adverse reactions to foods have now been subclassified by the American Academy of Allergy and Immunology into three categories: food anaphylaxis, food hypersensitivity, and ...

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