Diagnosis and Management of Food Allergy Induced Gastroesophageal Reflux
Disease in young Children -- EAACI Position Paper
Abstract
Gastro-oesophageal reflux (GOR) and food allergy (FA) are common
conditions, especially during the first 12 months of life. When GOR
leads to troublesome symptoms, that affect daily functioning of the
infant and family, it is referred to GOR disease (GORD). The role of
food allergens as a cause of GORD remains controversial. This European
Academy of Allergy and Clinical Immunology (EAACI) position paper aims
to review the evidence for FA-associated GORD in young children and
translate this into clinical practice that guides healthcare
professionals through the diagnosis of suspected FA-associated GORD and
the medical and dietary management. The Task Force (TF) on
non-IgE mediated allergy consists of EAACI experts in paediatric
gastroenterology, allergy, dietetics and psychology from Europe, United
Kingdom, United States, Turkey and Brazil. Six clinical questions were
formulated, amended and approved by the TF to guide this publication. A
systematic literature search using PubMed, Cochrane and EMBASE databases
(until June 2021) using a predefined inclusion criteria based on the 6
questions was used. The TF also gained access to the database from the
European Society of Paediatric Gastroenterology and Hepatology working
group, who published guidelines on GORD and ensured that all
publications used within that position paper were included. For each of
the 6 questions, practice points were formulated, followed by a modified
Delphi method consisting of anonymous web-based voting that was repated
with modified practice points where required, until at least 80%
consensus for each practice point was achieved. This TF position paper
shares the process, the discussion and consensus on all practice points
on FA-associated GORD.