Round Table Discussion

PRESENT DAY CONCEPTS OF ALLERGY

Chairman Glaser: By gastrointestinal allergy is meant an allergic reaction in an organ of the gastrointestinal tract. While gastrointestinal allergy most commonly occurs from foods, it may also be produced by allergens from other sources, as for example the patient with ulcerative colitis described by Rowe whose condition was shown to be due to the inhalation of pollen. By food allergy is meant an allergic reaction caused by a food, regardless of the tissue in which the reaction occurs; thus atopic dermatitis of infants may be the result of an allergy to egg, for example.

McGee believes that the first allergic reaction to occur in the human being may occur in utero, most commonly as a manifestation of allergy to food ingested by the mother, in the form of "fetal hiccoughs." While such spasmodic movements of the fetus are well authenticated, the general acceptance of McGee's views awaits confirmation by other investigators. The first allergic manifestation to occur in the newborn human being is urticaria. The urticarial wheals seen in the newborn infant, however, may not necessarily be due to an allergic reaction per se but may be due to the unstable vasomotor regulating mechanism of the newborn child. However, in many instances the urticarial wheals are produced by substances ingested by the infant or carried through the mother's breast milk when the infant nurses.

Colic or gastroenterospasm is the first clinical manifestation of allergy in the newborn human being of which the parents may complain. This commonly starts during the first weeks of life and usually terminates regardless of therapy by the time the infant is 3 months of age.

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