According to a clinical practice update published in April’s issue of Clinical Gastroenterology and Hepatology, some patients with alpha-gal allergy may suffer gastrointestinal issues without developing skin issues or anaphylaxis.
The update provided by Dr Sarah K McGill from UNC at Chapel Hill and colleagues details the presentation and management of alpha-gal syndrome in order to spread awareness among gastroenterologists.
The update notes that a subset patients with alpha-gal syndrome present with GI symptoms including abdominal pain, diarrhea, nausea, or vomiting without the typical symptoms of allergic reactions such as skin issues (rash, hives) or anaphylaxis. As such, an allergy to alpha-gal could be mistaken for any number of other ailments.
In patients with GI distress and increased serum alpha-gal immunoglobulin E (IgE) antibodies whose symptoms are relieved on an alpha-gal avoidance diet, alpha-gal syndrome can be diagnosed. An alpha-gal avoidance diet eliminates mammalian meat (i.e. “red” meat such as beef, pork, venison, goat, bison, lamb, mutton) and products derived from such animals.
The update urges counseling for an alpha-gal avoidance diet because it is the primary means of management. Measures to avoid tick bites should also be included in counseling because additional bites can cause a further increase in alpha-gal IgE titers and worsen the allergy. Referral to allergists is recommended for patients who also have reactions such as facial swelling, urticaria, and respiratory difficulty.
“It is important for gastroenterologists to be aware of this condition and to be capable of diagnosing and treating it in a timely manner,” the authors write.
To learn more about alpha-gal syndrome, see our Q&A: Everything You Need to Know About Alpha-gal Syndrome, the Meat Allergy You Can ‘Catch’.