Diagnosis Intoleransi Makanan

Oleh :

dr. William Sumoro

Diagnosis intoleransi makanan perlu dicurigai pada individu yang mengalami keluhan gastrointestinal tanpa penyebab yang jelas, terutama jika keluhan timbul berkaitan dengan konsumsi makanan tertentu. Hingga saat ini, belum ada suatu tes biomarker yang dapat digunakan untuk diagnosis intoleransi makanan. Penentuan agen pencetus dapat dilakukan dengan food diary dan eksklusi dari diet.[1,3]

Anamnesis

Pada anamnesis biasanya dapat ditemukan gejala gastrointestinal seperti nyeri perut, perut terasa kembung atau begah, diare, sering kentut dan sendawa, mual, dan muntah. Gejala biasanya muncul beberapa jam setelah makan dan dapat menghilang dalam hitungan jam hingga hari.

Referensi

1. Tuck CJ, Biesiekierski JR, Schmid-Grendelmeier P, Pohl D. Food Intolerances. Nutrients. 2019 Jul 22;11(7):1684. doi: 10.3390/nu11071684. PMID: 31336652; PMCID: PMC6682924.
2. Commins SP. Food intolerance and food allergy in adults: An overview. UpToDate. 2020. https://www.uptodate.com/contents/food-intolerance-and-food-allergy-in-adults-an-overview?search=alergia a la comida&source=search_result&selectedTitle=3~150&usage_type=default&display_rank=3.
3. Gargano D, Appanna R, Santonicola A, De Bartolomeis F, Stellato C, Cianferoni A, Casolaro V, Iovino P. Food Allergy and Intolerance: A Narrative Review on Nutritional Concerns. Nutrients. 2021 May 13;13(5):1638. doi: 10.3390/nu13051638. PMID: 34068047; PMCID: PMC8152468.
9. Wang XJ, et al. Review article: biological mechanisms for symptom causation by individual FODMAP subgroups - the case for a more personalised approach to dietary restriction. Aliment Pharmacol Ther, 2019. vol. 50, no. 5, pp. 517–529. doi: 10.1111/apt.15419.
12. Fasano A, et al. Epidemiology and pathogenesis of celiac disease and non-celiac gluten (wheat) sensitivity. INC, 2021.
13. Lee HJ, Kim HJ, Kang EH, Jung KW, Myung SJ, Min YW, Choi CH, Ryu HS, Choi JK, Kwon JG, Hong KS, Park KS. Self-reported Food Intolerance in Korean Patients With Irritable Bowel Syndrome. J Neurogastroenterol Motil. 2019 Apr 30;25(2):222-232. doi: 10.5056/jnm18125. PMID: 30827068; PMCID: PMC6474711.
14. Hegar B, Widodo A. Lactose intolerance in Indonesian children. Asia Pac J Clin Nutr. 2015;24 Suppl 1:S31-40. doi: 10.6133/apjcn.2015.24.s1.06. PMID: 26715082.
15. Shulpekova YO, Nechaev VM, Popova IR, Deeva TA, Kopylov AT, Malsagova KA, Kaysheva AL, Ivashkin VT. Food Intolerance: The Role of Histamine. Nutrients. 2021 Sep 15;13(9):3207. doi: 10.3390/nu13093207. PMID: 34579083; PMCID: PMC8469513.
16. Weaver KR, Melkus GD, Henderson WA. Irritable Bowel Syndrome. Am J Nurs. 2017 Jun;117(6):48-55. doi: 10.1097/01.NAJ.0000520253.57459.01. PMID: 28541989; PMCID: PMC5453305.
17. Lomer MC. Review article: the aetiology, diagnosis, mechanisms and clinical evidence for food intolerance. Aliment Pharmacol Ther. 2015 Feb;41(3):262-75. doi: 10.1111/apt.13041. Epub 2014 Dec 3. PMID: 25471897.
18. Seyedian SS, Nokhostin F, Malamir MD. A review of the diagnosis, prevention, and treatment methods of inflammatory bowel disease. J Med Life. 2019 Apr-Jun;12(2):113-122. doi: 10.25122/jml-2018-0075. PMID: 31406511; PMCID: PMC6685307.
19. Fritscher-Ravens A, Schuppan D, Ellrichmann M, Schoch S, Röcken C, Brasch J, Bethge J, Böttner M, Klose J, Milla PJ. Confocal endomicroscopy shows food-associated changes in the intestinal mucosa of patients with irritable bowel syndrome. Gastroenterology. 2014 Nov;147(5):1012-20.e4. doi: 10.1053/j.gastro.2014.07.046. Epub 2014 Jul 30. PMID: 25083606.
20. Hasan H, Nasirudeen NA, Ruzlan MAF, Mohd Jamil MA, Ismail NAS, Wahab AA, Ali A. Acute Infectious Gastroenteritis: The Causative Agents, Omics-Based Detection of Antigens and Novel Biomarkers. Children (Basel). 2021 Dec 2;8(12):1112. doi: 10.3390/children8121112. PMID: 34943308; PMCID: PMC8700514.
21. Vandenplas Y. Lactose intolerance. Asia Pac J Clin Nutr, 2015. vol. 24, no. December, pp. S9–S13. doi: 10.6133/apjcn.2015.24.s1.02.
22. Pilonis ND, Januszewicz W, di Pietro M. Confocal laser endomicroscopy in gastro-intestinal endoscopy: technical aspects and clinical applications. Transl Gastroenterol Hepatol. 2022 Jan 25;7:7. doi: 10.21037/tgh.2020.04.02. PMID: 35243116; PMCID: PMC8826043.
23. Gjini B, Melchior I, Euler P, Kreysel C, Kalde S, Krummen B, Kiesslich R, Hemmerlein B, Frieling T. Food intolerance in patients with functional abdominal pain: Evaluation through endoscopic confocal laser endomicroscopy. Endosc Int Open. 2023 Jan 13;11(1):E67-E71. doi: 10.1055/a-1978-6753. PMID: 36644536; PMCID: PMC9839425.
24. Gibson PR, Halmos EP, Muir JG. Review article: FODMAPS, prebiotics and gut health-the FODMAP hypothesis revisited. Aliment Pharmacol Ther. 2020 Jul;52(2):233-246. doi: 10.1111/apt.15818. Epub 2020 Jun 20. PMID: 32562590.

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