INTOLERANCIJA NA HRANU
Sažetak
Intolerancija na hranu je neimunološki odgovor indukovan hranom ili komponentom hrane u dozi koja se normalno toleriše. Obuhvata pseudoalergijske i farmakološke efekte uzrokovane: salicilatima, biogenim aminima, sulfitima, natrijum glutamatom, bojama i konzervansima, zaslađivačima, ili enzimopatijama. U okviru ovog preglednog rada prikazana je patofiziologija, kliničke manifestacije, dijagnostikovanje i lečenje najučestalijih intolerancija na hranu. Prietraživanje literature je sprovedeno korišćenjem sledećih ključnih reči: intolerancija, hrana, aditivi, ugljeni hidrati i gluten u okviru PubMed, Emabase, Scopus, SCIndex i Hrčak za period od 2001. do 2022. godine. Na osnovu pregleda literature može se konstatovati da nedostatak standardizovanih testova uslovljava nesklad između percipirane prevalencije štetnih efekata povezanih s hranom, koji su izuzetno česti, i stvarne prevalencije neimunoloških reakcija na hranu unutar ovih događaja. Intolerancija na hranu se manifestuju u prvom redu gastrointerstinalnim, a zatim i ekstrainterstinalnim (neurološkim, kardiovaskularnim, respiratornim i dermatološkim) znakovima i simptomima. Dijagnoza zahteva detaljnu anamnezu, fizikalni pregled, kao i vođenje dnevnika ishrane i pojave simptoma, sprovođenje eliminacijske dijete i dvostruko slepih placebom kontrolisanih oralnih ekspozicijskih testova na hranu. Lečenje podrazumeva modifikaciju ishrane, suplementaciju i lečenje osnovnog stanja kod osoba sa sekundarnom intolerancijom.
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