From the Research
Approximately 42% of anaphylaxis cases present with gastrointestinal (GI) symptoms. GI symptoms are common but not universal in anaphylaxis, typically including nausea, vomiting, abdominal pain, and diarrhea 1. It's essential to note that while GI symptoms can occur in anaphylaxis, they are usually accompanied by other systemic symptoms such as skin reactions (hives, flushing), respiratory difficulties, or cardiovascular symptoms. Healthcare providers and patients should be aware that the absence of GI symptoms does not rule out anaphylaxis, and conversely, the presence of isolated GI symptoms without other systemic involvement is unlikely to represent anaphylaxis. The variability in symptom presentation is due to the complex nature of the immune response in anaphylaxis, which can affect multiple organ systems to varying degrees, with the release of inflammatory mediators like histamine directly impacting the GI tract, leading to the observed symptoms 1. Key points to consider in anaphylaxis diagnosis and management include:
- Prompt recognition of symptoms
- Administration of intramuscular epinephrine as the first-line treatment
- Education on the use of epinephrine autoinjectors and emergency action plans for patients and caregivers
- Awareness of the potential for biphasic reactions and the need for prolonged observation and treatment as necessary 2. Given the most recent and highest quality evidence, the presence of GI symptoms in approximately 42% of anaphylaxis cases should guide clinical decision-making and patient education 1.