Can food cause acute gastritis in a child?

Food as a Cause of Acute Gastritis in a 5-Year-Old Child

Yes, certain foods can cause acute gastritis in a 5-year-old child, particularly through food allergies, which may manifest as eosinophilic gastritis or other gastrointestinal inflammatory responses. 1

Food-Related Causes of Acute Gastritis

Food Allergies

• Food allergies should be suspected in children who experience gastrointestinal symptoms shortly after ingesting certain foods, especially if symptoms occur repeatedly 1
• IgE-mediated food allergies can cause gastritis and other gastrointestinal symptoms within minutes to hours of ingesting the offending food 1
• Mixed IgE and non-IgE-mediated food allergies can affect the gastrointestinal tract with more chronic symptoms that may not be immediately associated with food ingestion 1

Common Food Allergens

• The eight major food allergens in the United States that may trigger gastritis include: cow's milk, egg, peanut, tree nuts, soy, wheat, fish, and crustacean shellfish 1
• Children under 5 years with persistent gastrointestinal symptoms should be evaluated for allergies to cow's milk, egg, peanut, wheat, and soy 1

Non-Allergic Food Triggers

• Highly acidic foods, spicy foods, or irritating substances may trigger gastric inflammation in some children 2
• Excessive consumption of fruit juice (especially acidic juices) may contribute to gastrointestinal symptoms in young children 1
• The American Academy of Pediatrics recommends limiting juice intake to no more than 4 ounces/day for children 1-3 years of age 1

Clinical Presentation and Diagnosis

Symptoms of Food-Induced Gastritis

• Symptoms may include abdominal pain, vomiting, and in some cases, diarrhea 1
• In severe cases, there may be evidence of dehydration requiring oral rehydration therapy 3
• Some children may present with food aversion or refusal of certain foods 1

Diagnostic Approach

• Food allergy should be suspected in children who have been diagnosed with gastritis, enteritis, or enterocolitis 1
• Elimination of suspected foods from the diet for 2-8 weeks may help identify the causative agent 1
• For exclusively breastfed infants, the suspected food can be eliminated from the mother's diet 1
• Document any significant improvements resulting from dietary elimination 1

Management Strategies

Immediate Management

• For acute gastritis with vomiting, provide small, frequent volumes of oral rehydration solution (5 mL every minute) using a spoon or syringe 4
• Gradually increase volume as tolerated 4
• Replace ongoing losses (each episode of vomiting) with additional oral rehydration solution 4

Dietary Management

• Once rehydrated, continue age-appropriate feeding during illness without delaying until symptoms resolve 3
• For formula-fed infants with suspected milk protein allergy, consider hydrolyzed infant formulas 1
• For older children, recommended foods include starches (rice, potatoes, noodles, crackers, bananas), cereals, yogurt, vegetables, and fresh fruits 1
• Avoid foods high in simple sugars (soft drinks, undiluted apple juice, Jell-O, presweetened cereals) and fats, which may exacerbate symptoms 1

Long-term Management

• If food allergy is confirmed, complete avoidance of the offending food is recommended 1
• Most children with food allergies to cow's milk, egg, soy, and wheat eventually develop tolerance 1
• Fewer children develop tolerance to peanuts, tree nuts, fish, and shellfish 1

When to Seek Medical Attention

• Seek immediate medical care for bilious vomiting (green color), which may indicate intestinal obstruction 4
• Persistent projectile vomiting requires emergency evaluation 4
• Signs of severe dehydration not responding to oral rehydration require medical attention 4
• Abdominal distension or tenderness warrants urgent evaluation 4

Prevention

• There is insufficient evidence to recommend routine food allergy testing before introducing highly allergenic foods in children at high risk of developing food allergy 1
• Restricting maternal diet during pregnancy or lactation is not recommended as a strategy for preventing food allergies 1
• For infants at risk of food allergy who are not exclusively breastfed, hydrolyzed infant formulas may be considered 1