{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T04:07:49Z","timestamp":1788840469465,"version":"build-2803163510"},"reference-count":48,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Allergy Immunology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Oral immunotherapy (OIT) is a promising therapeutic strategy for desensitizing patients with immunoglobulin E (IgE)\u2010mediated food allergies. Although effective, OIT is frequently associated with adverse events (AEs), and gastrointestinal (GI) manifestations are among the most common and challenging AEs, which are the leading cause of OIT discontinuation. These reactions range from immediate IgE\u2010mediated signs and symptoms to delayed, non\u2010IgE\u2010mediated, eosinophil\u2010associated disorders, including eosinophilic esophagitis (EoE). While systemic reactions, such as anaphylaxis, are well\u2010known concerns, GI manifestations are frequently encountered, although they are often less severe than systemic reactions. A thorough understanding of GI signs and symptoms is therefore essential for patients and clinicians to navigate OIT effectively. This narrative review provides a comprehensive overview of GI AEs observed during OIT, detailing their clinical presentation, underlying pathophysiology, and evidence\u2010based management approaches. A clear understanding of these manifestations and their management is essential for optimizing patient safety and treatment adherence in the era of OIT.<\/jats:p>\n                  <jats:p>\n                    <jats:boxed-text content-type=\"graphic\" position=\"anchor\">\n                      <jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/pai70417-gra-0001-m.png\">\n                        <jats:alt-text>image<\/jats:alt-text>\n                      <\/jats:graphic>\n                    <\/jats:boxed-text>\n                  <\/jats:p>","DOI":"10.1111\/pai.70417","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T19:05:29Z","timestamp":1783710329000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gastrointestinal manifestations during oral immunotherapy: A guide for pediatric allergists"],"prefix":"10.1111","volume":"37","author":[{"given":"Martina","family":"Votto","sequence":"first","affiliation":[{"name":"Maternity and Pediatric Services \u2013 Local Health Units  Benevento Italy"},{"name":"Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences University of Pavia  Pavia Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Olcese","sequence":"additional","affiliation":[{"name":"Allergy Center IRCCS Giannina Gaslini  Genoa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2900-9642","authenticated-orcid":false,"given":"Maria","family":"De Filippo","sequence":"additional","affiliation":[{"name":"Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences University of Pavia  Pavia Italy"},{"name":"Department of Maternal, Infantile and Urological Sciences AOU Policlinico Umberto I  Rome 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Miraglia","family":"Del Giudice","sequence":"additional","affiliation":[{"name":"Department of Woman, Child and General and Specialized Surgery University of Campania \u2018Luigi Vanvitelli\u2019  Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9568-6882","authenticated-orcid":false,"given":"Mattia","family":"Giovannini","sequence":"additional","affiliation":[{"name":"Allergy Unit Meyer Children's Hospital IRCCS  Florence Italy"},{"name":"Department of Health Sciences University of Florence  Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Barberi","sequence":"additional","affiliation":[{"name":"Pediatric Unit ASST\u2010Rhodense, RHO  Milan 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