WHAT IS A FOOD ALLERGY?

As with any allergy, a food allergy develops when the immune system attacks a normally harmless substance and creates specific antibodies for this substance. From this point on, whenever the food allergy sufferer eats the food to which they’re allergic, the antibodies respond by releasing chemical mediators, like histamine, which cause allergic symptoms to appear.

WHO IS AT RISK FOR FOOD ALLERGIES?

Approximately 12 million Americans suffer from food allergies. According to the Asthma and Allergy Foundation of America, three to eight percent of children will have an adverse reaction to food at some point, and one to two percent of children have true food allergies. Those at risk include people who have a family history of allergies and people who have other kinds of allergies, including asthma. Asthma sufferers are at higher risk for experiencing a life-threatening allergic reaction to food.

DO CHILDREN OUTGROW FOOD ALLERGIES?

Many children outgrow food allergies by age four; however, allergies to peanuts, tree nuts, and shellfish usually last a lifetime.

WHAT ARE COMMON FOOD ALLERGENS?

Only eight foods account for over 90% of food allergies. These include:

• cow’s milk
• eggs
• peanuts
• wheat
• soy
• fish
• shellfish
• tree nuts

In addition to the most common foods listed above, really any food can cause an allergic or adverse reaction. Other more commonly reported food allergens include apples, apricots, asparagus, avocados, berries, buckwheat, carrots, chicken, cinnamon, citrus fruits, coconut, corn, dates, grapes, honey, lamb, lettuce, mustard, oats, peaches, pears, peas, pork, raisins, rice, rye, safflower oil, strawberries, sweet potatoes, tomatoes, turkey, veal, and yeast. Many people are also intolerant of or allergic to food dyes, additives, and preservatives in processed foods.

WHAT ARE THE COMMON SYMPTOMS OF FOOD ALLERGY?

Signs and symptoms of food allergy range from very mild to extreme and may include: a tingling of the mouth; fatigue; hyperactivity; anxiety; headaches; crying; sore muscles and joints; sneezing; runny nose; stuffy nose; urticaria (hives); eczema (skin rash); itchy skin; recurrent ear infections; congestion; abdominal pain; vomiting; constipation; diarrhea; swelling of the hands, feet, eyelids, tongue and lips; dark circles under the eyes; bronchitis; difficulty breathing; asthma; a drop in blood pressure; loss of consciousness; and death. Symptoms normally appear within a few minutes to a couple of hours after ingesting the allergenic food, but in some cases they may not appear until days later.

HOW DO I KNOW IF I HAVE A FOOD ALLERGY?

An allergist/immunologist can perform diagnostic tests to determine most things to which you’re allergic. If you believe a specific food is causing allergic reactions, then you should avoid it, but do not make any extreme changes to your diet without consulting a physician. If possible, before seeing a doctor, keep a food diary and record what you eat at specific times throughout the day and also record symptoms and when they appear. This information may help your doctor determine the problem.

HOW IS A FOOD ALLERGY DIAGNOSED?

Many people figure out the food to which they’re allergic by systematically eliminating suspected foods from their diet; this is known as an elimination diet. A skin test is often helpful in uncovering hidden food allergies, and while false positives are common, a negative skin test is a good indicator that one is not allergic to the food in question. A blood test, or a Radio-Allergo-Sorbent Test (RAST), measures the number of antibodies in the bloodstream. A positive RAST test is a reliable sign of an allergy; however, false negatives are common among RASTs, meaning that all allergies may not be detected. The best indicator of a food allergy is the observation of an allergic reaction. Sometimes doctors will give patients a small amount of a suspected allergenic food to see if an allergic reaction occurs; this is known as an oral food challenge. Oral food challenges can be dangerous and should never be attempted outside of a doctor’s care.

HOW DO I TREAT A FOOD ALLERGY?

Currently, there is no cure for food allergy. Strict avoidance of the allergenic food is the only way to prevent allergic reactions. Always check labels, ask about ingredients, and watch out for cross-contamination. Always carry your EpiPen in case of accidental exposure; it may save your life. If your child has a food allergy, make sure all teachers and caregivers know about the food allergy. Visual indicators such as clearly marked lunchboxes and food allergy t-shirts let people know about the child’s food allergy; such visual indicators are particularly valuable in situations like summer camp, where all adult supervisors may not know about the food allergy. Eating out in restaurants is risky; always carry Food Allergy Restaurant Cards to be safe. If you have a small child with a food allergy, use Table Toppers on public tables to avoid accidental exposure. You never know what’s on the surface of a restaurant table. People who are extremely allergic should always wear a medic alert bracelet.

Make sure you read labels in order to avoid foods or preservatives that cause a reaction. At the first sign of an allergic reaction to a food, call 911 immediately. Time is of the essence. Most food allergy fatalities occur within an hour of ingesting the allergenic food. If you are not minutes away from an emergency room, you may need to use an EpiPen, which you should always carry in case of an emergency.

WHAT IS AN EPIPEN?

An EpiPen is an auto-injector that administers epinephrine, also known as adrenaline. It can be self-administered to the fleshy, outer part of the thigh. Adrenaline makes the heart beat stronger, shrinks blood vessels to offset low blood pressure, relaxes the lungs, and helps stop swelling. This medicine temporarily reverses a severe allergic reaction but should not be used as a substitute for medical care. Always see a doctor after using an EpiPen. Learn how to use the EpiPen properly and make sure the medication is not expired. Practice with an EpiPen trainer pen, which contains neither the medicine nor the needle.

WHEN SHOULD I USE MY EPIPEN?

Use the EpiPen at the first sign of a severe allergic reaction, and immediately seek medical assistance. EpiPen may also be used to treat severe allergic reactions to medicines, stinging insects, latex, and other allergens. The EpiPen should be used with extreme caution among people with heart conditions and diabetes.

WHAT IS CROSS-CONTAMINATION?

Cross-contamination occurs when an allergenic food touches another food or surface, such as a utensil, grill, countertop, table, plate, or someone’s hand. Cross-contamination is the primary vehicle of accidental exposure to food allergens. To avoid cross-contamination, pay close attention to food preparation, storage, and serving methods.

WHAT’S THE DIFFERENCE BETWEEN FOOD ALLERGY AND FOOD INTOLERANCE?

Food intolerance occurs when your digestive system cannot handle a certain type of food, normally due to a missing enzyme. An intolerance may present some of the same gastrointestinal symptoms as a food allergy, such as abdominal pain and diarrhea. A food allergy, however, involves an allergic response from the body’s immune system.

WHAT IS LACTOSE INTOLERANCE?

Lactose intolerance occurs when a person lacks the enzyme lactase, which is needed to properly digest lactose, a sugar found in milk and dairy products. A food allergy to milk, on the other hand, involves an allergic reaction to dairy proteins like casein.

WHAT IS CELIAC DISEASE?

Also known as coeliac, nontropical sprue, celiac sprue, gluten intolerant enteropathy, or gluten sensitive enteropathy, celiac disease is the most common genetic disease in Europe. While similar to wheat allergy, celiac disease is actually an intolerance to gluten rather than an allergy. Gluten is a protein in wheat; it’s also found in rye, barely, oats, other grains, and many processed foods. When people who have celiac disease ingest gluten, it causes their immune system to attack the villi, the delicate lining of the bowel, and this can lead to bloating, cramping, gas, diarrhea, constipation, skin rashes, chronic fatigue, and even malnutrition (since the villi lining is responsible for absorbing nutrients).

WHAT IS EOSINOPHILIC ESOPHAGITIS?

Eosinophilic esophagitis is an inflammatory allergic reaction of the esophagus, the tube that goes from the mouth to the stomach. “Eosinophilic” refers to eosinophils, types of white blood cells that increase in number during inflammation. Eosinophilic esophagitis commonly occurs among those allergic to cow’s milk, soy, eggs, and wheat, and it’s often accompanied by other symptoms of an allergic reaction.

WHAT IS ORAL ALLERGY SYNDROME?

Oral allergy syndrome (OAS) is a reaction to certain raw or fresh fruits or other foods that occurs in people who have been sensitized to airborne pollen. The syndrome is caused by a cross reactivity between airborne pollen proteins (tree, grass, weeds, plants), and proteins in fruits or vegetables. In people who are already allergic to pollen, the body’s immune system sees a similarity between the proteins of pollen and those of the food, and triggers a reaction.

For some people, seasonal allergy symptoms may be made worse by consuming fresh fruits or vegetables due to “oral allergy syndrome,” according to the American Academy of Allergy, Asthma & Immunology (AAAAI).

The most frequent reaction involves itchiness, and/or swelling of the mouth, face/lip, tongue and throat area. The symptoms usually appear immediately after eating raw fruits or vegetables, although the reactions can occur more than an hour later. Rarely, OAS can induce severe throat swelling or even a systemic reaction in a person who is highly allergic. However, severe reactions can occur even the first time an individual tries a food as well as to foods that have been consumed previously without any problem.

People with ragweed allergy, for example, may experience itching and tingling of the mouth, tongue, and throat after eating watermelon, cantaloupe, banana, or cucumber.

Immunotherapy (Allergy shots) has been shown to improve this syndrome.