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ARE YOU ALLERGIC OR INTOLERANT TO FOOD?

Q. What is a food allergy?

A. Food allergy is defined as an immune reaction to proteins in the food and can be IgE (Immunoglobulin E)-mediated or non-IgE-mediated. IgE-mediated food allergy is a worldwide health problem that affects millions of persons and numerous aspects of a person's life. Allergic reactions secondary to food ingestion are responsible for a variety of symptoms involving the skin, gastrointestinal tract, and respiratory tract.1

Q. What is the difference between food allergy and food intolerance?

A. Physical reactions to certain foods are common, but most are caused by a food intolerance rather than a food allergy. Food intolerance can cause some of the same signs and symptoms as a food allergy, so people often misinterpret the two. A food allergy affects the immune system. Even small amounts of the offending food allergen can trigger a range of symptoms, which can be severe or life-threatening. In contrast, food intolerance often affects only the digestive system and causes fewer symptoms.1,2 Causes of food intolerance include:
1. Absence of an enzyme needed to fully digest a food.
2. Irritable bowel syndrome. This chronic condition can cause cramping, constipation, and diarrhea.
3. Sensitivity to food additives.

Q. What are the most common food allergens?

A. More than 170 foods are known to cause food allergies, but eight foods account for 9 out of 10 reactions in the United States. These eight foods, identified as major food allergens are: milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, and soybeans.3

Q. What are the symptoms of a food allergy reaction?

The symptoms of a food allergy almost always develop a few seconds or minutes after eating the food. Some individuals may develop a severe allergic reaction (anaphylaxis), which can be fatal and life-threatening. The most common type of allergic reaction to food is IgE-mediated food allergy. Several common symptoms include tingling or itching in the mouth, a raised, itchy red rash (hives), in some cases the skin can turn red and itchy, but without a raised rash, swelling of the face, mouth (angioedema), throat, or other areas of the body, difficulty in swallowing, wheezing or shortness of breath, feeling dizzy and lightheaded, feeling sick (nausea) or vomiting, abdominal pain or diarrhea, hay fever-like symptoms, such as sneezing or itchy eyes (allergic conjunctivitis).3,4 Anaphylaxis- The symptoms of anaphylaxis, a severe allergic reaction, can be sudden and are fatal in nature too. Initial symptoms include a swollen tongue, breathing difficulties, tight chest, trouble while swallowing or speaking, feeling dizzy or fainting, and collapse. Anaphylaxis is a medical emergency. Without quick management, it can be life-threatening.1-4 Don’t hesitate. Visit https://drdangslab.com/ServiceAllergytesting.aspx and talk to our panelists and work with them to know which allergen affects you or your child. Dr. Dangs lab provides the ultimate comprehensive panels to resolve all your queries associated with allergies.

Q. What are the other types of food allergies?

A. Non-IgE-mediated food allergy: Another type of allergic reaction is a non-IgE-mediated food allergy. The symptoms of this type of allergy can take much longer to develop, sometimes up to several days. Some symptoms of a non-IgE-mediated food allergy may be what you would expect to see in an allergic reaction, such as redness and itchiness of the skin, although not raised, itchy red rash (hives), the skin turning dry and cracked (atopic eczema). Other symptoms can be much less obvious and are sometimes thought of as being caused by something other than an allergy; that include vomiting with or without diarrhea, abdominal cramps, and constipation. Small children/infants may experience signs and symptoms like excessive and inconsolable crying and don’t pass stools or have constipation.3,4 Mixed reaction: Some children can have a mixed reaction where they experience both IgE symptoms, such as swelling, and non-IgE symptoms, such as constipation. This can happen to children who have a milk allergy. Exercise-induced food allergy: In some cases, a food allergy can be triggered after eating certain food and then exercising. This can lead to anaphylaxis in severe cases, sometimes known as food-dependent exercise-induced anaphylaxis. Drinking alcohol or taking a non-steroidal anti-inflammatory drug (NSAID) such as aspirin or ibuprofen may also trigger an allergy in people with this syndrome.4

Q. How much of a food allergen does it take to cause a reaction?

A. Even trace amounts of a food allergen can cause a reaction in some people with food allergies. Although ingestion is the primary cause of severe reactions, in some cases, skin contact or breathing in a food protein (e.g., steam from cooking shellfish) can cause symptoms.1-4 For highly allergic people, even tiny amounts of an allergen (as little as 1/44,000 of a peanut kernel) can trigger a reaction. Less-sensitive people may be able to have small amounts of food that they are allergic to.5 Identification of the allergen is the key to preventing fatal complications. For more information visit https://drdangslab.com/ServiceAllergytesting.aspx and talk to our panelists and work with them to know which allergen affects you or your child. Dr. Dangs lab provides the ultimate comprehensive panels to resolve all your queries associated with allergies.

Q. How long does it take for a reaction to start after eating a food?

A. Food allergy symptoms usually develop within a few minutes to 2 hours after eating the offending food.2 In some cases, after the first symptoms go away, the second wave of symptoms comes back one to four hours later (or sometimes even longer). This second wave/set is called a biphasic reaction. The risk of a biphasic reaction is why patients who have a severe reaction should stay at a hospital for four to six hours for observation.6

Q. Who is most at risk for a severe allergic reaction to food?

A. Anyone who has a food allergy can have a severe allergic reaction to food allergens. However, data depicts that individuals having asthma are at higher risk. Fatal outcomes of anaphylaxis include a disproportionate number of teens and young adults, possibly because they take more risks with their food allergies (eating dangerously and delaying treatment). In most fatal cases of food anaphylaxis, the fatality is not due merely to a simple, linear relationship between the allergen and exposure in a sensitized individual. Compounding factors such as the allergic disease burden, particularly the presence of asthma, comprehension of the potential severity of an event, training in the appropriate use of epinephrine, and emerging metabolic factors should be considered when assessing risk and establishing management strategies.2,7

Q. Can the severity of a person’s allergic reactions to food be predicted from his or her previous reactions?
A. No, the severity of a person’s allergic reactions to food cannot be predicted from his or her previous reactions.2,6

Q. How many people have food allergies?

A. The problem could soon gain momentum in India as well. Alex Gazzola, the author of the book Living with Food Allergies, says, “With a population of well over a billion, food allergy could become an enormous problem in India. Some estimates suggest up to 3 percent of Indians may already have food allergies, the majority of these under 40 years of age.” He adds, “Food allergies cause roughly 30,000 emergency treatments and 100 to 200 deaths per year in the nation. Up to 3 million Indians may have peanut allergy alone.”8

Q. Will antihistamines stop anaphylaxis?

A. If you're with someone having signs and symptoms of anaphylaxis, don't wait to see whether symptoms get better. Seek emergency treatment right away. In severe cases, untreated anaphylaxis can lead to death within half an hour. An antihistamine pill isn't sufficient to treat anaphylaxis. These medications can help relieve allergy symptoms but work too slowly in a severe reaction.1,2,8

Q. Why are food allergies increasing?

A. Food allergy is increasing in prevalence (Savage and Johns, 2015) for reasons that are not yet clear. A rigorous population-based study utilizing food challenges to demonstrate food allergy showed that approximately one in 10 Australian children had a food allergy at one year of age (Osborne et al., 2011). Estimates in the US and Canada indicate a prevalence rate of 1 in 15 to 1 in 20 (Soller et al., 2012, Sicherer and Sampson, 2014). Factors such as hygiene and lack of exposure to microbial factors, the composition of the intestinal microbiota, diet, obesity, Vitamin D, and environmental chemical exposure have all been proposed to contribute to this alarming rise in the rate of food allergy in countries with a westernized lifestyle.9,10

Q. Is there a cure for food allergy?

A. Not yet. Strict avoidance of the food allergen is the only way to prevent a reaction. To prevent allergies, the key factor is identification. For more information visit https://drdangslab.com/ServiceAllergytesting.aspx and talk to our panelists and work with them to know which allergen affects you or your child. Dr. Dangs lab provides the ultimate comprehensive panels to resolve all your queries associated with allergies.

Q. Can a person outgrow their food allergies?

A. Peanut, tree nut, fish, and shellfish allergies usually are lifelong. Milk, egg, wheat, and soy allergies usually begin in childhood and eventually may be outgrown. 2,8,9

Q. If I think I or my child has outgrown an allergy to a food, is it okay to try a small amount of that food?
A. No, NOT at all. Even the slightest trace of the allergen can be fatal. Only your allergist can test for this. For more information on tests for food allergies, visit https://drdangslab.com/ServiceAllergytesting.aspx and talk to our panelists and work with them to know which allergen affects you or your child. Dr. Dangs lab provides the ultimate comprehensive panels to resolve all your queries associated with allergies.

Highlights

• Emerging evidence suggests that the route of exposure to food allergens in early life determines sensitization versus tolerance.
• The microbiota and dietary factors appear to play a key role in susceptibility to food allergy.
• Immunotherapy applied via different routes is currently the most promising form of an experimental treatment for food allergies.
• Even the slightest trace of the allergen can be fatal. Only your allergist can test for this. For more information on tests for food allergies, visit https://drdangslab.com/ServiceAllergytesting.aspx and talk to our panelists and work with them to know which allergen affects you or your child. Dr. Dangs lab provides the ultimate comprehensive panels to resolve all your queries associated with allergies. About Dr. Dangs Lab Allergy Test-
 Multiparameter assay containing optimized combinations of relevant allergens enabling the simultaneous analysis of specific IgE against these allergens.
 Highly sensitive and specific assay with minimal cross-reactivity among different allergens.
 Non-invasive, single prick blood test with comprehensive coverage of common Respiratory and Food Allergens.
 Availability of experienced pediatric sampling experts with Pediatric Allergen profile covering component testing of milk for a-Lactalbumin, B-Lactoglobulin, Casein and BSA (Bovine serum albumin).
 Assay is performed under the direct supervision of highly trained and specialist doctors.
 Lab follows the highest levels of infection control.

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Publisher’s name- Dr. Dangs Lab

References:-

Lopez CM, Yarrarapu SNS, Mendez MD. Food Allergies. [Updated 2022 Mar 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482187/, accessed on 27/05/2022
Food allergy vs. food intolerance: What's the difference? Available at https://www.mayoclinic.org/diseases-conditions/food-allergy/expert-answers/food-allergy/faq-20058538#:~:text=A%20true%20food%20allergy%20affects,and%20causes%20less%20serious%20symptoms., accessed on 27/05/2022
Food Allergies. Available at https://www.fda.gov/food/food-labeling-nutrition/food-allergies#:~:text=This%20law%20identified%20eight%20foods,peanuts%2C%20wheat%2C%20and%20soybeans, accessed on 27/05/2022
Food allergy. Available at https://www.nhs.uk/conditions/food-allergy/symptoms/, accessed on 27/05/2022
Food Allergy and Food Intolerance. Available at https://www.webmd.com/allergies/food-allergyintolerances#:~:text=For%20highly%20allergic%20people%2C%20even,have%20to%20stop%20eating%20it, accessed on 28/05/2022.
Living with Food allergies. Available at https://www.foodallergy.org/resources/common-questions, accessed on 28/05/2022
Smith PK, Hourihane JO, Lieberman P. Risk multipliers for severe food anaphylaxis. World Allergy Organ J. 2015;8(1):30. Published 2015 Nov 24. doi:10.1186/s40413-015-0081-0
Down to Earth. Available at https://www.downtoearth.org.in/news/food-allergies-on-the-rise-43889#:~:text=Some%20estimates%20suggest%20up%20to,may%20have%20peanut%20allergy%20alone.%E2%80%9D, accessed on 28/05/2022
Anaphylaxis. Available at https://www.mayoclinic.org/first-aid/first-aid-anaphylaxis/basics/art-20056608#:~:text=An%20antihistamine%20pill%2C%20such%20as,slowly%20in%20a%20severe%20reaction, accessed on 28/05/2022
Sara Benedé, Ana Belen Blázquez, David Chiang, Leticia Tordesillas, M. Cecilia Berin,The rise of food allergy: Environmental factors and emerging treatments, EBioMedicine, Volume 7, 2016, Pages 27-34, ISSN 2352-3964, (https://doi.org/10.1016/j.ebiom.2016.04.012.)

https://www.sciencedirect.com/science/article/pii/S2352396416301463

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion.