Food Allergy vs. Food Intolerance

Food Allergy vs. Food IntoleranceAs fall approaches many people look forward to the sensational fall colors, outdoor activities, college football, Halloween, and Thanksgiving. But for those who suffer with food allergies, these can be challenging situations. Most of us eat without any thought, other than perhaps wondering what we are going to eat. However, if you suffer from a food allergy, your immune system reacts to a particular protein found in a certain food, and you have to watch what you eat very carefully. If accidentally exposed, symptoms can range from hives to a life-threatening anaphylactic reaction. Symptoms can even occur when coming in contact with just a minuscule amount of the food.

Many food allergies are first diagnosed in children, though they may also appear in older children and adults. Food allergy can strike children and adults alike. While many children outgrow a food allergy, it is also possible for adults to develop allergies to particular foods. Eight foods are responsible for the majority of food allergies:  cow’s milk, eggs, fish, peanuts, shellfish, soy, tree nuts, and wheat.

Food intolerance and food allergy may have similar symptoms. However, it is very important to understand the differences between the two. Food intolerance involves the digestive system; food allergy involves the immune system. With a food allergy, even a microscopic amount of the food can result in life-threatening reactions. People with food allergy must be very careful to avoid their food triggers.

Allergic reactions to food normally occur within minutes of eating the trigger food, though in some patients it may occur a few hours later. Symptoms of a food allergy may include hives or nasal congestion, itchy nose, sneezing or itchy eyes, vomiting, stomach cramps or diarrhea, angioedema (swelling of lips, tongue or throat), or anaphylaxis (a potentially life-threatening reaction).

The proper diagnosis of food allergies is extremely important. Studies have shown that many suspected food allergies are actually caused by other conditions, such as a food intolerance. Skin tests that involve introducing the food allergen into the superficial skin with a plastic device or immunoassays, i.e. blood tests, are utilized to make the diagnosis and to screen for resolution of a food allergy. An oral challenge to a food is sometimes indicated, usually under the care of an allergist/immunologist, to confirm an allergy.

Management of food allergies is multifaceted. The first step to managing your condition is a correct diagnosis and the development of a treatment plan. The foundation of the treatment plan will be to learn about your food allergen, where it is commonly found, and where it can be found unexpectedly, and then strictly avoiding that food. Read food labels to ensure that you don’t eat foods containing foods to which you are allergic. Always ask about ingredients when eating at restaurants or when you are eating foods prepared by family or friends. There is currently no cure for food allergies. There are medicines or treatments to prevent reactions, and fortunately, there is much ongoing research focused on developing ways to overcome food allergies. Some of these should be available over the next few years. Currently there are no FDA-approved treatments for food allergy.

If exposed to your food allergy you must be prepared to treat the reaction. For milder reactions, antihistamines, such as Benadryl®, may help relieve symptoms. For severe allergic reaction, it’s important to have an anaphylaxis action plan and access to epinephrine. Epinephrine should be with these patients at all times and readily accessible. This medicine is for severe reactions and can rapidly treat angioedema, wheezing, shortness of breath, or the vascular compromise seen with some food reactions. If epinephrine is used, the patient should be evaluated in the emergency room and monitored for resolution of the reaction and for a rare recurrence of symptoms hours later, a biphasic reaction.

Always be understanding and accommodating to those who suffer with food allergies. Be very careful when preparing food for them and carefully read all labels. Sadly, many children with food allergy encounter bullying all too frequently. This is intolerable and unacceptable. Hopefully with continued education this behavior will become less and less commonplace.

With accurate diagnosis, education, avoidance measures and development of an action plan, patients with food allergies can also enjoy all that fall has to offer.

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