Food Allergies

Food allergies are a potentially life-threatening condition and require medical intervention to effectively manage. They may present with symptoms like itching, rashes and throat swelling – potentially even leading to anaphylaxis (a potentially life-threatening allergic reaction).

Food allergies to milk, eggs, wheat and soy usually go away during childhood; however, those to peanuts, tree nuts, fish or shellfish often remain lifelong issues.

What is a food allergy?

Food allergies are serious immune system reactions that can be life-threatening. An allergic response occurs when your body mistakenly recognizes certain food or food ingredients as dangerous and produces antibodies called IgE that attack them, then releases chemicals into your bloodstream that lead to symptoms like hives, swelling of lips and tongue, decreased blood pressure or anaphylaxis (a potentially life-threatening whole-body reaction).

An actual food allergy differs significantly from food intolerances such as lactose intolerance or celiac disease, where symptoms include gas, abdominal cramping and diarrhea. On the contrary, true food allergies can trigger severe, potentially life-threatening reactions within minutes after ingesting certain food products.

Allergists are medical specialists specializing in allergies and immunology. They can help determine whether a suspected food allergy is responsible for your symptoms, providing tests to confirm diagnosis as needed. In some instances, allergists also suggest conducting oral food challenges where small quantities of the suspected allergen are consumed under strict medical supervision to monitor for reactions and identify triggers.

Food allergies may increase if other members of your family already suffer from them or if you suffer from hay fever, eczema, or asthma – three conditions known to increase your chances of food allergies. Food allergies affect people of all ages; however they tend to be more prevalent among children who outgrow them over time.

Symptoms

Food allergy symptoms can range from mild to severe, including life-threatening anaphylaxis that requires immediate treatment with epinephrine. Allergic reactions typically begin within minutes to two hours after eating the offending food and may affect any part of the body – most frequently, eggs, cow’s milk (dairy), peanuts, tree nuts, fish and shellfish are responsible; although any food could potentially trigger an adverse reaction.

Food allergies typically present themselves with symptoms that include tingling or itching in the mouth or throat, swelling of lips, tongue, face or other parts of body and belly pain; additionally, diarrhea, nausea and vomiting may follow as a result. More serious reactions of food allergy can also include wheezing or trouble breathing; swollen eyes; hives; as well as reduced blood pressure levels.

Food allergies can sometimes trigger food protein-induced enterocolitis syndrome (FPIES), characterized by symptoms including steatorrhea and poor weight gain in breastfed infants. Furthermore, this disorder may result in bloody-streaked stool as a medical emergency requiring urgent treatment with IV fluids.

Individuals with food allergies should avoid foods which trigger their symptoms, consult their doctor about whether skin prick testing or medically supervised food challenges are needed to confirm diagnosis, carry an epinephrine autoinjector such as Adrenaclick or EpiPen that can treat life-threatening symptoms, notify their health care team, school personnel and others of their allergy, and ensure that they know what steps should be taken if a severe reaction occurs.

Diagnosis

Food allergies occur when the immune system mistakenly recognizes proteins found in certain food as threats and responds by producing antibodies against it, triggering other systems in the body such as hives or swelling, or worse, anaphylaxis (an immediate whole-body response which leads to difficulty breathing) requiring treatment with injectable epinephrine injection.

Your care team will want to understand which foods trigger your symptoms in order to diagnose a food allergy, ask you about symptoms that occur after consuming suspect foods, discuss family histories of allergies or asthma/eczema and conduct a physical exam as part of the diagnosis process.

Your doctor will investigate other possible conditions that could be the source of your symptoms, such as lactose intolerance or celiac disease (which prevents you from digesting gluten). They may conduct skin or blood tests to test for food-specific antibodies that could be present.

Oral food challenges provide the most accurate way to diagnose allergies. At NY Food Allergy & Wellness, we use Basophil Activation Test (BAT), which offers unsurpassed accuracy in allergy diagnostics allowing us to provide tailored care.

Treatment

Food allergies often necessitate changing one’s diet in order to avoid foods which cause symptoms. Your healthcare provider may suggest skin or blood tests or a medically supervised food challenge test (OIT), whereby small amounts of the offending food will be eaten under close guidance from healthcare provider.

OIT involves starting with very small doses of food allergens and gradually increasing them over months to desensitize you to them. You should work closely with an experienced allergist when undertaking this procedure. Researchers supported by NIAID are also working on sublingual immunotherapy (SLIT), in which you put liquid or tablets under your tongue to treat your allergy symptoms.

Your doctor may suggest carrying an auto-injector such as EpiPen or Auvi-Q with you at all times for use at the first sign of a severe allergic reaction. They may also provide medications to relieve symptoms and prevent reactions, such as antihistamines.

People with food allergies should learn how to read food labels and prepare their own meals at home with care to avoid contamination from harmful sources, while being careful when dining out as waiters and kitchen staff may not always know about the ingredients of dishes they prepare or serve. A new diagnosis should prompt a thorough cleaning out of pantry and refrigerator in order to eliminate potential allergens from your home, while those sharing kitchens should consult their doctor regarding using dedicated cutting boards and utensils specifically for them to reduce cross-contact.