Food Allergies

If you have food allergies, eating the food you are allergic to can make you sick, possibly with deadly consequences. It is estimated that there are at least 15 million people in the US that suffer from food allergies. This represents 4% of adults and 6% of children and the numbers of food allergy patients rises each year. Food allergies are a social and growing public health concern.

What are symptoms of food allergies?

Symptoms of food allergies range from mild to deadly. Symptoms include itching of mouth and throat, hives, facial swelling, tongue swelling, choking, abdominal pain, nausea, vomiting, diarrhea, coughing, wheezing, eczema, dizziness, fainting, fast heart rate, cardiovascular collapse, anaphylaxis, and death. These symptoms can occur by themselves or more commonly together. Generally, the faster a reaction occurs after eating a food, the more severe it can be. Patients who react to small amounts of foods are more severely allergic. Patients with a history of asthma are more likely to suffer a more severe food allergy reaction.

What is anaphylaxis?

Anaphylaxis is the most serious type of immediate allergic reaction and can occur with food allergies. It is a reaction that occurs quickly after exposure to an allergen and involves at least 2 organ systems.  For example, skin reactions like facial swelling and hives, along with lung reactions like wheezing and coughing, would be regarded as signs of an anaphylactic reaction. Since this type of allergic reaction can be fatal, immediate treatment is required for these patients and this includes the immediate use of an injected epinephrine, like an Epipen. Calling 911 for emergency services or care in an emergency room are needed for treatment of anaphylaxis.

What are causes of food allergies?

Having other allergic conditions like eczema, nasal allergies, and asthma are risk factors for developing food allergies. Common allergic foods are peanuts, tree nuts, eggs, cow's milk, soy, shellfish, fish, and wheat. Allergies to certain foods like peanuts, tree nuts, and shellfish are difficult to "outgrow" for children. Some patients may have an exercise-food reaction, where exercise is required to trigger a food allergy reaction.

How are food allergies evaluated?

Like other allergic diseases, a thorough history and physical exam are required. Bringing in a list of suspected foods can be helpful in the evaluation. All foods that have been known to cause reactions should be included in this list. Allergy tests are very important and can be performed by blood or skin testing. The use of an elimination diet and food diary can be very helpful. The gold standard test for determining if a person is truly food allergic is to perform an oral food challenge. During these challenges a person is given small amounts of the suspected food to determine if the person is allergic to a food or not. This is done in a controlled environment so that immediate reactions can be treated if needed.

How are food allergies treated?

Once the diagnosis of a food allergy is made, we can help you develop a personal treatment plan. The first step is to avoid known food allergens. Avoiding the food can prevent allergic reactions. Eating an allergic food can cause allergies to get worse. Learning to read labels and asking questions about prepared foods is very important. Using a diet diary and possibly an elimination diet can be helpful for treatment and diagnosis. In addition, taking medications on both a daily basis and an emergency basis can be very important, depending on the severity of the allergic reaction. New desensitization drugs for specific foods, such as peanuts, will soon be approved by the FDA.

We can also help with a treatment plan for food allergies when eating out, at work or at school. Taking medications and treating other allergy problems is very important in reducing the risk of a severe allergic reaction. Having access to injectable epinephrine, like an Epipen, is very important for patients with a history of severe allergic food reactions.