Food Allergy Symptoms, Rash, Common List, Testing, Treatment (original) (raw)

What is a food allergy?

Peanuts

Food allergy is not common but can be serious.

Food allergies or food intolerances affect nearly everyone at some point. When people have an unpleasant reaction to something they ate, they often think they have an allergy to the food. However, research shows that only about 3% of adults and 6%-8% of children have clinically proven true allergic reactions to food.

This difference between the prevalence of clinically proven food allergy and the public's perception of the problem is due primarily to misinterpreting food intolerance or other adverse reactions to food as a food allergy. A true food allergy is an abnormal response to food (known as a food allergen) triggered by a specific reaction in the immune system and expressed by certain, often characteristic, symptoms.

Other kinds of reactions to foods that are not food allergies include food intolerances (such as lactose or milk intolerance), food poisoning, and toxic reactions. Food intolerance also is an abnormal response to food, and its symptoms can resemble those of food allergy.

Food intolerance is far more prevalent, occurs in a variety of diseases, and is triggered by several different mechanisms distinct from the immunological reaction responsible for food allergy. People who have food allergies must identify and prevent them because, although usually mild and not severe, these reactions can cause devastating illness and, in rare instances, can be fatal.

What are the most common food allergies?

According to the American Academy of Asthma, Allergy, and Immunology, eight foods are responsible for most food allergies:

In adults, the most common foods that cause allergic reactions are shellfish, such as shrimp, crayfish, lobster, and crab; nuts from trees, such as walnuts; fish; eggs; and peanuts, a legume that is one of the chief foods that cause serious anaphylactic reactions.

In highly allergic people, even minuscule amounts of a food allergen (for example, 1/44,000 of a peanut kernel) can evoke an allergic reaction. Less sensitive people, however, may be able to tolerate small amounts of food to which they are allergic.

In children, the pattern is somewhat different from adults, and the most common foods that cause allergic reactions include:

Children sometimes outgrow their allergies, but adults usually do not lose theirs. Also, children are more likely to outgrow allergies to cow's milk or soy formula than allergies to peanuts, fish, or shrimp.

Adults and children tend to react to the foods they eat more often. For example, in Japan, allergy to rice is more common, and in Scandinavia, allergy to codfish is more common than elsewhere.

What causes allergic reactions to food?

Both heredity and environmental factors may play a role in the development of food allergy. The allergens in food are those ingredients responsible for inciting an allergic reaction. They are proteins that usually resist the heat of cooking, the acid in the stomach, and the intestinal digestive enzymes. As a result, the allergens survive to cross the gastrointestinal lining and enter the bloodstream causing (protein-induced) allergic reactions throughout the body. The mechanism of food allergy involves the immune system and heredity.

What are food allergy risk factors?

Both adults and children may develop food allergies.

Factors that increase one's risk of having a food allergy include the following:

SLIDESHOW The Most Common Food Allergies for Kids and Adults See Slideshow

What are the symptoms of a food allergy?

The complex process of digestion affects the timing, location, and particular symptoms of an allergic reaction to food. All of the symptoms of food allergy occur within a few minutes to an hour of eating.

A food allergy can initially be experienced as itching in the mouth and difficulty swallowing and breathing. Then, during digestion of the food in the stomach and intestines, symptoms such as nausea, vomiting, diarrhea, and abdominal pain can start. The gastrointestinal symptoms of food allergy are those most often confused with the symptoms of different types of food intolerance.

As mentioned previously, the allergens are absorbed and enter the bloodstream. When they reach the skin, allergens can induce hives or eczema, and when they reach the airways, they can cause asthma. As allergens travel through the blood vessels, they can cause lightheadedness, weakness, and anaphylaxis, which is a sudden drop in blood pressure.

Anaphylactic reactions are severe even when they start with mild symptoms, such as a tingling in the mouth and throat or discomfort in the abdomen. They can be fatal if not treated quickly.

What conditions have mistakenly been attributed to food allergy?

Research studies have shown that individuals who are prone to migraines can have their headaches brought on by histamine, which is one of the compounds that mast cells produce in an allergic reaction. The theory that food allergies can cause migraine headaches, however, is unproven.

There is also inadequate scientific research evidence to support the claims that food allergies can cause or aggravate rheumatoid arthritis, osteoarthritis, tension-fatigue syndrome, cerebral allergy (headaches and difficulty concentrating), environmental-toxic reactions, or hyperactivity in children.

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Do infants and children have problems with food allergy?

Most allergies to foods begin in the first or second year of life. While some of these reactions may resolve over time (such as allergies to cow's milk or eggs), other food allergies acquired in infancy (such as allergies to nuts or shellfish) typically persist throughout life. Allergies to milk or soy formula (a milk substitute made from soybeans) sometimes occur in infants and young children. These early allergies sometimes do not involve the usual hives or asthma but rather can cause symptoms in babies resembling infantile colic, and perhaps blood in the stool, or poor growth. The clinical picture of infantile colic, which usually starts within one month of birth, is that of a crying child who sleeps poorly at night. The cause of colic is uncertain.

A variety of psychosocial and dietary factors have been implicated, however, and allergy to milk or soy has been proposed as a cause of colic in a minority of infants with colic.

In infants, food allergy is usually diagnosed by observing the effect of changing the infant's diet; and rarely, by using a food challenge.

Other factors that influence an infant or child's allergy to food include the following:

What is exercise-induced food allergy?

Exercise can induce an allergic reaction to food. The usual scenario is that of a person eating a specific food and then exercising. As they exercise and their body temperature increases, they begin to itch, get lightheaded, and soon develop the characteristic allergic reactions of hives, asthma, abdominal symptoms, and even anaphylaxis (a severe allergic reaction).

This condition has been referred to as food-dependent exercise-induced anaphylaxis (FDEIA) and is most common in teens and young adults. The cure, actually a preventive measure, for exercise-induced food allergy, is simple -- not eating for at least two hours before exercising.

What is cross-reactivity?

Cross-reactivity is the occurrence of allergic reactions to foods or other substances that are chemically or otherwise related to foods known to cause allergy in an individual. If someone has a life-threatening reaction to a certain food, the doctor will counsel that patient to avoid related foods due to possible cross-reactivity, which also might induce the same reaction. For example, if a person has a history of a severe allergy to shrimp, he or she can also possibly be allergic to crab, lobster, and crayfish.

What is oral allergy syndrome?

The oral allergy syndrome is another type of cross-reactivity. This syndrome occurs in highly sensitive people, for example, ragweed or birch pollen. During the seasons that these allergens pollinate, the affected individual may find that when he or she tries to eat fruits, chiefly melons, and apples, a rapid onset of itching is experienced in the mouth and throat, and the fruit cannot be eaten.

The oral allergy syndrome is also known as pollen-food allergy syndrome and is thought to be a type of contact allergy related to the presence of proteins in certain foods that cross-react with allergy-causing pollen proteins.

Oral allergy syndrome occurs in up to 50% of those who have allergic rhinitis caused by pollen.

Symptoms are immediate upon ingestion of fresh or uncooked foods and include:

Cooked fruits and vegetables usually do not cause the reaction. The symptoms usually go away within minutes, although up to 10% of people will develop systemic (body-wide) symptoms, and a small number (1%-2%) may experience anaphylactic shock.

Tree nuts and peanuts tend to cause more severe reactions than other foods.

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What types of healthcare specialists diagnose and treat food allergies?

Allergists (including pediatric allergists) are medical doctors who have had special education and training in the diagnosis and treatment of allergies, including food allergies.

How do healthcare professionals diagnose food allergies?

To diagnose food allergy, a health care professional first must determine if the patient is having an adverse reaction to specific foods. A history of foods consumed and resulting symptoms is key information for the physician in the early stages of diagnosis. The doctor assesses with the help of a detailed history from the patient, the patient's dietary diary, or an elimination diet. The diagnosis is then confirmed by more objective skin tests, blood tests, or food challenges.

Health history usually is the most important diagnostic tool in diagnosing food allergy. The physician interviews the patient to determine if the facts are consistent with a food allergy.

The healthcare professional may ask the following questions:

What skin and blood tests diagnose the causes of food allergies?

What types of diets help diagnose the cause of food allergies?

If the patient's history, dietary diary, or elimination diet suggests that a specific food allergy is likely, the doctor then will use tests, such as skin tests, blood tests, and a food challenge, which can more objectively confirm an allergic response to food.

What is the oral food challenge used to diagnose food allergies?

The double-blind food challenge has become the gold standard for objective allergy testing. (Some physicians prefer the term double-masked, rather than double-blind.)

IMAGES Food Allergy See pictures of allergic skin disorders such as eczema, contact dermatitis and more caused by allergies See Images

What are food allergy treatments?

Treatment for food allergies may include the following:

What is the prognosis (outlook) for food allergy?

Avoidance of the trigger food is the primary treatment for food allergy. The outlook is excellent for those who can avoid consuming the allergen and who remain prepared to treat a severe allergic reaction such as anaphylaxis. There are no long-term complications associated with food allergy, other than the risk for severe reactions.

What are complications of food allergies?

The most serious complication is the development of a life-threatening anaphylactic reaction.

Anaphylaxis is a severe allergic reaction that can be life-threatening. If you have any of the following symptoms of anaphylaxis, call 9-1-1 to go to a hospital's emergency department immediately (If you carry an epinephrine auto-injector shot with you, use it while awaiting the medical team to arrive):

Are allergy shots effective in preventing or decreasing food allergy?

Allergy shots, a form of treatment known as immunotherapy, involve injecting small quantities of substances to which the patient is allergic. The shots are given regularly for a long time to desensitize the patient or get the patient to tolerate the allergen without developing symptoms. This type of therapy is effective in controlling symptoms of allergies related to hay fever, indoor allergens, and insect stings. Researchers have not yet proven that these shots can prevent any allergic reactions to food.

What research is being done on food allergies?

Research is ongoing in many areas of food allergy. Food Allergy Research and Education (FARE) is an organization that awards research grants to investigators who are studying questions such as who gets food allergies and the possible role of factors including diet, hygiene, geography, ethnicity, and others in causing food allergy. FARE also has resources and education for families and patients suffering from food allergies.

Food allergy is caused by immune reactions to foods, sometimes in individuals or families predisposed to allergies. Several foods, especially shellfish, milk, eggs, peanuts, and fruit can cause allergic reactions (notably hives, asthma, abdominal symptoms, lightheadedness, and anaphylaxis) in adults or children. When a food allergy is suspected, a medical evaluation is the key to proper management.

It is important to distinguish a true food allergy from other abnormal responses to food, that is, food intolerances, which are far more common than food allergy. Once the diagnosis of food allergy is made (primarily by the medical history) and the allergen is identified (usually by skin tests), the treatment is to avoid the offending food.

People with food allergies should work with their physicians and become knowledgeable about allergies and how they are diagnosed and treated.

What is histamine toxicity? Is it a type of food allergy?

Many conditions can mimic food allergies. It is critical to distinguish true food allergy from other abnormal responses to food, that is, from food intolerance, which can occur in a variety of other illnesses, or food poisoning, which occurs when contaminated food is ingested. If a patient says to the doctor, "I think I have a food allergy," the doctor has to consider several diagnoses.

The possibilities include not only food allergy but also any other diseases that have symptoms brought on by food. These include reactions to certain chemicals in food for example, histamine or food additives, food poisoning, several other gastrointestinal diseases, and psychological symptoms.

Are food poisoning and food allergies the same condition? Is lactose deficiency a food allergy?

Medically Reviewed on 12/27/2023

References

American Academy of Allergy Asthma & Immunology. "Food Allergy." <https://www.aaaai.org/conditions-and-treatments/allergies/food-allergies>.

Food Allergy Research & Education. <https://www.foodallergy.org/home>.

Sicherer, S. H., et al. "Food Allergies." Medscape.com. 27 Jul 2015.

American Academy of Asthma and Immunology: "Food Allergy."

American College of Allergy, Asthma, and Immunology: "Allergies 101," "Food Allergy," "Hives."

Food Allergy Research and Education: "Recognizing and Treating Reaction Symptoms."

GI Society: "Food Allergy vs. Intolerance: Know the Difference."

Johns Hopkins Medicine: "Allergies and the Immune System."

Medscape: "diphenhydramine," "Food Allergies Workup."

National Eczema Association: "Ask the Ecz-perts: Food Allergies," "Everything you need to know about eczema and food allergies."

Seattle Children's Hospital: "Food Allergy."

Texas A&M Health: "Food allergy: Symptoms and types."

U.S. Department of Health and Human Services Office on Women's Health: "Food allergies."

World Allergy Organization: "Angioedema," "Food Allergy."