Food allergies are a special kind of allergy. They are usually much more severe than a regular pollen allergy. This is likely because the food particle is absorbed into the person’s blood stream where it can trigger a whole-body (“systemic”) reaction. These reactions can be mild but have to potential to be very severe and some people die from eating a food to which they are allergic!
Mild reactions may involve just skin itching or hives. Sometimes there is some mild swelling. More severe reactions involve swelling of the tongue or throat which can block the ability to breathe properly. Sometimes patients have an asthma-like attack or they can pass out due to a sudden fall in blood pressure. In the most severe cases a patient can stop breathing or go into cardiiac arrest due to the severe reaction.
Food reactions must always be taken very seriously! A reaction can look very mild at first but quickly progress to a very severe reaction. Always treat food reactions quickly and aggressively!
- Food allergies are diagnosed much like regular allergies. A skin test can be done where small amounts of the foods in question are applied to the skin and a small skin reaction develops if an allergy is present. Due to the higher risk of a reaction with food skin testing sometimes a blood test is done that can give similar information.
- Food testing however is typically less accurate than the pollen, pet and mold testing done for regular allergies. Sometimes the testing will look like the patient is positive to a specific food even though they can eat it with having any symptoms.
- Because of this a food allergy can never be diagnosed based on a test result alone! Many patients show up in our clinic labeled with multiple “food allergies” based on a test result even though they have never actually had an allergic reaction!
- If there is any doubt about the accuracy of a test then the ultimate test is a food challenge. In this situation a patient is slowly and carefully fed small amounts of the food in question to see if an actual reaction develops. If the food is eaten without symptoms then a food allergy does not exist. If a reaction does develop it is typically mild due to the very small amount of food eaten and any symptoms can be treated in the clinic.
There is no cure for food allergies at this time. The only effective plan is to avoid the food that triggers a reaction. This can be difficult due to hidden ingredients and accidental ingestions.
All patients with a food allergy should carry injectable epinephrine (EpiPen or Auvi-Q) to quickly treat any significant symptoms triggered by a food ingestion. These devices need to be carried everywhere because a reaction can happen at any time.
Patient who only have very mild symptoms can often use Benadryl or another antihistamine but epinephrine should always be available in case a more severe reaction develops unexpectedly.
Researchers are constantly working on ways to build up a patient’s tolerance to their food allergy and reduce the likelihood of a severe or fatal reaction. These methods have shown some promise but are not felt to be quite ready for regular use at this time.
The next several years appear to hold great promise for food allergy sufferers!