Food allergies occur most often in babies and children but can
appear at any age. Foods that you have eaten for years without problems
can cause allergies.
An allergy occurs when something causes your body’s natural defenses
to overreact. Some 40 to 50 million Americans have an allergy of some
kind, but food allergies are rare. Up to 4 percent of adults have food
allergies.
Here are some answers to common questions about food allergy.
What Are the Symptoms of Food Allergy?
In some people, an allergy can start within minutes of eating a
food. In others, the reaction may not start for several hours.
Reactions can be mild, such as a runny nose and sneezing, or very
severe, such as swelling of the throat or tongue, wheezing, or drop in
blood pressure.
The most common symptoms of food allergy are:
- Skin rashes: hives (itchy, red blotches on the skin) and eczema (an itchy, oozy rash)
- Intestinal problems: vomiting, nausea, stomach cramps, indigestion and diarrhea.
Other common symptoms are:
- Itchy, stuffy, runny nose and sneezing
- Swelling of the tongue, lips or throat
- Asthma (difficulty in breathing), with cough or wheezing
- Rarely, a severe allergic reaction (anaphylaxis) can be life threatening.
Sometimes bad reactions to foods are not caused by allergy. Eight
percent of children under age 6 have bad reactions to the foods they
eat, but only 2 percent to 5 percent actually have a food allergy. Some
people have bad reactions to cow’s milk that are not allergies. These
reactions are sometimes mistaken for a food allergy. A doctor or an
allergist can find out if your reaction is caused by a food allergy.
What Causes Allergy Symptoms?
The body’s natural defense network is called the immune system. It
keeps you healthy by fighting off infections and other dangers to good
health. Most people have no problem eating many kinds of foods. An
allergic reaction occurs when the immune system attacks a specific food
or something in a food by mistake. This battle causes:
- Blood vessels to swell up,
- Smooth muscles to contract, and
- Skin areas to become red, itchy and swollen.
Why Do I Have Food Allergy?
If both your parents have allergies, you have about a 75 percent
chance of being allergic. If one of your parents is allergic, or if one
of your relatives from either side has allergies, you have a 30 percent
to 40 percent chance of having some form of allergy yourself. If
neither parent has allergy, the chance is only 10 percent to 15
percent.
The amounts of a food or a kind of food you eat, and how often you eat, it may be important to why you become food allergic.
Which Foods Are Most Likely to Cause Allergy?
The most common foods causing allergies are:
- Eggs
- Cow’s milk
- Peanuts
- Soy
- Wheat
- Tree nuts
- Fish and shellfish.
Almost any food can start an allergy. Foods most likely to cause a severe allergy are peanuts, tree nuts and shellfish.
Someone allergic to a food may also react to related foods. A person
allergic to walnuts may also react to pecans. Persons allergic to
shrimp also may react to crab and lobster. A person allergic to peanuts
may have problems with soy, peas or certain kinds of beans.
Most food allergy patients only react to one or two foods. Someone
allergic to pecans may not have to stop eating all nuts. This should be
discussed with your allergist.
How Do Allergists Tell Which Foods Make Me Sick?
Some people know exactly what food causes their allergy. They eat
peanuts or a product with peanut in it and immediately break out in a
rash. Others need a doctor’s help in finding the cause. Sometimes, the
symptoms show up many hours after they have eaten the food.
Your allergy treatment will typically begin with a complete medical history. Your allergist will ask you about:
- The symptoms you have after eating the food
- How long after eating the food these symptoms occur
- How much of the food you had
- How often has the reaction occurred
- What type of medical treatment, if any, you had.
The medical history will also include questions about your diet,
your family's medical history, and your home and living area.
Your allergist asks these questions to find out what is causing your
allergy or making your symptoms worse. Allergy to pollen in the air,
such as ragweed pollen, can be the cause of the swelling or itching in
your mouth and throat if you eat certain foods like melons.
What Is Allergy Testing?
Your allergist may recommend allergy tests. This may include skin
testing. In an allergy skin test, a very small drop of a liquid food
extract, one for each food, is placed on the skin. The skin is then
lightly pricked. This is safe and generally not painful. Within 15 to
20 minutes, a raised bump with redness around it, similar to a mosquito
bite, may appear. It shows that you are probably allergic to that food.
Sometimes, an allergy blood test may be used. The blood test
generally costs more than skin testing. The results are usually not
ready for one to two weeks.
If done right, skin tests or blood tests are reliable and can rule
in or out food allergy. Some people do test “allergic” to a food (by
skin or blood testing) and yet have no symptoms when they eat that
food. To confirm test results, your allergist may ask you to do a
challenge test. This means that you have to eat or drink small portions
of a food in increasing amounts over a period of time to see if an
allergic reaction occurs. This is usually done under a physician’s
supervision.
Can Special Diets Help Pinpoint the Problem?
Your allergist may narrow the search for foods causing allergies by
placing you on a special diet. You may be asked to keep a daily food
diary. It lists all food you eat and medication you take, along with
your symptoms for the day.
If only one or two foods seem to cause allergies, you may try
avoiding them. In this diet, you do not eat the suspect food at all for
one to two weeks. If the allergic symptoms decrease during that period
and flare up when you eat the food again, it is very likely the food
causing your allergy.
However, which food you should avoid (and for how long) and when you
should eat the food again (if ever) should be decided together with
your allergist. You should never try to eat even a small quantity of
any food you and your allergist have decided against.
Your allergist may want to confirm these diet tests with a challenge test.
Once My Allergy Is Known, How Is It Treated?
Once a food allergy is certain, the best treatment is to avoid the
food. You need to carefully check ingredient labels of food products.
You should learn other names for the food or foods that you and your
doctor think it best to avoid to be sure not to eat them.
When you eat out, you should be extra careful. Waiters (and
sometimes the kitchen staff) may not always know every dish ingredient
on the restaurant’s menu. Sometimes, even walking into a kitchen or an
eatery where food is being prepared can cause a dangerous reaction.
Vapor may carry extremely small particles that can be harmful.
All patients with food allergies must make some changes in the foods
they eat. Your allergist can direct you to helpful resources, such as:
- Special food allergy cookbooks
- Patient support groups
- Registered dietitians
What if I Eat a Food I'm Allergic to?
You need to have a clear plan of action in case you eat a food you
shouldn’t. Place a list of symptoms and your doctor’s instructions for
treatment within easy reach in your kitchen. Medications can be very
useful in treating many early symptoms of mild food allergies.
If you have had severe allergic reactions, you need to know when and
how to give yourself a shot of epinephrine (adrenaline) to treat a
severe reaction. You should go to the hospital or call 9-1-1 and
arrange for follow-up care when the reaction is severe. Bracelets or
necklaces may be worn to quickly alert medical personnel or other
caretakers about food allergies.
Will I Ever Be Able to Eat These Foods Again?
Over time, allergies to cow’s milk, eggs and soy may disappear.
Allergies to peanuts, tree nuts, fish and shellfish typically last a
lifetime. About one-third of children and adults who had food allergies
at some point are eventually free from food allergies after very
carefully avoiding the foods.
After you have avoided foods causing allergies for at least six
months, your allergist may want to run a test, under observation, to
see if you are cured. If you have no reaction and can eat a normal
portion of the food, you will be able to start eating the food again if
you wish. If any allergy symptoms occur, you should continue to avoid
the foods.
Once you have had a severe, sudden, life-threatening reaction to a
certain food you may be advised to never again eat this food. In some
very allergic persons, a very small quantity of a food can produce a
life-threatening reaction.
By using caution and carefully following an allergist’s advice, you
can bring food allergy under control. Please contact your allergist
with further questions and concerns about food allergy.
Last.Update: June 2008
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