What to Know About Food Allergies

What Are Food Allergies?

Food allergies occur when a person’s immune system overreacts to a protein found in food. Symptoms can occur with even the tiniest amount of protein. Most often food allergies are diagnosed in young children but can also appear in older children and adults. For every 13 children, one suffers from a food allergy.

What Are The Most Common Foods That Cause Allergies?

Nine foods are responsible for 90% of food allergies. These include cow’s milk, soy, egg, peanuts, tree nuts, sesame, fish, and shellfish.

What Are Some Common Symptoms Of Food Allergies?

Patients can experience hives, itching, stuffy or runny nose, sneezing, watery eyes, vomiting, diarrhea, abdominal cramping, facial swelling, throat tightness, or wheezing. Reactions can be severe and life-threatening, involving multiple symptoms, often referred to as anaphylaxis. These reactions require action, such as using epinephrine, calling 911, or going to the emergency room. Symptoms usually occur within minutes to an hour, though there are exceptions.

How Are Food Allergies Diagnosed?

Proper diagnosis of food allergies is extremely important. This includes a good history and a positive skin test and/or blood test. A food challenge, under the care of an allergist, may be needed. Many suspected food allergies are actual food intolerances, or digestive issues, such as the case of lactose intolerance presenting with isolated abdominal symptoms. Many patients coming to us, who’ve had their lab work or skin testing done by non-allergy physicians, are overly anxious about the results and may be avoiding foods unnecessarily. Other food allergy symptoms may present with an itchy mouth, as in oral allergy syndrome, caused by cross-reacting allergens found in pollen and fruits, vegetables, or nuts. Eosinophilic esophagitis (an inflammation of the esophagus triggered by foods) may present with swallowing difficulties and FPIES (food protein induced enterocolitis syndrome) mainly occurs in infants with severe vomiting and diarrhea. An allergy specialist, like myself, can make these distinctions.

How Can Food Allergies Be Managed?

A proper diagnosis with an allergist is the key. Avoidance, reading food labels, carrying epinephrine for emergencies, having an anaphylaxis treatment plan for school have been the standards of care. Some children outgrow food allergies, and proper education, reassurance from the allergist, and yearly monitoring are sufficient. Less than 10% of allergy practices offer OIT (oral immunotherapy) for food allergies, and The Woodlands Allergy, Asthma & Immunology Center is one of those practices. Through OIT, patients are desensitized with gradual, step-wise food introduction. The process takes about 9-12 months, with visits generally done twice a month for food “updoses.” At about one year, patients can typically consume a serving size of food (depending on their age) such as one egg or eight peanuts. OIT has been the most rewarding part of my practice. It is gratifying to see children or adults with anaphylaxis to food, such as peanuts or egg, now eating those foods safely, remaining tolerant, able to eat out and travel without fear.