Introduction
- Food allergy is an immune system reaction triggered by specific foods. Even a small amount of the allergenic food can cause symptoms, ranging from mild to life-threatening.
- Common allergens include nuts, shellfish, dairy, eggs, wheat, and soy.
- Management involves strict avoidance of allergens, early recognition of symptoms, and prompt treatment.
Causes of Food Allergy
- Immune System Reaction
- The immune system mistakenly identifies certain proteins in food as harmful, triggering an allergic response.
- Genetic Factors
- Family history of allergies increases risk.
- Common Allergens
- Tree Nuts: Almonds, walnuts, pecans.
- Peanuts: Legumes but act as allergens.
- Shellfish: Shrimp, crab, lobster.
- Dairy Products: Cow’s milk and derivatives.
- Eggs: Especially egg whites.
- Wheat and Soy: Common in children, often outgrown.
Symptoms of Food Allergy
- Mild Symptoms
- Skin reactions: Hives, redness, or itching.
- Gastrointestinal discomfort: Nausea, vomiting, diarrhea, or abdominal pain.
- Nasal symptoms: Sneezing, runny nose, or nasal congestion.
- Moderate Symptoms
- Swelling of lips, tongue, or face.
- Coughing, wheezing, or difficulty breathing.
- Severe Symptoms (Anaphylaxis)
- Rapid pulse, drop in blood pressure, or dizziness.
- Tightness in the throat or airway obstruction.
- Loss of consciousness.
Complications of Food Allergy
- Anaphylaxis: A life-threatening allergic reaction requiring immediate medical attention.
- Growth Impairment: In children, due to restricted diets and malnutrition.
- Social and Emotional Impact: Anxiety about accidental exposure.
Diagnosis of Food Allergy
- Medical History
- Detailed review of symptoms, timing, and suspected foods.
- Skin Prick Test (SPT)
- Small amounts of allergens are introduced into the skin to observe for reactions.
- Blood Tests
- Measures IgE antibodies specific to certain allergens.
- Oral Food Challenge
- Controlled ingestion of suspected allergen under medical supervision.
- Elimination Diet
- Gradual removal and reintroduction of specific foods to identify triggers.
Treatment Options for Food Allergy
1. Immediate Treatment for Allergic Reactions
Medication | Brand Name | Manufacturer | Cost Range |
---|---|---|---|
Epinephrine Auto-Injectors | EpiPen, Auvi-Q | Mylan, Kaléo | $300–$600 per twin pack |
Antihistamines | Benadryl, Zyrtec | Johnson & Johnson, GSK | $10–$20 per bottle |
Bronchodilators | Ventolin, ProAir | GSK, Teva | $30–$50 per inhaler |
- Epinephrine is the first-line treatment for anaphylaxis. Always carry an auto-injector if prescribed.
- Antihistamines and bronchodilators manage mild to moderate symptoms but are not substitutes for epinephrine in severe reactions.
2. Long-Term Management
- Avoidance of Allergen
- Read food labels carefully for hidden allergens.
- Educate caregivers, teachers, and friends about allergy management.
- Oral Immunotherapy (OIT)
- Gradual exposure to small amounts of the allergen under medical supervision to build tolerance.
- Desensitization Therapy
- Involves controlled allergen exposure to reduce severity of reactions over time.
3. Dietary Support
- Substitute Foods
- Dairy alternatives: Almond, soy, or oat milk.
- Gluten-free products for wheat allergy.
- Nutritional Counseling
- Ensures balanced nutrition, especially in children.
Monitoring Parameters
- Track frequency and severity of allergic reactions.
- Ensure epinephrine auto-injectors are always accessible and unexpired.
- Regular follow-ups with an allergist to reassess triggers and treatment.
Patient Counseling Points
- Educate on early recognition of symptoms, especially anaphylaxis.
- Demonstrate proper use of epinephrine auto-injectors.
- Discuss cross-reactivity (e.g., peanuts and tree nuts).
- Encourage wearing medical alert bracelets for severe allergies.
- Stress the importance of avoiding allergens, even in trace amounts.
Use in Children
- Ensure caregivers and schools are trained to manage allergic reactions.
Use in Pregnancy
- Food allergies may persist, but management remains similar; epinephrine is safe for use in anaphylaxis.
Use in Elderly
- Monitor for delayed reactions or interactions with other medications.
FAQs About Food Allergy
Q1: What causes food allergies?
- Overreaction of the immune system to specific proteins in foods.
Q2: Can food allergies be cured?
- No, but symptoms can be managed; immunotherapy may reduce severity.
Q3: What is anaphylaxis?
- A severe, life-threatening allergic reaction requiring immediate epinephrine administration.
Q4: How are food allergies diagnosed?
- Through history, skin prick tests, blood tests, or oral food challenges.
Q5: Are food allergies hereditary?
- Yes, a family history of allergies increases risk.
Q6: Can children outgrow food allergies?
- Yes, especially to milk, eggs, and soy. Peanut and tree nut allergies are less commonly outgrown.
Q7: What foods should I avoid with a peanut allergy?
- Peanuts and foods with hidden peanut ingredients like sauces or desserts.
Q8: How can cross-contamination be avoided?
- Use separate utensils and cooking equipment for allergen-free foods.
Q9: Is it safe to eat processed foods with food allergies?
- Only if labels confirm no allergen presence or contamination.
Q10: Can stress worsen food allergies?
- Stress does not cause allergies but may exacerbate reactions.
Q11: Is lactose intolerance a food allergy?
- No, it is a digestive issue, not an immune response.
Q12: Can I reintroduce allergens into my diet?
- Only under medical supervision, such as during an oral food challenge.
Q13: How do I store epinephrine auto-injectors?
- Keep at room temperature and replace before expiration.
Q14: Can food allergies develop later in life?
- Yes, adult-onset allergies can occur.
Q15: Are all reactions immediate?
- Most are immediate, but some (e.g., alpha-gal syndrome) have delayed onset.