Food reactions can be easily misdiagnosed
A food allergy is a particular type of immune system reaction to an ingredient or component of a food, usually a protein. The most common foods that cause allergies are milk, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish.
The body creates antibodies to keep out foreign substances, such as proteins. An allergen from food meets up with antibodies in blood cells, which are called mast cells. These mast cells lie in wait in the eyes, nose, sinuses, lung and gastrointestinal tracts, and in the skin, all the places that go crazy when you’re having a bad reaction. When summoned, mast cells trigger chemical fighters such as histamines, which create defensive changes in muscles, tissues, glands to rid the unwanted visitor.
So if you start itching, sneezing, cramping, vomiting, having hives, or experiencing shortness of breath, it’s a sign that your body is battling an unwelcome invader. No wonder you feel awful!
But few people have true food allergies. The more common food intolerance is an adverse reaction to a food substance or additive that involves digesting or break food down but does not involve the immune system. Lactose intolerance is an example, occurring when a person lacks the enzyme needed to digest milk sugar.
Food idiosyncrasy is an abnormal response to a food or food substance that brings on symptoms similar to food allergies. Sulfite sensitivity is one example of this. Sulfites are used to preserve many foods, including wine. The burning feeling you get when eating spicy food is another response, a chemical food reaction that doesn’t involve the immune system.
Even a reaction to a histamine-type substance in chocolate can be misdiagnosed as a food allergy. Notes Dr. Ronald Simon, head of the allergy department at Scripps Clinic, a prestigious research hospital in San Diego, “When you eat chocolate, it’s like you’re eating a little bit of histamine. Some people are more sensitive to [substances like histamines], and they get allergy-like symptoms.”
ANAPHYLACTIC SHOCK
Nearly 1,000 food-induced anaphylactic reactions occur each year in the United States, requiring immediate emergency care. Anaphylaxis is a rare but potentially deadly reaction when several parts of the body have a severe reaction to a food, usually including severe swelling of the skin and throat. Breathing can be difficult or impossible. Blood pressure drops, and the person may lose consciousness.
PEANUT ALLERGY
Peanuts appear to cause most episodes of anaphylaxis. In June 1999 a major cookie manufacturer had a nationwide recall when peanuts accidentally slipped into the batter.
Arlene Chang knows exactly what a severe food reaction is. Her 16-month-old son Tyler is violently allergic to peanut butter: “His face just started to turn red, from the chin up. Within ten minutes, half his face was red and bumpy, full of hives.”
Unlike most food allergies, peanut allergy is rarely outgrown. Peanuts or peanut butter may be used in candy, biscuits, pastry, chili, spaghetti sauce, and even egg rolls, often as filler. Cross-contamination occur during preparation if a mixing bowl isn’t properly washed. It only takes a few bits of peanut to trigger a life-threatening reaction in those with peanut hypersensitivity.
SEAFOOD AND FISH
A quarter of a million Americans are allergic to seafood or fish. A partial list of seafood people are allergic to includes shrimp, crab, crayfish, lobster, oysters, scallops, and squid. Fish that cause reactions include swordfish, tuna, cod, salmon, bass, herring, sardines, and orange roughy.
But the problem might not be the food itself. Seafood and fish in the process of spoiling contain histamines, causing allergy-like symptoms like hives. This is actually a case of food poisoning. Make sure the seafood and fish you eat are fresh. For more information on seafood safety, see Healthsurfing.com’s report on Fish and Seafood Safety.
TESTING
Testing can determine if an allergy exists and if it does, its exact nature. There is no reason to restrain from eating all seafood, for example, if you’re only allergic to shrimp. An allergist will take a medical history and diet inventory.
Skin testing may be required to pinpoint the allergy. A small amount of an allergen is poked into the skin to see if a reaction (usually a small bump) occurs. Antihistamines, some anti-depressants, heartburn and sleeping medications can interfere with testing and therefore need to be temporarily stopped 2 days to 6 weeks before the test. Secondary testing is sometimes done to rule out the possibility of a false negative.
Allergy shots may be administered to gradually build up resistance to particular allergens so that future contact won’t trigger such dramatic reaction.
FEEDING THE BABY
Sometimes, it’s a good idea to delay the introduction of solid foods to your baby. If your family has a history of food allergies, it may be a good idea to wait until her/his system is more mature. Rice or oat can be better cereal choices than wheat. Gradual introduction helps in isolating allergies.
Bloating, gas, rash, diarrhea, runny eyes or nose, or unusual crankiness are signs that the baby may be allergic to a new food. Egg whites and cow’s milk are generally withheld, sometimes even until the first birthday, because many babies tend to be allergic to them. It can take trial and error, so parent and doctor need to work together with withdrawal of a food for a week or so then reintroduction to see if the reaction returns. Later your baby may have outgrown the allergy; they usually do.
GUARDING FOR AN EMERGENCY
See a board-certified allergist if you suspect you or your child has a food allergy. Get tested.
Avoid the foods that cause your food allergy. It sounds simple, but the whole world of food can be threatening to the person with a severe food allergy. Practice good habits to reduce the risks.
A person with a food allergy has to closely monitor food preparation, especially when eating in restaurants. Discuss your food allergy with the waiter. Talking to the manager or the chef can emphasize your point, so that nothing is lost in the translation from order to preparation.
Read labels on food products closely. Food manufacturers change their additives occasionally, so it’s important to routinely re-read the labels as a precaution.
Tell your world about your food allergy. Parents need to discuss child’s food allergy with teachers, school nurses, and cafeteria managers or food planners. Allergies should be highlighted in a child’s health records at school and at the doctor’s office in case a severe reaction occurs and information is needed right away. When traveling alone or on a special field trip away from the regular care providers, this information should accompany the child. A bracelet ID can show this information.
The drug epinephrine (a form of adrenaline) can be self-administered or given by a parent or friend when anaphylactic shock occurs. This may save your life or your child’s by buying enough time to get to a hospital. Kits are available for easy carrying in a bag or purse.
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