Food Allergy and Food Intolerance

With all the incredibly devastatingly high pollen counts we have recently had, when the subject of allergy is brought up, most of his focus is on the sneezing and wheezing due to all the stuff in our air that we breathe in.  In my career as an Ear Nose & Throat physician who also practices allergy, most of the focus generally is on testing for allergies to those types of things we inhale.

But of course many of us, particularly children, suffer from allergy or sensitivity to the foods we eat.  In order to treat allergies a doctor has to have experience with food problems.  Before going farther I would like to differentiate true allergy to food to other unpleasant reactions that come from eating the wrong thing. A true allergic reaction is officially categorized as immediate hypersensitivity.  It arises from previous exposure to a certain food, which results in formation of abnormal antibodies.  Once antibodies, in the form of something called IgE, develop, with every subsequent exposure very quickly an allergic reaction occurs.  For foods it can involve wheezing, swelling of the airway and an asthma-like condition.  Unfortunately, it can be very severe.  Most of us have heard about children who may have a peanut allergy, and with even exposure to a minute amount of peanut protein develop severe life-threatening reactions. One study estimated that 32 million Americans, both adults and children have this type of food allergy. At present once the offending food is identified, the only accepted treatment is total avoidance of that food. Some academic hospitals are trying desensitization, like “allergy shots”. Testing for this type of food allergy can be done with either skin prick techniques or blood testing. The blood test looks for that bad antibody, IgE.

Not all food allergy or sensitivity is easy to detect. Multiple studies have indicated adverse reactions to foods such as skin itching or hives, intestinal cramps, muscle aches and headaches exist. It is interesting that some research has pointed to the problem being a reaction to what is normally considered to be the most helpful infection fighting type of antibody, called IgG. Your body makes IgG in response to immunizations such as a tetanus shot. Your body will also create IgG to any type of protein, including those that come from foods. Studies have shown a direct correlation with the health of our intestinal tract and development of food sensitivity. The condition known as “leaky gut syndrome” literally means that proteins in the food we eat leak through the lining of the gut into the bloodstream without breaking down. This results in an abnormal IgG formation causing different types of sensitivity.

Many types of food sensitivity are difficult to diagnose. There are some new and innovative blood tests that help make the diagnosis easier. Unfortunately many insurance companies as well as Medicare consider these tests to be experimental and will not pay for them. Some patients then have to cover the expense themselves.  However, the least expensive type of allergy test can be done at home and it is called Elimination/Challenge. The suspected food is eliminated from the diet for 4 days in adults, 3 days in children then consumed in small quantities. Often the reaction is obvious.

Issues with food allergy and sensitivity can lead to the need for emergency room visits or other emergency care measures such as injection of epinephrine. One source stated that every 3 minutes in the United States a patient goes to the emergency room because of a food allergy reaction.