Food Allergy and Intolerance
What are food allergies?
Food allergies are unusual immune responses to certain food exposures. Usually, food allergies are connected to an immune cell called immunoglobulin E. Even tiny amounts of the food can cause severe reactions. These reactions are rare and unpredictable. They have the potential to progress to a serious or life-threatening reaction called anaphylaxis. The six most common food allergens in the United States are dairy, wheat, eggs, nuts, soy and shellfish.
What is food intolerance?
Food intolerance refers to difficulty digesting or metabolizing a particular food. Food intolerances are not immunologic allergies and do not carry the same risk. The amount of food ingested is directly related to the severity of symptoms. The food causes similar symptoms with each exposure. Food intolerance is common and occurs in 15 to 20 percent of the population. Food intolerances are even more common among patients with irritable bowel syndrome. Lactose intolerance is a common example of a food intolerance.
What are the differences between food allergies and food sensitivities?
| Food Intolerance | Food Allergy | |
|---|---|---|
| Development | Develops at any age | Develops in infancy |
| Frequency | Very Common | Rare |
| Symptoms | Chronic fatigue, weight gain, stubborn weight loss, acne, migraines, bloating, gas, diarrhea, brain fog | Hives, shortness of breath, itching, rash, swelling, tingling, nausea, vomiting |
| Timing of Symptoms | Delayed response, up to 72 hours after consumption | Immediately to a couple hours after consumption |
| Common Allergens | Carbohydrates, Wheat (Gluten), Dairy, Fruit, Vegetables | Peanuts, Soy, Fish/Shellfish, Dairy, Wheat, Eggs |
How do you diagnose food allergies?
Skin prick testing and other blood testing are available to evaluate for food allergies. These are accurate tests. They are often administered by an allergist/immunologist.
How do you diagnose food intolerance?
There are many commercial tests available that claim to identify which foods a person might be intolerant to. These tests are either unproven or have been disproven.
These tests include:
- Immunoglobulin G (IgG) food tests
- Antigen leukocyte antibody testing (ALCAT)
- Intradermal or sublingual provocation
- Hair analysis
- Electrodermal testing
- Kinesiology
These tests lack biologic plausibility. For example, the presence of a specific IgG to a certain food is a marker of tolerance to that food and is normal. There are currently no reliable tests available to diagnose food intolerance. An elimination diet is the most reasonable approach to evaluating for food intolerance.
How can you treat food allergies and intolerance?
The primary way to manage both food allergies and intolerance is to avoid consuming the food that causes you problems. Carefully check ingredient labels of food products, and learn whether what you need to avoid is known by other names. A dietitian or a nutritionist may be able to help. Food allergies, but not food intolerance, may require emergency injection of epinephrine and a trip to the emergency room.
Our experienced team of physicians and advanced practice providers at Associates in Gastroenterology can help you with your concerns, questions and management of all aspects of gastrointestinal and liver disease. We would love to be your gastroenterology practice. Please schedule an appointment either by calling us (719-635-7321) or by clicking here.
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