One speaks of a food allergy or food allergy when the body of the affected person reacts hypersensitively to various foods or foods. This results in allergic reactions with typical signs and symptoms. Abdominal pain, shortness of breath, asthmatic attacks, reddening of the skin, sneezing and continuous rhinitis are particularly charkateristic. Because food allergy can also lead to circulatory shock, a doctor should always be consulted early if suspected.
What is a food allergy?
Food allergy or food allergy is when certain foods or components of food cause an intolerance reaction. This can range from a mild skin rash to a severe allergic shock reaction. However, not all food intolerances belong to the category of allergies. Approximately one third of adults believe they are allergic to a particular food. However, a closer examination reveals that only 2% of adults have a food allergy. The remaining 31% are intolerance triggered by food poisoning, psychological aversion to the food, or food intolerance.
Causes
Compared to the other intolerance reactions, food allergy requires the immune system to be involved in the defensive reaction. A normally harmless component of the food, usually a protein, is seen by the body as a perceived threat and triggers an immunologic counter-reaction. As a result, antibodies and messenger substances such as histamine are produced. They are responsible for the symptoms of allergy such as itching of the skin and eyes, swelling of the mucous membranes of the mouth and nose, runny nose, allergic asthma, nausea or diarrhea. The likelihood of developing a food allergy depends on family history. If one of the parents suffers from an allergy, the child is about twice as likely to develop an allergy as well. If both parents are allergic, the risk even increases to four to six times. Breastfeeding seems to protect against the development of food allergies. Studies show that during the first 4-6 months, breastfed infants have a lower risk of developing allergies than infants fed formula.
Symptoms, complaints, and signs
Food allergies (food allergies) should be distinguished from intolerance to certain foods or their components. The symptoms of both may be similar. Food allergies have clear immunologic evidence. Intolerances to food (ingredients), on the other hand, are due to metabolism. The symptomology of food allergy can be complex. Often allergic reactions take place on the skin or mucous membranes. Possible skin reactions may include extensive redness (exanthema), swelling or wheals, and eczema. In other cases or in addition to skin reactions, reactions in the gastrointestinal tract may occur with food allergy. Unexplained stomach discomfort or diarrhea, abdominal cramps, vomiting, or nausea occur. Possible allergic symptoms may further include a runny nose, swollen airways or watery eyes. Sneezing attacks or hives after eating certain foods may indicate food allergies. In severe cases, shortness of breath or asthma attacks may occur. Any symptoms that occur in the mouth should be taken seriously. Swelling of the lips, tongue or palate with or without itching can be dangerous. In the presence of other allergies, food allergies can be a cross-reaction. In addition, allergic symptoms to food can be exacerbated by stress, exercise, or alcohol. The greatest danger with food allergies is anaphylactic shock. This can lead to death.
Disease progression
The most severe form of complications can occur in food allergy in the form of a severe allergic reaction or even as anaphylactic shock. This is a total circulatory collapse that becomes life-threatening and requires immediate medical treatment.An example of a food that is capable of causing anaphylactic shock is peanut. The most common allergenic foods include nuts, milk, eggs, grains, shellfish, fish, and soy. However, stone fruit, celery and buckwheat also cause allergic reactions in some people. In contrast, in food intolerances, such as lactose intolerance, the immune system remains uninvolved. In lactose intolerance, the intolerance reaction is triggered by the lack of the digestive enzyme lactase. This enzyme is responsible for breaking down the milk sugar. If it is missing, the lactose passes undigested into deeper parts of the intestine, triggering flatulence and diarrhea.
Complications
As a rule, food allergy in any case leads to very unpleasant symptoms. The quality of life of the patients is reduced by this allergy and there are various restrictions in the everyday life of the patient. The affected persons suffer thereby primarily from abdominal pain or stomach ache. Likewise it can come thereby to vomiting or to diarrhea. Not infrequently, a food allergy also leads to an itchy rash on the skin. As long as the affected person abstains from any critical ingredient, the symptoms usually do not occur and there are no particular complications. Thus, the food allergy can be limited relatively well and easily. Furthermore, the food allergy can also lead to a loss of appetite and thus to a loss of weight or to various deficiency symptoms. A direct treatment of the food allergy is usually not possible. The symptoms are limited and reduced by a strict diet. However, a completely positive course of the disease usually results only when the patient abstains from the triggering substance. In most cases, the patient’s life expectancy is not affected or reduced by the food allergy.
When should you go to the doctor?
Food allergy is a relatively common occurrence, but it is not always reason to see a doctor. However, symptoms that appear for the first time should be examined by a doctor and the food allergy diagnosed. Subsequently, however, the visit to the doctor is important only in certain cases. These include allergies whose symptoms are so pronounced that they can become life-threatening. An example of this is patients in whom an allergy to nuts or fruit leads to a local reaction in the mouth and throat. This can trigger swelling that greatly impedes the breathing of the affected person. Anaphylactic shock as a severe complication is also possible, so these patients require consistent medical treatment due to the intensity of their allergy. Allergy sufferers whose digestive tract is massively affected should also talk to a doctor. This may be the case, for example, if cow’s milk protein or the gluten from wheat is not tolerated. These are usually not life-threatening manifestations. However, if the restrictions on quality of life due to weight loss, pain, or bloating become too great and persist, a trip to the doctor is advisable.
Treatment and therapy
Food allergy is diagnosed via a skin test or an oral provocation test. In a skin test, the substance allegedly causing the allergy is introduced into the skin. If an allergy is present, redness, itching and swelling occur at the corresponding site. However, the significance of this test is not one hundred percent reliable. In the oral provocation test, the patient must swallow a capsule containing either the allergenic substance or a placebo. Subjective misperceptions are avoided via the placebo control. However, the allergenic food must be known for this test. In most cases this is not the case. A food exclusion procedure helps to identify the relevant food. In this process, the food in question is removed from the menu for about two weeks. If intolerance reactions occur again when the food is reintroduced, this is a definite indication of the presence of an allergy. Once a diagnosis has been made, however, there are as yet no therapeutic or curative options. Only the avoidance of the respective food protects against a renewed intolerance reaction. It is important to ensure an adequate intake of nutrients despite avoiding the food in question.Thus, in the case of cow’s milk allergy, care should be taken to ensure adequate calcium, vitamin D, and protein intake through alternative foods.
Outlook and prognosis
The prognosis of food allergy is unfavorable. In most cases, an allergic reaction persists throughout life. However, there are various numerous therapeutic approaches and alternative methods that can lead to significant relief and even freedom from symptoms. Depending on the individually existing allergic reactions and triggers of the allergy, an avoidance of the corresponding stimulus can already lead to a permanent relief of the symptoms. Therefore, some sufferers can make a significant contribution to their recovery even without medical treatment. However, most patients experience changes in the irritant substances over their lifespan. Often, the number of foods that cause physical discomfort increases. Therefore, in addition to a regular check-up visit, there should be adequate education about cross-allergies and immediate action. In severe cases, a food allergy can take a fatal course. The more frequently symptoms occur, the more difficult it is to organize one’s life. The psychological resilience increases and secondary diseases threaten. The circumstances described must be taken into account when making an overall prognosis. Close cooperation with the physician is recommended, so that medical treatment can be initiated at any time if complaints and irregularities increase. In some patients, lifelong therapy is necessary to prevent acute situations from developing.
Follow-up
Infants are known to have food allergy usually only until they are seven years old, after which it resolves on its own. Follow-up after recovery is unnecessary because experience has shown that no further symptoms are to be expected. The situation is different in the years before school enrollment. Follow-up care is aimed at preventing complications. Parents are primarily responsible for this. They have to take a number of things into account when choosing food. Above all, allergy triggers should be avoided. Parents should always carry an emergency kit against acute attacks. The attending physician will inform the parents as part of the initial diagnosis. Sometimes participation in nutritional counseling can be useful. Subsequently, the implementation of the nutritional advice is the responsibility of the mother or father. Adults can also suffer from food allergies. For them, however, lifelong follow-up care is usually necessary, since the intolerance reaction does not disappear. The same requirements apply to them as to children. However, they are responsible for avoiding the triggers themselves. Scheduled examinations are usually only common when the health condition worsens. A skin test and a blood test then provide clarity about a change in reaction.
What you can do yourself
The most important thing in the everyday life of affected allergy sufferers is to avoid the relevant foods and their traces. This turns out, depending on the particular food, different difficulties. Thus, a general grain intolerance is more far-reaching than a celery allergy. It is important for those affected to find a diet that is sufficiently balanced, tasty and fulfilling. Avoiding major food groups makes this difficult, but with a little research and a willingness to try new culinary things, a good diet can be found for everyone. Clues can be eating habits from completely different countries, which are often characterized by a completely different food composition. Food allergy sufferers should also always carry an emergency kit with them, as it can never be ruled out that they will come into contact with an allergen. In order to maintain personal well-being, it is not advisable to avoid all large events, etc., because an allergen source could be located somewhere. In a private setting, the person affected by a food allergy can sufficiently inform his or her environment so that consideration is given to this at possible events. In the case of people who generally consider allergies to be imaginary or try to relativize them by referring to small amounts, showing the emergency kit may be sufficient.