Nutrition For Life

How is food allergy diagnosed?

To diagnose food allergy, a doctor first must determine if the patient is having an adverse reaction to specific foods. The doctor makes this assessment with the help of a detailed history from the patient, the patient’s dietary diary, or an elimination diet. He or she then confirms the diagnosis by the more objective skin tests, blood tests, or food challenges.

History: The history usually is the most important diagnostic tool. The physician interviews the patient to determine if the facts are consistent with a food allergy. The doctor may ask the following questions:

* What was the timing of the reaction? Did the reaction come on quickly, usually within an hour after eating the food?

* Was treatment for allergy successful? For example, if hives stem from a food allergy, antihistamines should relieve them.

* Is the reaction always associated with a certain food?

* Did anyone else get sick? For example, if the person has eaten fish contaminated with histamine, everyone who ate the fish should be sick. In an allergic reaction, however, only the person allergic to the fish becomes ill.

* How much did the patient eat before experiencing a reaction? The severity of the patient’s reaction can sometimes relate to the amount of the suspect food eaten.

* How was the food prepared? Some people will have a violent allergic reaction only to raw or undercooked fish. A thorough cooking of the fish destroys those allergens in the fish to which they react, so that they then can eat it with no allergic reaction.

* Were other foods eaten at the same time as the food that caused the allergic reaction? Fatty foods can delay digestion and thus delay the onset of the allergic reaction. Read more…

How do allergic reactions to food occur?

The allergens in food are those components that are responsible for inciting an allergic reaction. They are proteins that usually resist the heat of cooking, the acid in the stomach, and the intestinal digestive enzymes. As a result, the allergens survive to cross the gastrointestinal lining, enter the bloodstream, and go to target organs, causing allergic reactions throughout the body. The mechanism of food allergy involves the immune system and heredity.

Immune system: An allergic reaction to food involves two components of the immune system. One component is a type of protein, an antibody called immunoglobulin E (IgE), which circulates through the blood. The other is the mast cell, a specialized cell that is found in all tissues of the body. The mast cell is especially common, however, in areas of the body that are typical sites of allergic reactions, including the nose and throat, lungs, skin, and gastrointestinal tract.

Heredity: The tendency of an individual to produce IgE against something seemingly as innocuous as food appears to be inherited. Generally, people with allergies come from families in which allergies are common — not necessarily to food but perhaps allergies to pollen, fur, feathers, or drugs. Thus, a person with two allergic parents is more likely to develop food allergies than someone with one allergic parent.

Mechanism: Food allergy is a hypersensitivity reaction, meaning that before an allergic reaction to an allergen in food can occur, a person needs to have been exposed previously, that is, sensitized, to the food. At the initial exposure, the allergen stimulates lymphocytes (specialized white blood cells) to produce the IgE antibody that is specific for the allergen. This IgE then is released and attaches to the surface of the mast cells in different tissues of the body. The next time the person eats that food, its allergen hones in on the specific IgE antibody on the surface of the mast cells and prompts the cells to release chemicals such as histamine. Depending upon the tissue in which they are released, these chemicals cause the various symptoms of food allergy. Read more…