Information and advice for patients with food allergiesAdverse reactions caused after eating certain foods can be divided into two main groups: those characterized food intolerance and others who represent the food allergy.Food intolerance reactions may be due either to characteristics of the food (eg, pharmacological actions of substances contained in food, such actions of histamine, tyramine, caffeine, or toxic substances may be present in food), or to particular features of person who consumes the food (eg, presence of metabolic disease, pancreatic and liver failure or insufficiency of the enzyme lactase as a result of intolerance to dairy, etc).In contrast, allergic reactions to foods are hypersensitivity reactions caused by immunological mechanisms.
Although 25% of the population considers that it has an allergy to one or more food, real food allergy has 2.5% of adults and 6-8% of children younger than 6 years. The others are food intolerance reaction, which, as mentioned, does not involve immunological mechanisms.Any food can potentially cause sensitization and therefore food allergy, but usually the foods that cause allergic reactions are specific. In fact 90% of allergic reactions caused by the following 8 groups of foods: egg, milk, wheat, soy, nuts, fish, seafood and some fruits. Moreover, depending on the patient's age and vary the type of food that can cause food allergy. Thus, milk and egg are important allergens for children, while only rarely implicated in food allergy in adults.Many foods that are similar chemicals can exhibit cross-sensitivity between them. This means that patients with food allergy to a food should avoid foods and other cross-sensitivity. Examples of cross-sensitivity is between cow's milk and goat's milk, including seafood, etc.It should be stressed here that the person has food allergies may develop allergic reactions taking even traces of responsible food. The symptoms presented differ from person to person and in the same patient from exposure to exposure. Other additional factors other than food, such as exercise, alcohol or aspirin can affect the appearance of allergic reaction in sensitized individuals.Food allergy in infants and children manifesting a variety of symptoms may occur immediately after eating the food (eg, vomiting, urticaria, angioedema, bronchoconstriction and systemic anaphylaxis), or may occur after several hours (such as gastrointestinal disorders, atopic dermatitis, blood in stool infant colic). The adults may have oral allergy (itchy mouth, lips, tongue, and local swelling) immediately after contact with food or events from different systems (acute urticaria and angioedema, bronchospasm, abdominal pain, vomiting and diarrhea or more serious incidents , systemic allergic reaction and shock). Allergic reactions after eating the suspect food may be hazardous to the patient's life and should be treated in hospital. Moreover, because there is the possibility of recurrence of symptoms several hours after the treatment of allergic reaction (biphasic response), the patient has severe episode of allergic reaction after eating, should be hospitalized and monitored for 24 hours.
The diagnosis of food allergy should be done by specialist allergist, taking a detailed history and subjecting the patient to the appropriate clinical-laboratory testing. Note here that screening with skin tests or blood tests (specific IgE to certain foods, known as RASTs) has no value whatsoever. Most times, especially when the person has experienced systematic anaphylaxis, the diagnosis is easy and no need to test food challenge. In other cases, particularly when the reactions do not occur immediately after eating, to put the diagnosis of food allergy and to pinpoint the culprit food, will be presented by the patient in a challenge test to study food. A similar procedure is followed when we want to reintroduce a food to which the patient had an allergic reaction in the past but there are indications that it may have overcome this sensitivity (eg, children who were allergic to milk, but after a certain age exceeded the ).After the diagnosis of food allergy, the only treatment that currently exists and it must follow the patient, is the strict avoidance of that food. The patient should be very careful when consuming food that does not know the exact contents, or when they know the conditions under which prepared, since even traces of culpable food can cause severe allergic reaction. The allergist should give clear written instructions on how to deal with a possible further reaction after accidental exposure to this food, so patients themselves and their family members, and school and teachers if a child. Patients with a history of systemic anaphylaxis after eating should have with them some medication for immediate treatment of allergic reaction. Moreover, the specialist will need to educate the person to carefully read food labels and recognize the existence of the culpable substance that may not appear clearly, but with another name.The prognosis of food allergy is good when you identify the responsible food and be strict avoidance. Over the years some people lose their sensitivity to certain foods and can still eat it. This usually occurs in children with foods such as egg and milk, while less common when food allergy is fish, seafood and nuts and when it occurs in adults. Under no circumstances should a person with a history of food allergy to experiment alone to determine if it has overcome the problem, but should always follow the instructions of the allergist.Can and should take preventive measures in infants at high risk for onset food allergy. In these cases the mothers are advised not to consume certain foods that are potent allergens during pregnancy and breastfeeding are encouraged to breastfeed and if you can not do this, the child receives special sub-allergenic formulas, while the introduction of various food allergens are highly regarded in the broadest possible age.Food allergy is a major problem as most allergic diseases, has a growing impact, especially in developed countries. Has significant morbidity and impact on quality of life of people having significantly restricted their social life. We should not lightly be called any reaction after eating a lot more allergic and should not avoid foods that may be important for our nutrition. Any patient with food allergy should be directed to the specialist for proper diagnosis and appropriate treatment.