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Thursday, December 12, 2013
Are there any Food Allergy Treatments?
I have what has been diagnosed (via a skin prick test) with several minor food allergies (dairy products, mustard, tea, and beer). What treatment(s) are proven, and in evaluation (other than avoidance)?
Food allergy is often over- or incorrectly diagnosed by physicians. In general, food allergies are uncommon in adults (<1% of all allergic reactions) compared to children where the incidence is approximately 3-5%. Patients with food allergy typically experience allergic symptoms such as hives, soft tissue swelling (called angioedema), respiratory symptoms such as wheezing, occasional gastrointestinal symptoms and in severe circumstances dizziness with loss of consciousness due to vascular collapse. When all or many of these symptoms occur together this is called `anaphylaxis`. The diagnosis of food allergy is made by taking a thorough history for symptoms that occur within 15-30 minutes after eating a specific food such as a peanut(which is a legume), shrimp or nut. Delayed food reactions have been reported but are less common. Confirmation of a food allergy with allergy skin testing or by serologic RAST testing to detect specific allergic antibody to the food protein is usually performed but does not represent definitive confirmation of a food allergy if positive. Definitive diagnosis of a food allergy requires a double-blinded placebo controlled food challenge. The reason a challenge is necessary is because allergy skin testing is about 60% accurate for foods. Many false positive reactions occur with food skin testing. The foods you mention such as tea, mustard and beer are not common food allergens. Milk and dairy products are more common allergens but are seen usually in infants or young children and this allergy is usually outgrown after 2-3 years. The only acceptable treatment for food allergy to date is absolute avoidance. People with severe life threatening reactions to a food should carry adrenaline with them at all times especially when they go out to eat. I would recommend you review the type of reactions, if any, you are experiencing with these foods. It may be the reactions you are having are `adverse reactions` and not `allergic` reactions. For example, milk products can thicken secretions and in lactose intolerant individuals cause cramping and diarrhea. Beer can cause nasal congestion in some people and so on. These are not `allergic reactions`. Good Luck. ,
Jonathan Bernstein, MD
Associate Professor of Medicine
College of Medicine
University of Cincinnati