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    New Food Allergy Guidelines Out

    Comprehensive Guidelines Aim to Help Doctors Diagnose, Treat Food Allergies

    Food Allergy Guidelines: Definitions and More

    The guidelines define food allergy as "an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food."

    It distinguishes allergies from intolerances. Foods that cause the same reproducible adverse reaction but don't have a likely or established immune system response are not considered allergies, but rather intolerances.

    For instance, someone allergic to cow's milk due to an immune system response to milk protein has a food allergy. But someone who has a difficult time drinking milk due to an inability to digest the lactose in milk has a food intolerance.

    Among the most common food allergies are reactions to:

    • Peanuts
    • Tree nuts
    • Seafood
    • Milk
    • Eggs

    Anaphylaxis, a serious allergic reaction that comes on rapidly and may cause death, can occur in response to food. Up to 65% of anaphylaxis cases are thought to be due to food.

    Food Allergy Guidelines: Diagnosis

    Under the new guidelines, the panel of experts recommends that intradermal or skin testing should not be used to make a diagnosis of food allergy.

    The experts recommend skin puncture tests, in which a small amount of the extract of a suspected food in placed on the skin, then the skin is punctured through the droplet, to help identify possible troublesome foods but not to make a diagnosis based on it alone.

    It also recommends against the routine use of measuring total blood IgE, the antibody formed in reaction to an allergen.

    It recommends allergen-specific IgE blood testing but cautions that the test results alone are not enough to make a diagnosis.

    Food elimination diets -- taking away one or a few specific foods to see if the reaction disappears -- may help.

    Oral food challenges -- exposing the person to the suspected food under medical supervision -- are thought to be helpful.

    If exposure to a certain food triggers symptoms, the doctor should then see if that finding matches with lab tests and medical history.

    Food Allergy Guidelines: Management

    Avoidance is best, the experts agree. They write: "There are nomedications currently recommended by the EP [expert panel] to prevent IgE-mediated food-induced allergic reactions from occurring in an individual with existing food allergies."

    When food allergies trigger anaphylaxis, the experts recommend epinephrine injections first.

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