Food Allergies Limiting, But Manageable

From the WebMD Archives

Nov. 15, 1999 (Chicago) -- People with food allergies can manage them effectively if they ask questions, read labels, and avoid doubtful foods, according to a panel presenting at the 57th Annual Meeting of the American College of Allergy, Asthma and Immunology. Successful management means that the patient totally avoids the offending foods and seeks treatment immediately after a reaction, says panel member Barbara Magera, MD, PhD.

The field of food allergies is full of confusing information, Magera, an allergist in private practice in Charleston, S.C., tells WebMD. On the one hand, people may not know they have food allergies. They may mention to their physicians, almost as an afterthought, "When I eat crab, my mouth breaks out." On the other hand, some people have sent blood work into a mail-order lab or have seen an alternative provider that uses unconventional methods, such as scanning the iris. These people have often been told falsely that they have multiple food allergies. These inaccurate diagnoses have needlessly rendered such people "food cripples" who follow highly restrictive diets, she says.

"It's important that people [know] what true food allergies are and what they aren't," moderator James Claflin, MD, tells WebMD. "When people have known or suspected food allergies, they need to see an allergist, so that they can be accurately diagnosed and [get] correct information." Claflin is a physician with the Oklahoma Allergy and Asthma Clinic in Oklahoma City and an assistant clinical professor at the University of Oklahoma Health Sciences Center.

The term "food allergies" is often misapplied to all food-related problems, says Magera. Examples of nonallergic food problems include intolerances and sensitivities, which may cause uncomfortable symptoms such as gas or bloating. Poisonings are also often given the label "allergy."

True food allergies cause symptoms that are triggered by a component of the immune system, immunoglobulin E (IgE). IgE causes symptoms such as hives, eczema, runny nose, and swelling throughout the body. In more severe reactions, called anaphylactic reactions or anaphylaxis, patients may have breathing difficulties, go into shock, and even die, Magera says. Patients with true food allergies need to avoid those foods completely, to carry epinephrine auto-injectors in case of accidental exposure, and to wear medical alert bracelets, she says.

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Most fatal or near-fatal reactions to food allergies are due to delayed epinephrine treatment, says John James, MD, who practices with the Colorado Allergy and Asthma Centers in Fort Collins. Although patients can be reluctant to use an epinephrine injection and rely on antihistamines, they should know that antihistamines are ineffectual against anaphylaxis, he says.

A food allergy diagnosis can be overwhelming, says Sherry Hubbard, RD a dietitian with the Oklahoma Allergy and Asthma Clinic. Reading labels is a must each time the products are bought because ingredients change. "Patients or parents should ask questions about anything they're eating or thinking of eating," she tells WebMD.

Having a positive attitude can help the food-allergic person from getting discouraged, says Anne Mu' oz-Furlong, the founder and president of Food Allergy Network. Parents of food-allergic children should discuss the allergies with school staff, including food service personnel, she says.

Researchers are trying to identify ways of treating food allergies beyond avoidance, Harold S. Nelson, MD, tells WebMD. He is a senior staff physician at National Jewish Medical and Research Center in Denver, where he is a professor of medicine at the University of Colorado.

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