Food allergies or intolerances: The importance of a correct diagnosis
It is essential to distinguish between a food allergy and an intolerance. This is not uncommon, as both problems can have similar symptoms, such as abdominal pain, diarrhea, or digestive discomfort. More and more people are coming to the doctor’s office confused about food allergies and intolerances.
Differentiating between a food allergy and a food intolerance is crucial, since the former involves an immunological reaction, which can be very serious, while intolerance is limited to digestive difficulties, with no risk of anaphylaxis. A proper diagnosis allows for specific and safe management in each case.
Food allergies involve an immune system reaction that can be serious, even fatal. Failure to diagnose them correctly could put the patient’s life at risk.
Food intolerances, on the other hand, are not dangerous for life, but they do generate annoying symptoms that impact daily life and the relationship with food.
It’s common for patients with food intolerances to feel fear and stop eating foods unnecessarily, believing they may be allergic. On the other hand, some people think their symptoms are simply due to an intolerance, when in reality they are facing a potentially serious and dangerous allergy.
In our office we not only treat food allergies, but we also carry out an exhaustive differential diagnosis to identify food intolerances, such as those associated with lactose, fructose, gluten or even intestinal bacterial overgrowth (SIBO).
Our goal is to provide clarity, eliminate unnecessary fears and design a personalized care plan for each patient.
If you have questions about how your symptoms may be related to diet, we are here to help you find answers and improve your quality of life.
What is a food allergy?
Food allergy is an immune system reaction that occurs when the body mistakenly identifies a protein in a food as a threat. This triggers an allergic response, which can vary in severity and manifest itself through different symptoms.
Milk, eggs and fish are the most common causes of allergies in children under five years of age.
From the age of 15 onwards, the most common allergies are related to cross-reactions between pollen and plant foods. People with pollen allergies react to fruits, nuts, legumes, and vegetables, as their proteins are similar and the body confuses them.
Know the symptoms of food allergies
An allergy to a food you’ve eaten can cause a wide variety of symptoms. These symptoms are not always present or the same for all people, and reactions can vary depending on various factors, such as the amount of the food allergen consumed.
If you are allergic to a food you’ve eaten, symptoms may appear from a few minutes to a few hours later.
Food allergy symptoms (allergic reactions) may include:
– Hives
– Skin reddening or rash
– Tingling or itching in the mouth
– Swelling of the throat
– Vomiting or diarrhea
– Abdominal cramps
– Coughing or wheezing
– Dizziness or lightheadedness
– Swelling of the face, tongue, or lips and vocal cords
– Difficulty breathing
– Loss of consciousness
Most people with food allergies can avoid symptoms simply by avoiding the triggering food. However, some people are extremely sensitive and can react to even the smallest traces, making their daily lives very complicated.
These reactions can be severe and even lead to anaphylaxis, the most severe form of food allergy.
Anaphylaxis is a life-threatening medical emergency. These reactions do not depend on the amount of food ingested, but rather on the patient’s sensitivity to that food, so it is vital for these patients to avoid contact with even minimal amounts of food. The foods that most frequently produce anaphylactic reactions are nuts and shellfish.
Anaphylaxis is a systemic allergic reaction that can affect multiple organs simultaneously and be life-threatening.
It manifests with symptoms that generally appear within a few minutes, such as intense itching of the scalp, palms, and soles, generalized erythema, difficulty breathing, and in extreme cases, a drop in blood pressure with loss of consciousness, leading to anaphylactic shock.
Its treatment requires the immediate administration of adrenaline, which can be challenging in emergency situations, especially if the person does not have quick access to the medication.
Today, medicine has advanced significantly, allowing for the performance of diagnostic analyses at the molecular level. These studies are essential for:
– Identifying people at high risk of anaphylactic reactions
– Identifying patients who are candidates for oral food immunotherapy for food desensitization.
– Providing appropriate therapeutic advice based on their molecular profile.
We are pleased to announce that we have the option of performing this study at our facilities, providing patients with a valuable tool for their health and well-being.
Eosinophilic esophagitis
If you experience symptoms such as difficulty swallowing, chest pain, regurgitation of food or a feeling that food is stuck in the esophagus after swallowing (esophageal impaction) you could be facing a condition known as eosinophilic esophagitis.
Eosinophilic esophagitis is a chronic inflammatory disease of the esophagus, closely related to food allergies and other atopic conditions such as asthma, allergic rhinitis and atopic dermatitis.
Despite its growing recognition, it remains a little-known and, in many cases, underdiagnosed pathology. The symptoms can be confused with other conditions, which generally delays diagnosis. It is essential that whether or not you have an allergic condition and experience these symptoms of difficulty swallowing or regurgitation of food, you consult an allergist, as early detection and appropriate treatment can significantly improve your quality of life.
Food protein-induced enterocolitis syndrome (FPIES)
Does your child experience vomiting or diarrhea after eating a food? Have they sometimes vomited so much that they show symptoms of dehydration?
Food protein-induced enterocolitis syndrome is a type of food allergy, not mediated by IgE.
Like other food allergies, reactions are triggered by eating a particular food. The most common triggers include cow’s milk, soy, and grains (rice, barley, oats). Unlike most food allergies, there are no blood or skin tests available for diagnosis. Most children outgrow FPIES by age three or four.
Vomiting and diarrhea may not appear until several hours after consuming the offending food, so the link between the symptom and the food may not be obvious. If you suspect your child has symptoms of FPIE S, consult your allergist for an accurate diagnosis and treatment.
OIT (oral immunotherapy with food)
Oral Food Immunotherapy (OIT)
Oral food immunotherapy (OIT) is a treatment that aims to induce the immune system’s tolerance to a food to which the person is allergic. It consists of the gradual and controlled administration of the food in question, starting with very small doses, which are then safely increased under medical supervision.
The purpose of this treatment is not to “cure” the allergy, but to increase the reaction threshold, so that the patient can tolerate a certain amount of the food without presenting symptoms, which significantly reduces the risk of serious reactions due to accidental exposures and, in some cases, allows its inclusion in the usual diet. This significantly reduces the risk of severe reactions from accidental exposure and, in some cases, allows its inclusion in the regular diet.
In what cases is it indicated?
In our practice, OIT is indicated exclusively for cases of persistent IgE-mediated food allergy, which has been correctly diagnosed through clinical history, skin testing, and specific analyses.
It is not indicated for:
Non-IgE-mediated food allergies, such as:
· Eosinophilic esophagitis
· Eosinophilic gastroenterocolitis
· Food protein-induced enterocolitis (FPIES)
· Celiac disease
· Non-celiac gluten sensitivity
We also have specific protocols for performing OIT in patients with plant-based LTP protein allergy syndrome.
What are the most common foods?
OIT is mainly performed for the foods most commonly implicated in persistent allergies, such as:
· Cow’s milk
· Eggs
· LTP of fruits and vegetables
At what ages can it be performed?
Oral immunotherapy can be considered in pediatrics and adults, as long as certain medical criteria are met and the patient (or their family) is motivated and committed to following the protocol.
Benefits and risks
Benefits:
· Increased safety against accidental exposure.
· Possibility of introducing the food into the diet in some cases.
· Improved quality of life for the patient and their loved ones.
Risks:
· During treatment, mild reactions (oral itching, digestive discomfort) or more serious reactions (hives, vomiting, asthma attacks, or anaphylaxis) may occur. Therefore, it should always be carried out in a controlled medical setting with close monitoring.
In our practice, we perform this treatment in a specialized manner tailored to each case. If you think that OIT may be an option for you or your child, we invite you to request a first assessment visit, where we will analyze your situation individually and explain in detail what the process consists of.
