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ALLERGIES

Food Allergy & Intolerance
REMAINS A OF MEDICINE

By Victor Estrada, MD

If there ever has been a gray area of medicine, it is food allergy The highest risk foods for anaphylaxis include peanuts, tree nuts
and/or food intolerance. and seafood, with cow's milk and eggs in young children.

Even the definition of "food allergy" varies from allergist to aller- Food Allergy versus Intolerance
gist. For some, it is an allergic reaction caused by a food that is Food allergy symptoms typically begin soon after eating the food
specifically IgE mediated (positive skin test or positive IgE mediated
blood test, such as ImmunoCap IgE, or the old Rast test). For oth- and can occur with even tiny amounts ingested. Reactions can be
ers, it is an immune mediated reaction, not necessarily IgE medi- cutaneous, such as urticaria and angioedema, gastrointestinal, such
ated, that occurs after ingestion of a food. as vomiting and diarrhea, respiratory, such as wheezing and short-
ness of breath, as well as anaphylactic, involving any of the above,
Approximately 12 million Americans suffer from food allergies in addition to larygeal edema and/or hypotension,
and 1 in 12 children have food allergies. People can be allergic to
any food, but 90 percent of food allergic reactions are caused by the In contrast, food intolerance symptoms take longer to appear than
following: food allergy symptoms and small amounts may be tolerated without
any reaction. Symptoms are varied, and can include intestinal such
• Milk • Wheat as gas, abdominal bloating, pain, or diarrhea, as well as cough, runny
• Peanuts • Fish nose, headaches, migraine headaches, skin problems such as eczema
• Eggs • Soy or urticaria, joint pain, lethargy, etc. Symptoms can be vague and
• Tree Nuts • Shellfish difficult to diagnose.

18 San Antonio Medicine • March 2017