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Follow Up on Food Allergies

by Sue Hubbard, M.D.

We had a lively and informative discussion on food allergies on the show yesterday. We were fortunate to have a pediatric allergist as a guest along with an ER doctor whose son was diagnosed with numerous food allergies when he was an infant. Between the two of them, they were a wealth of information for anyone who is concerned about the possibility of food allergies in their children. We had a lot of good phone calls, but unfortunately did not have the opportunity to answer all of the questions as we ran out of time, so will hit a few of the high points here.

One of the take home messages was to identify the difference between a true food allergy and food intolerance. A food intolerance is not an allergic event, in other words, it is not immune mediated. People who have a food intolerance may complain of nausea with a certain food, or abdominal cramps. They do not demonstrate allergic symptoms such as hives, swelling of the lips or tongue or breathing or wheezing problems seen with a food allergy. With anaphylaxis you also have a drop in blood pressure and it is a life-threatening emergency. Food allergies usually present early in life, often when the child has their first known exposure to the offending food, and they usually have symptoms within minutes to an hour after ingestion.

Several callers today wanted to know what to do if they think that their child had had “a” reaction to a food. If the allergic reaction was significant, you have probably already been through an emergency room and have been referred to a pediatric allergist. If you are unsure if they have had an allergic reaction, make an appointment with your pediatrician to discuss the history. History is the most important part of the puzzle, but there are screening blood tests that may be done to look at allergic antibodies to foods (most commonly nuts, milk, eggs, fish). The gold standard for diagnosis is an evaluation and skin testing with a pediatric allergist and then most importantly education about food allergies.

That’s your daily dose, we’ll chat again tomorrow.

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