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Q. What is food allergy?

A. It is the appearance of some unpleasant symptomsin a sensitive (allergic) person after taking aparticular food. The same food ordinarily causesno such symptoms in the vast majority of peoplewho take it.

Q. What are the symptoms noticed in foodallergy?

A. The symptoms may pertain to the gastrointestinaltract, the skin, the lungs or the whole body. Theremay be itching rash around the mouth, swellingof the lips, sores inside the mouth, vomiting,gaseous distension, or diarrhoea. Thecommonest skin reaction is urticaria (hives) inwhich red, itchy swollen patches appear in theskin. They arise suddenly in clusters in one areaand disappear quickly from there to reappear inanother area. Lung reactions in the form of asthmaare uncommon as part of the food allergy.

Sometimes, food allergy manifests in the formof severe anaphylactic reaction withbreathlessness, cyanosis (bluishness) andunconsciousness. If quick relief is not provided,it can be fatal.

Q. How long after taking the offending food, dothe symptoms of food allergy appear?

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A. The symptoms of food allergy may appear soonafter taking it or may appear several hours later;in the latter case, it becomes difficult to identifythe offending article of diet.

The same food in one particular season mayproduce symptoms, while in others, it may not.This depends on the combination with otherallergic factors.

Q. Which foods cause allergy reactions morecommonly ?

A. Food which cause allergic reactions include fish,prawns, oysters, lobsters, eggs, chocolate, cow’smilk, peanuts, soyabeans, dry fruits, citrus, etc.

The parts of food that cause allergic reaction, areusually proteins.

Q. What are the characteristics of fish allergy?

A. Fish and other sea foods are amongst the mostpotent allergic agents. Those who developreactions on eating fish should avoid other seafoods as well. Even the smell of fish can produceurticaria in some people who are strongly allergicto it.

Q. What are the characteristics of egg allergy?

A. White of an egg is pure albumin (protein), and apotent source of allergy. Taking a raw egg by a

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person allergic to it, can cause a severe reaction.Even the smell of egg’s content can cause allergicreactions in highly sensitive people.

Q. What are the characteristics of cow’s milkallergy?

A. It is seen more often in infants; 1 in 200 infantsare said to be allergic to cow’s milk.

The symptoms produced are varied: from beingunwell after taking cow’s milk to sores aroundthe mouth, vomiting, diarrhoea, urticaria, eczemarash on the face or difficulty in breathing.

Q. What are the characteristics of wheatallergy?

A. An infant may develop a rash, abdominal colic ordiarrhoea when it is given a cereal for the firsttime.

An older child or an adult may have asthma ora patch of eczema which is found to be improvedby not taking wheat in any form.

Q. Are all reactions to food in infants andchildren allergic in nature.

A. That may not be so. Rash around the mouth insome children may be due to acid in foods likefruit juice. It is non-allergic in nature and usuallya temporary problem.

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Other reactions may be due to the presence ofvarious preservatives in the commercial foods.

As the child grows older, even the foods whichpreviously caused allergic reactions may betolerated, perhaps, because of the maturingimmune system.

Q. What is cross allergy to food?

A. All foods belong either to vegetable source oranimal source and in either case they are groupedin families. Peas, soya beans, kidney beans,peanuts, etc. are all members of the pea (legume)family, just as garlic, onion, asparagus, belong tolily family. Similarly, many of the sea foodsbelong to one family.

Allergy to one member of a family may resultin the person being allergic to other members ofthe same family. This is called cross allergy.Knowledge about this, fore-warns a person as towhich foods to avoid.

Q. Is a person allergic to egg, allergic to chickenas well?

A. Usually not, Albumin, the pure protein in the egg,does not exist in the chicken.

Q. Is a person allergic to cow’s milk alsoallergic to beef?

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A. Cooking usually reduces the ability of proteinsin the food to cause allergic reactions. But somereactions may still occur. Boiled milk and cookedeggs still cause some reactions.

Q. How can one diagnose the allergy-causingfood?

A. Diagnosis as to which food is causing allergicsymptoms is, many a time, like investigating amurder case with hardly any obvious clues. Thedifficulty is compounded when the offending foodis either milk, egg or wheat, each of which is acommon ingredient of many other foods, and itspresence is not generally suspected by the patient.

A thorough history of the patient is of the greatesthelp.

Skin tests in food allergy are not of much help.This is because the tests are done with foodsextracted in the raw state but they are eaten inthe cooked state. Many a time, there is nocorrelation between the skin tests and the trialswith foods.

Blood tests are equally unreliable.

Food elimination tests are helpful. The patientis instructed to note in his diary, all the food hetakes and the symptoms, if any, produced. Bystudying these daily notes for two to three weeks,

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one can often detect the onset of symptoms aftertaking a new food or after repeated use of acertain food. The elimination of these foods fromthe diet one by one results in disappearance ofthe symptoms, just as the intentional ingestionis followed by symptoms.

Even after carrying out all the investigations,sometimes one is not sure of the food causingallergic symptoms.

Q. How is a case of food allergy treated?

A. The best method of treating food allergy is tofind out the incriminating food and to avoid it.While eliminating one food, it is necessary thata non-allergic substitute of equivalent food value,be added to maintain nutrition and avoidmonotony. Along with this, the patient is advisedto take as far as possible, cooked foods, whichbeing denatured, cause less allergy.

Whenever possible, the infant should bebreast-fed. This reduces the chances ofdevelopment of allergic symptoms. Giving ofcow’s milk should be delayed upto the age of ninemonths to a year in a potentially allergic child.Milk prepared from the soyabeans is a goodsubstitute. Soyabean milk should be given upto ayear or so and then a re-trial made with the

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offending milk. If only a few symptoms appear,then the cow’s milk may be gradually added inthe diet. Soyabean milk is as nutritious as themother’s milk; however, this needs to besupplemented with vitamins and minerals.

Injections of the incriminating foods are bothdangerous and useless.

Those who are highly allergic to some foods,must carry epinephrine (adrenalin) and should betaught how to inject themselves with it, whennecessary. Such people should also wear anidentification bracelet which describes theirallergy.

Q. What is food intolerance and how does itdiffer from food allergy?

A. Food intolerance reactions are caused by factorsin the diet other than proteins. A common foodintolerance reaction is the result of the body’sinability to properly digest milk sugar, lactose;this gives rise to diarrhoea and increasingweakness.

Food additives and preservatives are some ofthe other factors that cause reactions that are notreally allergic but look like it. The food dyetartrazine has been shown to cause asthma-likesymptoms in some persons. Sulphite

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preservatives such as sodium and potassiumsulphite, bisulphite and metabisulphite are knownto have the potential to cause a serious attack insome sulphite-sensitive asthma patients.Sulphites are used in some restaurants as “stayfresh” agents, particularly as chemicals sprayedon salads to prevent wilting. They are also foundin some processed foods and beverages likefresh shrimp, mushrooms, potato chips, driedfruits and wines.

Since reactions to these chemical can be verysevere, people taking food outside their homefrequently, should be aware of this problem.

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