The food allergiess are adverse reactions to foods or ingredients that, even in small quantities or traces, can cause serious and even fatal reactions for susceptible people if action is not taken in time. In 2003, the World Allergy Organization proposed to call hypersensitivity to adverse reactions to foods of non-toxic origin and to diagnose food allergy when it has been demonstrated that the adverse reaction has an immune mechanism.
It is estimated that thefood allergies affect more children than adults in percentages ranging from 4% to 6% in children and 1% to 3% in adults. Any food can trigger an allergic reaction, it depends on many factors, including lack of familiarity with an ingredient, but it can be noted that more than 70 foods have been identified that cause food allergies, although serious reactions due to ingestion are more common. of cereals containing gluten, shellfish, eggs, fish, soy, milk, peanuts and nuts.
Food allergies affect the quality of life and the economy of those who suffer from them and involve not only these patients and allergists but also those who participate in the supply and preparation of food (food industry, restaurants, family members, etc.).
Causes of food allergy
IgE-mediated and non-IgE-mediated adverse reaction
Food allergy mechanisms can be activated by antibodies or cells, or by a combination of both; However, the best known and studied is the one that occurs when an excess of antibodies (defenses) against immunoglobulin E (IgE) is created. IgE is found mainly in the lungs, skin and mucous membranes and causes mast cells, cells involved in the immune system response process, to release chemicals, including histamine, into the bloodstream. It is these substances that trigger many of the symptoms.
IgE-mediated food allergy. There is a specific IgE antibody for each allergen; Even minimal ingestion of the food causing the immune reaction can cause the most serious immediate reactions (anaphylaxis). This can be life-threatening.
There is also non-IgE mediated food allergy. In this case, the amount of food responsible for the adverse reaction or symptoms is usually greater and takes longer to appear or even becomes chronic. In this case the patient’s nutritional status may be affected. In addition, it also influences the conclusion of the diagnosis since it can be difficult to establish the relationship between the ingestion of the offending food and the reaction.
Foods that most frequently cause allergies in adults:
– Seafood.
– Peanuts.
– Nuts.
– Fish.
– Foods that most frequently cause allergies in children:
– Peanuts.
– Nuts.
– Eggs.
– Cow’s milk.
– Wheat.
– Soybeans.
Children generally outgrow allergies to milk, soy, wheat, and eggs. As we grow, the digestive system matures, limiting the absorption of foods or ingredients that trigger allergies.
Among the risk factors for developing a food allergy are:
– Family history of asthma, eczema, hives or allergic rhinitis (due to oral allergy syndrome in which some vegetables, fresh fruits, nuts and spices can cause an allergic reaction).
– Suffer from asthma, eczema, hives or allergic rhinitis.
– Have other food allergies.
Symptoms of food allergy
They can appear in minutes or a couple of hours
The symptoms of a food allergy usually appear a few minutes or even a couple of hours after eating the food that causes the adverse reaction. The most common symptoms are:
– Tingling or itching in the mouth.
– Hives, itching or eczema on the skin.
– Inflammation in the lips, face, tongue and throat or even in other parts of the body.
– Difficulty breathing, nasal congestion and wheezing.
– Abdominal pain, diarrhea, nausea or vomiting.
– Dizziness, lightheadedness or fainting.
The most severe cases present anaphylaxis, a reaction that can be life-threatening. It can be identified by:
– Swelling in the throat or feeling of a lump in the throat that makes it difficult to breathe.
– Sudden drop in blood pressure.
– Accelerated pulse.
– Dizziness, lightheadedness or loss of consciousness.
In the event of anaphylaxis, you should always have an epinephrine autoinjector in good condition on hand and it is key to be very clear about how the device works.
Another complication of food allergy can be the appearance of atopic dermatitis.
Diagnosis of food allergy
Clinical history, demonstration of hypersensitivity, intake-symptoms
The allergist will perform a questionnaire and a physical examination exploring the airways and looking for eczema or dry skin. You might order a dietary diary from the patient and perform the following diagnostic tests:
– Blood test to detect IgE-mediated allergy reactions.
– Prick test skin test: a drop of the allergen extract, raw or cooked, is placed on the anterior surface of the forearm and a puncture is made through the applied drop.
– Patch test: it is used in patients with contact dermatitis and in non-IgE mediated allergies or delayed hypersensitivity, although it is not considered very reliable. A patch with the allergen is placed on the healthy skin of the back.
– Oral exposure or provocation tests: in a controlled manner, in the hospital or in the hospital environment, the patient is exposed to the food/allergen.
– Microarrays or molecular diagnosis. It is under development and allows several specific IgE molecules to be analyzed against a high number of allergens simultaneously.
Food allergy treatment and medication
Be careful with diet, antihistamines and epinephrine
The only way to avoid an allergic reaction is not to eat foods that can trigger allergy symptoms, although it is true that, even involuntarily, you can come into contact with the allergen. If the reaction is minor, the symptoms may subside with antihistamines. If the reaction is severe, epinephrine should be injected. It is important to know how to use it and have the epinephrine in good condition. It is even a very good idea to have a spare autoinjector. The autoinjector must accompany the allergic person at all times.
In addition, there are therapies still being studied such as anti-immunoglobulin E therapy or oral immunotherapy in which small doses of foods that cause allergies are swallowed or placed under the tongue. The dose is increased gradually. Early exposure to the allergen is also being applied to increase tolerance to it.
Food allergy prevention
Avoid the allergen
The only way to avoid the consequences of food allergies is to not consume the
foods that cause them. One of the fundamental measures is food information. The committee on food labeling of the Codex Alimentarius commission of the WHO recommends that the presence of potentially allergenic foods and their derivatives should always be declared on labels or food information.
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