While food allergies are most common in babies and young children, adults are also susceptible. This week on “Take Care,” we discuss food allergies with Dr. Neeta Ogden.
Dr. Neeta Ogden is an adult and pediatric allergist and immunologist in private practice in New York City, as well as a spokesperson for the American College of Allergy, Asthma and Immunology.
“A true food allergy is basically an immune reaction and it occurs when your body sees a certain food substance, which we refer to as food allergens as doctors, and it sort of identifies it as a danger and triggers an allergic response, which is what we usually see as the typical food allergy reaction,” says Ogden.
According to Ogden, there is a difference between food allergies and food intolerances.
Food intolerance, or sensitivity, leads to different symptoms that typically occur hours after the reaction. These symptoms can include bloating, stomach aches, diarrhea and headaches.
A food allergy includes an immediate reaction occurring within minutes to up to two hours after the food has been eaten. The most common food allergy symptoms include itching and hives, while a swollen lip or tongue can become dangerous due to airway blockage. Asthma-like symptoms of food allergies include coughing and wheezing.
Anaphylaxis is a drastic response to a food allergen. As a result of anaphylaxis, the heart rate often slows down and an EpiPen can be used to bring the heart rate back up. An EpiPen is a device that contains a medication called epinephrine and is self-injectable. This medication temporarily reverses the effects of the allergic reaction.
Those with known food allergies should carry an EpiPen with them at all times and be aware of how to properly self-inject the medication.
“It’s something that, if you’re prescribed by your doctor, is very important that you go over how to use it,” says Ogden.
Once a person has had an allergic reaction, it is important to address the possible allergen.
“When diagnosing allergies, people should be going to see a board-certified allergist because they have a very specific knowledge of how to do this,” says Ogden.
There are multiple diagnostic tools used by allergists.
First, the allergist will take a very detailed history of what reaction the patient has experienced, which is then generally followed by one of two diagnostic tests.
A skin prick test is an in-office test that includes touching the skin with standardized forms of food allergens. After 20-30 minutes, the allergist will then check to see if the patient’s skin has had a reaction of any kind to the allergen. Generally if someone is allergic to an allergen they will develop something similar to a mosquito bite. Redness, itchiness and a wheal lead the allergist to believe that there is a positive reaction to an allergen.
A blood test is similar to a skin prick test and is used if someone cannot have the in-office skin prick test, which includes patients on any antihistamine medication that could inhibit the response of the skin prick test.
“Why they’re useful to us is with the right clinical history if you have a positive test we can fairly certainly say that you have a food allergy. These tests, however, do not predict severity,” Ogden says.
Just because a person’s initial symptoms are mild does not mean that the reaction will not become more severe later on in life. If a person has any hint of a reaction they are considered allergic and should not eat the allergen.
“The treatment once you have an established food allergy is avoidance – elimination of this thing from your diet,” says Ogden.
It is possible that the person could eventually outgrow a food allergy. If you suspect you’ve outgrown a food allergy, it is important to continue to avoid the food and until you can be retested.