Health NW: Food allergies and intolerances

<center>Kathryn B. Brown, FNP</center>

Many people believe they are allergic to some foods, but it's much more common to have an intolerance to a food rather than a true allergy.

Food allergies are a completely different problem than the allergies that cause hay fever. Although people who suffer from allergies due to pollen, dust, animal dander and other environmental substances do indeed suffer, their symptoms are rarely life threatening. Symptoms of food allergies can be much more severe, like swelling of the throat and tongue, difficulty breathing , stomach cramping and a rash or hives.

The worst possible type of allergic reaction is called an anaphylactic reaction. Also called anaphylaxis, this type of reaction is an immune-system response that often occurs within minutes of eating an allergy-causing food. It can also be caused by insect stings or medications in susceptible people.

A person having an anaphylactic reaction has difficulty breathing, and may be wheezing and coughing. They will complain of tightness in the chest or throat. They may seem anxious and confused. Stomach cramping and vomiting can occur. Often, they feel light headed because of low blood pressure and can pass out. Their eyelids, lips, throat and tongue can swell up. They may have hives all over their body.

Since anaphylaxis is potentially fatal, immediate action is necessary. Call 911 for assistance right away. While waiting for help to arrive, have the person lie down with their feet elevated to increase blood supply to the brain and vital organs. Make certain the person's airway is open to help them breathe. Quick treatment with injectable epinephrine is essential.

People who are at risk for anaphylactic reactions (especially anyone who has had one before) should carry injectable epinephrine with them at all times. EpiPen® is available by prescription.

About 1.5 percent of the American population has a serious food allergy. Each year, there are 30,000 cases of anaphylaxis that result in emergency room visits. Between 150 and 200 of these cases are fatal.

Unfortunately, there is no cure for food allergies. Getting allergy shots can be helpful for people who suffer from environmental allergies, but has not proven effective for food allergies. Avoiding the food that causes the allergic reaction is the only prevention.

Children can outgrow their food allergies, especially those to milk, eggs, soy and wheat. Adults usually do not outgrow their allergies.

Food intolerance is much more common than food allergies, but much less serious. Food intolerance is caused by the body's inability to digest certain foods.

A common example is lactose intolerance. Lactose is an enzyme in milk products (milk, cheese, ice cream, yogurt) that is normally digested by an enzyme called lactase. When a person's body does not produce enough lactase, they can't digest lactose. They usually have bloating, nausea and diarrhea when they consume more milk products than their bodies can handle.

Food intolerances can also cause problems such as eczema or other skin problems, runny nose, asthma and headaches in addition to gastrointestinal symptoms.

Anyone who has year-round symptoms such as these should consider trying an elimination diet. This should be done with the help of your health care provider or a licensed dietitian. Foods that are suspected of causing your symptoms are eliminated from your diet for about two weeks, then gradually reintroduced. You should keep a diary during this time, noting what you eat and how much your symptoms are bothering you each day. Hopefully, this will help you pinpoint any problem foods and help you avoid them in the future.

Kathryn B. Brown is a family nurse practitioner with a master's degree in nursing from OHSU. Is there a health topic you would like to read about? Send your idea to

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