Dr. Roy

Food Allergy Question & Answers

Experts answer your questions about content in the new Food Allergy Guidelines

Although millions of people around the world suffer from food allergies, until now no standard
recommendations were available to help diagnose, treat and manage patients with known or
suspected food allergy. Now there are several released Guidelines for the Diagnosis and
Management of Food Allergies, which are technical, scientific and designed for healthcare
professionals, also provide plenty of useful information for patients as well. The leading experts in food allergy got together to answer some basic questions.

If my family physician reads these Guidelines, will he/she be better able to diagnose and treat food allergies?

Yes, the Guidelines provide your physician with the latest information on diagnosing and managing food allergies. With this, your physician will have a clearer idea of how to identify, evaluate and refer you for food allergy to a specialist who can monitor and treat your food allergies better.

With these Guidelines, will consumers be able to self-diagnose food allergies?

No. Only a trained physician using proper testing can accurately diagnose a food allergy. Additionally, it takes an expert to identify all of the allergens that have the potential of triggering a cross reactivity response. When it comes to the potential for life- threatening food allergies, consulting with professionals is extremely important

The Guidelines include a section on "natural history." What does that mean?

Natural history is what happens to the allergy over time without treatment.

The Guidelines define a food allergy as “an adverse health effect arising from a specific immune response that occurs reproducibly on exposure to a given food.” What is an adverse health effect?

This is any type of allergic reaction to a food. It could involve:
the skin: hives, swelling and/or eczema
the gastrointestinal tract: abdominal pain, vomiting and/or diarrhea
the respiratory system: congestion, cough, wheezing and/or difficulty breathing
the cardiovascular system: low blood pressure anaphylaxis, in which multiple     body systems are involved

What is cross-reactivity?

If your immune system overreacts to a protein in a particular food group, it might also cross over and trigger a response to a similar allergen found in something else.

How do you define “reproducibly”?

With food allergy, a reaction is likely to occur over and over again with each exposure to the problem food. Yet the specific symptoms may vary from one reaction to another.

Can you have a food allergy without ever having eaten that specific food?

You must first be in contact with that particular food, but that doesn’t necessarily have to be from eating it. For example, the exposure could occur through skin contact, inhaling it or in utero.

Is it possible to outgrow a food allergy?

Allergies to egg, milk, wheat and soy are often outgrown, although some people remain sensitive throughout the teen and early adult years. In contrast, most people allergic to peanut, tree nuts and seafood will not outgrow their disease and must maintain strict elimination diets throughout life.

Are there any medications to prevent food allergic reactions?

Epinephrine is the first choice for treating anaphylaxis and antihistamines might block a minor reaction. But there are no drugs or medications that prevent severe reactions.

When do you think that peanut and tree nut immunotherapy will be ready for use by patients?

The available studies have been encouraging but they are still considered experimental. Oral immunotherapy (OIT) to milk, egg, soy, peanut and tree nuts have been successfully done under an Allergy super specialist’s guidance and careful supervision due to risk of reactions.