Food allergies are undesirable effects on health that occur with each ingestion, associated with an abnormal response of the immune system to a food. It is of great importance because it can cause very serious reactions that threaten life.
What is the frequency of food allergies?
Food allergies have been increasing all over the world in recent years, and although the number of definitively proven patients is lower, it is reported to approach 10%.
It is more common in children than adults. Food allergies can occur at any age. Since allergic foods can pass through the mother’s milk, it can also be seen from birth in babies who take only breast milk.
What are the risk factors for food allergy?
Food allergy develops as a result of genetic, environmental causes and gene-environment interaction. Food allergy is more common especially in children whose mother, father or sibling has an allergic disease. However, since a single gene is not responsible, this effect is in the form of susceptibility.
Male gender, Asian and black race, elimination of beneficial microbes of the intestine, vitamin D deficiency, low intake of omega 3 and antioxidant foods, use of antacid drugs, obesity and delay in starting complementary foods are suggested as risk factors that increase food allergy.
No relationship was found between childhood vaccines and food allergy.
What foods cause food allergies?
The most common foods are milk, eggs, soy, peanuts, nuts, wheat, fish and shellfish. Cow’s milk, egg, soy and wheat allergies are most common in children, while peanuts, nuts and seafood can occur at any age.
What are the symptoms of food allergy?
Food allergies can affect many systems, causing a wide variety of symptoms. Findings vary according to the underlying mechanism.
The most common findings in food allergy are skin rash, redness, allergic eczema (atopic dermatitis).
Nausea, vomiting, abdominal pain, severe gas pain, bloody and mucous poop may be present as a sign of gastrointestinal allergies that have increased in recent years.
Sneezing, itching and discharge in the nose, shortness of breath, cough can also be seen as a sign of food allergy.
In severe cases, low blood pressure, palpitations, fainting and shock may occur as a result of the reaction that affects the whole body called anaphylaxis. It is a life-threatening reaction and requires immediate treatment.
Which doctor should I go if I suspect a food allergy?
It will be helpful to take your child to a pediatric allergist when symptoms of food allergy are seen. Because pediatric allergy specialists are the most trained and experienced specialists in this regard.
- Food allergy occurs with a wide variety of findings and there may be severe life-threatening reactions. If the correct diagnosis is not made and the diet is not started as soon as possible, dangerous reactions may occur, and in case of misdiagnosis, unnecessary dieting may affect the health of the mother and child. A wide variety of foods can cause allergies. For this reason, the diagnosis of food allergy is difficult and should be evaluated by a trained and experienced doctor.
- Food allergy may be the first disease to appear in allergy-prone children. The risk of developing asthma and allergic diseases increases with age in a child with food allergy who has not been diagnosed and treated. For this reason, it is necessary to be careful in terms of the symptoms of asthma and allergic diseases and to be monitored by an experienced specialist.
How to prepare for food allergy when going to the doctor?
It will be useful for you to pay attention to the following warnings when coming to the examination, in order to provide the diagnosis correctly and in a short time.
- Note all the symptoms. Photos of visible signs if possible.
- Make a note of all the medicines your child uses or bring them with you.
- If you have previous tests, bring them with you.
- Write down all the questions you will ask your doctor.
- If allergy and cough medicines are used, these medicines should be discontinued 1 week in advance, as they affect the test result, so that the skin test can be performed when necessary to detect food allergy.
How is a food allergy diagnosed?
In the diagnosis of food allergy, symptoms should be evaluated first.
For the diagnosis of food allergy, first of all, information should be obtained from the family and it should be learned whether there is a suspicious food and what findings occur with the intake of that food. Then, a detailed examination should be made and it should be evaluated whether there is a finding related to food allergy in the child.
Tests to be done for the diagnosis of food allergy
In children with food allergy symptoms, the diagnosis is made as a result of tests such as skin allergy test, blood allergy test, and when necessary, suspending the intake of suspicious food and loading.
The food allergy test is more valuable because it is both faster and more reliable. Skin tests give results within 15-20 minutes. For this reason, skin allergy testing is generally preferred in the diagnosis of food allergy. However, in some cases both are required. Because it cannot be diagnosed with tests alone. In cases where the diagnosis cannot be made with blood and skin tests, a nutrient challenge test is performed. Since the blood and skin allergy tests do not yield results in food allergies with only intestinal involvement, the diagnosis can be made by performing diet and challenge tests, especially in such cases.
This test should be done in centers with experienced pediatric allergy specialists. Since serious allergic reactions can occur during the test, it can be dangerous if done by inexperienced people.
It is inconvenient to diet only according to the information given by the family or according to the results of the allergy test made from blood or skin. It can cause serious consequences.
At what age should allergy testing be done for food allergy?
Skin allergy test can be done after 1 month. Since food allergy starts in infancy, the test should be done when suspected. The information that a skin allergy test can be done after the age of three or five is definitely not true.
What are the other blood tests used in food allergy?
In recent years, a method called Component-Resolved Diagnosis (CRD) method, which measures all allergic proteins in foods separately, has been developed. In this way, more accurate diagnosis and treatment is provided by determining which allergen in the food the child is sensitive to and the presence of cross-related foods. For these tests, a small amount of blood is drawn from your child and analyzed in the laboratory.
In addition, it is definitely not recommended to look for IgG antibodies from blood to food protein, which has been on the agenda incorrectly in recent years.
Endoscopy and biopsy
In the presence of persistent digestive system complaints which are thought to be due to food allergy, if the suspicious food is removed from the diet and there is no improvement, it is a correct approach to take upper and lower digestive system endoscopic biopsies. There is no definitive evidence of food allergy. However, it is valuable both because it shows which part of the intestine is involved and because it enables the diagnosis of diseases other than food allergy.
Keep a Food Diary
If there is any doubt about the food that causes allergies, the food taken by the child and if the mother is taking breast milk should be written in the food diary every day and the dates of allergy symptoms should be noted. This method helps to find suspicious food.
How is food allergy treated?
There is no definitive treatment for food allergy. When the diagnosis is made, the first thing to do in the treatment is to avoid the food that causes the allergy. If the baby only takes breast milk, the mother should not take foods containing that nutrient or is taking supplementary food, it should be excluded from the child’s diet. About 70% of children with milk and egg allergies can tolerate baked goods (heated to 200-220 °C). This situation should be evaluated by your allergy doctor together with the tests.
If there is no improvement despite reaching the age at which tolerance should develop, oral immunotherapy (vaccine treatment by giving oral allergic food) can be done against some foods.
Your child may consume the food he is allergic to directly or without realizing the food containing that nutrient. In such cases, symptoms ranging from mild to severe occur. Treatments vary according to these symptoms.
Treatment for Mild Reactions
In mild reactions of food allergy, antihistamine drugs recommended by your allergist can help reduce symptoms. These antihistamine drugs are used to relieve the child by reducing the symptoms such as itching, urticaria, redness and swelling in the body after your child takes the food to which he or she is allergic.
Treatment for Serious Reactions
For severe symptoms in your child, you should go to an emergency room. With the treatments applied here, a life-threatening anaphylaxis shock is prevented.
If the shock picture called anaphylaxis occurs with the intake of allergic food, then an adrenaline autoinjector should be kept to protect the child, and when the symptoms appear, it should be applied immediately and the nearest emergency room should be consulted.
What happens if food allergy is not treated?
Conditions that may develop when food allergy is not treated;
If your child has a food allergy and is not treated, it can cause other health problems. These health problems can affect your child’s life or, in very serious cases, they can be life-threatening. For this reason, food allergy should be considered and followed up by a pediatric allergist with necessary examinations and treatments.
We can list the health problems that may occur when food allergy is not treated as follows;
- Anaphylaxis: If your child’s food allergy symptoms are not diagnosed as soon as possible, a shock condition called anaphylaxis may occur when he or she eats the food to which he or she is allergic. Anaphylaxis is a serious, life-threatening reaction.
- Atopic dermatitis (eczema): If your child’s food allergy is not treated, it can cause atopic dermatitis / eczema. Because the allergens that cause atopic dermatitis are mostly food allergens.
Can a food allergy be cured?
Most of the food allergies in children improve with advancing age. Milk, egg and wheat allergies improve by 50% around the age of 5. Most of the rest recover later. However, peanut, tree nuts (such as hazelnuts, walnuts), fish and shellfish allergies improve at a lesser rate.
If the sIgE values in the blood are lower, allergy symptoms are only hives (urticaria), or if only intestinal involvement is present, they recover more quickly. If there are findings such as atopic dermatitis or more anaphylaxis, recovery is delayed.
As a result;
- Cow’s milk allergy can present with a wide variety of symptoms.
- Allergy test can be done at any age in the diagnosis of cow’s milk allergy.
- Cow’s milk allergy may not be diagnosed with blood and/or skin allergy tests alone.
- It is very important that all methods are evaluated and diagnosed by an experienced pediatric allergist.
- The most important point in treatment is to avoid cow’s milk until tolerance develops.
- In cases of severe reaction, an adrenaline autoinjector should be kept and if necessary, it should be done immediately as a life-saving device until you go to the hospital.
- Tolerance develops in the vast majority of patients when they reach a certain age.
- In cases where tolerance is delayed, immunotherapy (vaccine therapy) can be tried by experienced pediatric allergists. You should discuss this issue with your doctor.