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Testing for Food Allergies
About 8% of all children and 2% of all adults suffer from food allergies.
Most allergic reactions will occur within minutes of eating the offending food.
Reactions such as itching, hives and swelling of the face, hands and feet are the most common reactions. Nasal congestion, sneezing, runny, itchy nose and eyes, nausea, vomiting, cramps and diarrhea. Shortness of breath, wheezing, coughing, chest tightness and low blood pressure, light headedness and rapid heart rate are all symptoms of food allergies as well.
When these reactions are severe then it is call anaphylaxis and can be life threatening.
It is an allergy or an Intolerance?
Reactions to food are probably not an allergic reaction but an intolerance.
This means that the person with the reaction has no allergic antibody present in their body against that particular food.
Intolerances are classified as toxic and non-toxic. A toxic reaction would occur in most people if they were to eat or drink a quantity of the offending food. Non-toxic intolerance occurs in those with intolerances such as lactose intolerance, which is due to the deficiency of lactase.
People with lactose intolerance have symptoms such as bloating, tummy cramps and diarrhea, either shortly after comsuming food containing lactose or they may experience symptoms even hours later. However they do not experience other symptoms of food allergies.
How are food allergies diagnosed?
Skin testing or a blood test can determine what food a person could be allergic to.
The blood test is also known as the RAST test, this is generally not as good as the skin test, but can still be helpful in predicting if a person has outgrown an allergy.
If after skin testing is done the allergy is still not clear, then an oral food challenge can be performed by an allergist. This involves the person eating an increased amount of the food over many hours under medical supervision.
A very small amount of an allergen is put onto the patients skin, normally the forearm. Then the skin is scratched slightly with a sharp implement.
Normally a reaction to the allergen will be noticable within minutes. The skin will become raised, red and itchy. This is slightly uncomfortable and generally settles down soon after.
Or the skin can be pricked with a needle or pin containing the allergen. This is known as a prick test or a scratch test.
A patch test can also determine an allergy. This is done by applying a patch that contains the allergen to the skin.
If a reaction is seen in the form of a rash, hives (urticaria) or ananphylaxis then it is obvious that the patient has an allergy to the allergen.
Further testing can then be done to identify the particular allergen.
A skin end point titration can also be performed. This is where an intradermal injection of allergens is injected into the skin at increasing concentrations to measure allergic response.
A very diluted solutions is used to prevent a severe reaction. After 10 minutes the injection site is measured to look for growth of the swollen area of the skin. 2mm of growth in 10 minutes is considered a positive reaction. If the growth exceeds 13mm then this is considered a major reaction.
What are the treatments?
If a person has an allergic reactions that can cause anaphalaxis then they should carry a self injectable form of epinephrine or adrenaline such as an Epi-pen with them at all times.
Avoidance of the food.
This would be the main way to prevent a reaction. Sometimes this can be difficult. Milk, soy, wheat and peanuts are such common ingredients in many foods.
It is important to read labels and ask questions in restaurants to find out what is in foods. This can be time consuming, but with time you will remember which foods you purchase regulary are safe for you to eat.
Always be prepared.
When you do have a reaction to food it is generally due to accidental exposure. So being prepared to treat your reaction is very important. You should also seek medical attention should you have a reaction whether you have used an epinephrine or not.
Family members, friends and if your child, your child's school, should know there is the problem of an allergic reaction to a particular food. They should be shown how to use the epinephrine and what medical care would be needed if a reaction was to occur.
Wearing a medical alert bracelet with the details of the allergy and whether an epinephrine is used or not is also advisable.
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