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How to Live Better With Food Allergies

Experts offer advice for preventing and responding to reactions

Food allergies can be a matter of life or death. If you suffer from a food allergy or know someone who does, it's vitally important to know what to do — and what not to do — if a reaction occurs.

According to the non-profit organization Food Allergy Research and Education, approximately 15 million Americans have a food allergy, and food allergy reactions send someone to the emergency room every three minutes. Studies also show that one in 13 children currently suffers from some sort of food allergy, and that number is on the rise.

Though the cause of food allergies is still under investigation, genetic predispositions, family history and the function of the digestive system all could be contributing factors. Allergies can appear in infancy or at any stage of life.

The severity of some food allergies may lessen with age for some, but be a lifelong problem for others. The most common food allergen culprits are usually milk, peanuts, eggs, tree nuts, fish, shellfish, wheat and soy.

Allergy vs. intolerance

Experts say it's important to understand that food allergy and food intolerance are not the same.

"A food intolerance typically causes mild intestinal symptoms," says Julianne Doucette, DNP, a pediatric nurse practitioner at Rush University Medical Center. "However, a food allergy causes a response by the body's immune system, which can affect many organ systems."

"An intolerance may be caused by lack of an enzyme, like lactase, or it can be related to additives in food," adds Mary Tobin, MD, an allergist and immunologist at Rush.

Here are some ways to tell whether it may be an allergy or an intolerance: 

Food allergies

  • Symptoms usually come on suddenly.
  • Minor symptoms can include a rash, itchy skin, runny nose and mild nausea
  • Severe symptoms, which can be life-threatening, can include the following:
    • Swelling of the throat, lips or tongue
    • Difficulty breathing
    • Widespread hives
    • Vomiting
    • Fainting
    • Shock
  • Symptoms occur every time you eat the food.
  • Even a small amount of the food can trigger an allergic reaction.

Food intolerances

  • Symptoms usually come on gradually.
  • Symptoms include the following:
    • Headaches
    • Nausea
    • Stomach pain
    • Vomiting
    • Diarrhea
    • Gas, cramps or bloating
  • Often, symptoms occur only when you eat a lot of the food at once, or eat it frequently.
  • Intolerances are not life-threatening.

If you or someone in your home has a food allergy, food labels are required reading — even on products that have been previously purchased and eaten without any problem.

Educate yourself and always be prepared

The keys to managing food allergies come down to a one-two punch of education and preparation.

Tobin suggests creating a food allergy action plan and reviewing it regularly with caregivers, teachers, daycare staff, coworkers and anyone else in regular contact with the allergy sufferer.

For mild allergic reactions, a dose of antihistamine usually resolves minor symptoms like itching and rashes. More severe reactions may require the immediate use of an epinephrine auto-injector (EpiPen), along with a call to 911.

"A second reaction can occur hours later and require additional treatment," Doucette explains. "That's why a person who has a severe allergic reaction should always go to the emergency room."

Doucette also urges sufferers to always keep an antihistamine, an inhaler (for asthma sufferers) on hand, as well as two EpiPens (in case one malfunctions or a second dose is needed).

"Some people forget to bring their medications with them and end up having a reaction without available treatment," she says. "This can be a life-threatening situation due to delay of treatment and worsening symptoms. Also, some people forget to hold the epinephrine auto-injector in the outer thigh for 10 seconds, and the full dose of medication may not be administered."

Check ingredients again ... and again

If you or someone in your home has a food allergy, food labels are required reading — even on products that have been previously purchased and eaten without any problem.

"Ingredients can change," Doucette notes. "As a safety precaution, I recommend my patients read the label when they buy the food at the grocery store, when they put it in the refrigerator or pantry and when they eat it."

Ingredients can go by different names; make sure you're familiar with all of them, and pay attention to where the food is processed as well.

"If a product is manufactured in a plant that also processes products with peanuts and tree nuts, you and your care provider have to determine whether your allergy warrants avoiding foods prepared in the same facility," Tobin says.

Don't forget to be vigilant when dining out at restaurants, too. Be clear with your server about food allergies, and if the menu doesn't spell out what's in a dish, don't be shy about quizzing the chef.

Report any food-related reaction to your doctor

Consult your doctor if you or your child has had a reaction to any food or drink. Skin and blood tests can help determine whether you might have a food allergy or intolerance.

The only proven treatment for a food allergy is to avoid the food and be ready to deal with any potential exposure to the allergen with antihistamines or epinephrine. 

Adults may be able to tolerate small doses of foods that cause intolerance symptoms, but this can only be determined through trial and error. 

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