Asthma Complexities (cont.)

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Food allergy

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Food intolerance is very common but is not food allergy since it does not involve the immune system. Often this can present with abdominal discomfort after eating the certain food. Lactose intolerance is a classic example and occurs when dairy products are eaten and the individual does not have the proper digestive enzyme for these diary products. Food allergy on the other hand involves the immune system and the production of specific antibodies to components of the food. These antibodies are usually of a specific type called immunoglobulin E (IgE). The most common food allergens are the proteins in cow's milk, soy, fish, shellfish, eggs, and peanuts.

Usually, the symptoms of food allergy relate to problems with the skin. Hives, which are raised, red, warm and itchy lesions, can develop suddenly. Atopic dermatitis (eczema) is more chronic and appears as raised, itchy, scaly lesions. Gastrointestinal symptoms can also occur. Severe reactions can occur rarely and result in failure of the respiratory system and/or cardiovascular collapse. This is referred to as anaphylaxis. Asthma, too, can occur following exposure to a food substance to which an individual is allergic. The optimal management of these food allergies is avoidance of the offending food if possible. When one discovers or suspects that a food allergy may be present, an evaluation and testing by a professional with expertise in allergies (allergist, immunologist) is recommended. These professionals will often perform a variety of skin tests and blood tests looking for evidence of IgE antibodies to the suspected offending substance. A food diary involving a detailed record of all substances consumed can be helpful in discovering the offending food. Once discovered, complete avoidance of these foods is recommended.

Medically reviewed by James E Gerace, MD; American Board of Internal Medicine with subspecialty in Pulmonary Disease

Previous medical author: Dennis Lee, MD


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