WHAT TO DO WITH FOOD ALLERGY?

   As with most medical disorders, the best way to establish food allergy begins with the medical history and physical examination. The doctor interviews the patient to determine if the facts are consistent with a food allergy. Based upon the information that will be gathered, various tests and laboratory studies may be ordered.

   Sometimes, a history alone cannot determine the diagnosis. In that situation, the doctor may ask the patient to make a food diary so that a record of the contents of each meal and whether reactions are consistent with allergy. This diary will provide a more detailed record that will help the doctor and patient to better determine if there is a consistent relationship between a food and the allergic reactions.

    The next step that some doctors use is an elimination diet. Under the doctor's direction, the patient does not eat a food suspected of causing the allergy, for example, eggs, and substitutes another food, in this instance, another source of protein. If after the patient removes the food, the symptoms go away, the doctor almost always can make a diagnosis of food allergy. If the patient then resumes eating the food (still under the doctor's direction) and the symptoms return, this sequence confirms the diagnosis. The patient should not resume eating the food, however, if the allergic reactions have been severe because this re-challenge is too risky. This technique is also not suitable if the allergic reactions have been infrequent.

   If the patient's history, food diary, or elimination diet suggests that a specific food allergy is likely, the doctor then will perform  tests such as allergy skin tests, blood tests for specific IgE, and a food challenge (done by a specialist, and in the hospital), which can more objectively confirm an allergic reaction to food.

   How is it treated? Avoiding the offending allergen in the diet is the primary treatment of food allergy. Once a food to which the patient is sensitive has been identified, the food must be removed from the diet. Affected people need to read lists of ingredients on the label of foods. Even those who know a lot about their own allergies can either make an error or be served food that does not comply with their instructions.

   People with severe food allergies must be prepared to treat an anaphylactic reaction. To protect themselves, people who have had anaphylactic reactions to a food should wear medical alert bracelets or necklaces These individuals also should always carry a syringe of adrenaline obtained by prescription from their doctors. (Note: The Allergy Club offers Anaphylaxis Kit and Allergy Emergency Card.)

  Several medications are available for treating the other symptoms of food allergy. For example, antihistamines can relieve gastrointestinal symptoms, hives, sneezing, and a runny nose. Bronchodilators can relieve the symptoms of asthma. These medications are taken after a person has ingested a food to which he is allergic to. They are not effective, however, in preventing an allergic reaction when taken prior to eating the food. In fact, no medication in any form is available to reliably prevent an allergic reaction to a certain food before eating that food.