Have you ever wondered if you have a food allergy or a food intolerance? Allergists can help answer that question. Identifying the mechanism behind food reactions is important.
Food allergy occurs when the allergic antibody, IgE, interacts with allergens and triggers the allergic cascade. Classic food allergy can lead to a wide range of symptoms, including anaphylaxis.
Food allergies can be evaluated with skin testing or blood testing, but skin testing is generally more sensitive. In addition, allergists take an extensive history to help determine which allergens may be causing food-related symptoms. Board-certified allergists use their training to identify food allergies based on a patient’s unique history and testing. For food allergies, we may recommend elimination diets to help patients feel better by removing allergic triggers from their diet.
Food intolerance involves difficulty digesting a particular food and can have symptoms that appear similar to symptoms of food allergy. The most common form of intolerance worldwide is lactose intolerance. According to the NIH, about 65% of the human population has a decreased ability to digest lactose after infancy. The symptoms of lactose intolerance are bloating, abdominal discomfort, and diarrhea. Lactose intolerance occurs when the gut cannot digest the sugar in milk. Skin testing for milk does not evaluate for lactose intolerance. Some patients have features of both lactose intolerance and milk allergy.
Celiac disease (gluten-sensitive enteropathy) is commonly referred to as an intolerance but is an immune condition that involves the IgA antibody. In celiac disease, gluten can cause damage to the small intestine. Gluten is a protein found in wheat, rye, and barley. Though commonly referred to as an allergy, skin testing to wheat does not identify Celiac disease. Celiac disease affects about 1% of the population and is diagnosed with a biopsy of the small bowel performed by a gastroenterologist. A lab test can also screen for celiac disease.
Why the mechanism matters
There are many different mechanisms of food allergy and intolerance that we help patients sort through. Sometimes, the differences are large. For example, lactose intolerance may cause mild abdominal symptoms. By contrast, milk protein allergy can be potentially life threatening and is mediated by specific IgE to cow’s milk. Milk protein allergic patients cannot drink lactose free milk because the milk protein is intact and triggers an allergic reaction. Skin testing for milk helps us evaluate milk protein allergy but does not evaluate for lactose intolerance.
We help you figure out what symptoms are due to your allergies. You deserve to feel good every day and shouldn’t be held back by food allergy symptoms.