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Recently, I dined with a friend who informed the waiter of her allergy to a certain food before placing her order. The waiter confirmed that her chosen dishes were free from that ingredient. After he left, she shared that this food often causes her stomach discomfort, prompting her to avoid it. While she is wise to steer clear, it’s important to clarify that she does not have a true allergy; like many, she has confused food allergies with food intolerances.
Food intolerances are legitimate reasons to ask for specific items to be omitted, but they are not the same as food allergies. I spoke with Dr. Lisa Thompson, a pediatrician and Chief Medical Officer at NourishWell, to distinguish between a genuine food allergy and a food intolerance, and why understanding this difference is crucial.
What Constitutes a True Food Allergy?
A true food allergy involves a malfunction in a specific part of the immune system, leading to potentially severe and life-threatening reactions. In contrast, food intolerance originates in the digestive system, resulting in inconsistent and episodic discomfort.
In cases of food allergies, the body’s IgE reacts to proteins found in common foods like dairy, eggs, or nuts. This immune response can trigger symptoms ranging from hives and vomiting in infants to more severe reactions in older children and adults. Conversely, food intolerances are not linked to the immune system but may arise from enzyme deficiencies, leading to gastrointestinal issues like bloating and gas.
Differentiating Symptoms
The symptoms of food allergies and intolerances are markedly different. Food allergy symptoms can be severe and may affect multiple organs, including rashes, hives, shortness of breath, and even anaphylaxis. For infants, reactions often manifest as hives or vomiting shortly after consuming the allergenic food. Dr. Thompson notes that eczema is a significant risk factor for developing food allergies, especially when allergens enter the body through the skin rather than the digestive tract.
Food intolerance, on the other hand, primarily affects the digestive system and is typically not life-threatening. Symptoms can vary each time the food is consumed and include gas, bloating, heartburn, and nausea.
Managing Food Allergies and Intolerances
Dr. Thompson emphasizes the importance of careful management of food allergies. Unlike intolerances, which can be somewhat flexible, food allergies require strict avoidance of the trigger food. While there is currently no cure for food allergies, some treatments can help individuals build tolerance to certain foods, but these are not definitive solutions.
Food intolerances are generally managed by avoiding the offending food, but the consequences of accidental ingestion are usually less severe.
Diagnosis of Food Reactions
Food allergies can develop at any age and are diagnosed through skin or blood tests performed by allergy specialists. The most reliable method is the oral food challenge, where the patient consumes the suspected allergen under medical supervision. In contrast, food intolerances are often identified based on symptoms or through an elimination diet.
As we navigate our food choices, it’s easy to label any adverse reaction as an “allergy.” However, distinguishing between food allergies and intolerances is vital, as one can pose serious health risks while the other typically does not.
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Summary
In summary, understanding the differences between food allergies and food intolerances is crucial for proper management and treatment. While both conditions can cause discomfort, their causes and implications differ significantly. If you suspect you have either condition, consult a healthcare professional for guidance.
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