Only 3-5% of children actually have a food allergy!
Studies have shown that 25% of care givers believe that their child has a food allergy when in reality, the true number is around 3-5% of children and 1-2% of adults.
This leaves a large proportion of people believing that they or their child have an allergy and it is crucial that individuals are able to access clear guidance on allergies so that foods are not unnecessarily removed from someone’s diet.
Removing certain foods may do more harm than good
Whilst removing foods may seem harmless, it can cause issues with nutrition and growth, not to mention, unnecessary worry and cost.
Broadly speaking, allergies fall into two categories:
- IgE Mediated allergies
- Non IgE mediated allergies
Taking a very clear, focused history from a family or patient is absolutely crucial in getting the diagnosis of allergy correct.
Given Dr Helen’s background as a General Practitioner as well as an Allergist, she approaches each consultation with an open mind and works hard to ensure no diagnosis is missed and that patients get some clear guidance, even when the issue is not a food allergy.
What is an Allergy?
An allergy occurs when there is an inappropriate response by the immune system to something which should be harmless, such as peanut, milk, pollen.
We can usually tell from the history if an individual is likely to have an allergy based on the symptoms someone has, the timing involved in reactions and the reproducibility of reactions.
IgE Mediated Food Allergy
These types of allergies are usually obvious to spot. They classically occur at weaning on one of the first exposures to the food but they can develop at any point through life.
Common foods that trigger these reactions are cow’s milk, soya, egg, peanuts, tree nuts, fish, shellfish, wheat and gluten.
However, they can occur with any food group and as our diets change to be more plant based, we are seeing new reactions occurring to wider food groups such as lupin and jackfruit.
IgE reactions tend to occur very quickly after exposure to the food and also resolve quite quickly. They present with hives, swelling, vomiting, diarrhoea, and potentially anaphylaxis.
These allergies are diagnosed based on the history and then they are confirmed with allergy testing.
It is vital that all patients with a possible IgE allergy are properly assessed and diagnosed as they all carry a risk of anaphylaxis.
Patients who visit Dr Helen will be given clear information about how to manage their food allergies and keep themselves safe.
Non IgE Food Allergy
These allergies can be some of the most challenging that we manage as parents. Non IgE allergies tend to present early in life and often have a more insidious onset than IgE allergies. They present with mainly gastrointestinal symptoms such as;
- Explosive, frequent nappies
- Blood in the stool
- Perianal redness
- Abdominal pain which presents as irritability
Children with these allergies may also have rashes, challenging eczema and congestion.
Currently there is no test which can diagnose this condition. A careful history by a specialist needs to be taken to help differentiate between allergy and many other common conditions which can present in childhood.
These allergies are generally not life-threatening but when severe, they can affect a child’s height and /or weight. They also cause significant levels of worry for families.
Food Protein Induced Enterocolitis Syndrome (FPIES)
Food Protein Induced Entercolitis Syndrome (or FPIES) is a condition which more commonly affects children but rarely, can also affect adults.
It presents with profuse vomiting and sometimes diarrhoea within one to four hours of exposure to a food.
It occurs every time the person is exposed to the food and the child will often look pale. Allergy testing does not help with diagnosis and a careful history needs to be taken to ensure the allergy is discovered and managed appropriately.
Some children will be so unwell with this condition that they will have been taken to hospital due to dehydration after the vomiting.
Eosinophilic Oesophagitis (EE)
Eosinophilic Oesophagitis (known as EE) is a condition which is becoming increasingly common, and, in America, it is now more diagnosed than inflammatory bowel conditions such as Crohns disease.
It affects adults and children and is more likely in the those with other atopic conditions such as eczema, food allergies, asthma or environmental allergies.
Patients with this condition tend to have reflux or indigestion which does not respond well to traditional medication like proton pump inhibitors. They may get chest pains or episodes of food getting stuck.
This condition needs careful management and usually has involvement of both an allergist and gastroenterologist.