Do I have them?
Getting right to the point, food allergies are much more serious than everyday allergy rhinitis. They can be very dangerous. Your parents have probably showered all sorts of love on you in your life but also given you food allergies, if they have a history of allergies too.  Similar to allergy rhinitis, a food allergy is an abnormal response to a food triggered by the body's immune system. People sometimes think they have a food allergy when they only have a food intolerance. Food intolerance usually produces symptoms in the intestinal tract, such as nausea, diarrhea or abdominal pain. Examples of common food intolerances are lactose intolerance or sensitivity to caffeine. Because food intolerance does not involve the immune system like food allergies, it is not potentially life-threatening like a food allergy. The severity of the symptoms is usually tied to the amount of the 'threatening' food eaten. Food poisoning is still another type of food reaction that is sometimes mistaken for food allergy. So, after ruling out food intolerances and other health problems, your health care provider will use several steps to find out if you have an allergy to specific foods.

Someone can have food allergies to a lot of things. Some are peanuts, tree nuts like walnuts, fish, shellfish, dairy products, eggs, wheat, and soy. Talk about deadly, they are the leading cause of anaphylaxis, the life-threatening reaction that causes difficulty breathing, swelling in the the mouth and throat, a sudden drop in blood pressure, and in some cases loss of consciousness. Statistically speaking, each year food allergies account for an estimated 30,000 emergency room visits, 2000 hospitalizations, and as many as 200 deaths from anaphylaxis.
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What's Going On in There (our bodies that is)?
So, what is the process our body goes through with a food allergy? An allergic reaction to food can take place within a few minutes to an hour. However, some people with very severe allergic reactions to some food, insect stings, medications and latex can have a dangerous anaphylactic reaction in a matter of seconds or minutes after exposure to the offending substance. That's why people with severe food allergies should carry a strong antidote with them at all times. The drug, racemic epinephrine, is a synthetic version of the naturally occurring hormone epinephrine, which counteracts anaphylaxis. It comes in the form of a pen (EpiPen) or dual pen and needle-and-syringe kit (Twinject).

The process of eating and digesting food affects the timing and the location of a reaction. 1. If you are allergic to a particular food, you may first feel itching in your mouth as you start to eat the food. 2. After the food is digested in your stomach, you may have GI symptoms such as vomiting, diarrhea, or pain. 3. When the food allergens enter and travel through your bloodstream, they may cause your blood pressure to drop. 4. As the allergens reach your skin, they can cause hives or eczema. 5. Lastly, when the allergens reach your lungs, they may cause asthma and an anaphylactic reaction.
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Cross-Reactivity:
If you have a life-threatening reaction to a certain food, your health care provider will show you how to avoid similar foods that might trigger this reaction. For example, if you have a history of allergy to shrimp, testing will usually show that you are not only allergic to shrimp but also to crab, lobster and crayfish. This is called "cross-reactivity". Another interesting example of cross-reactivity occurs in people who are highly sensitive to ragweed. During ragweed pollen season, they sometimes find that when they try to eat melons, particularly cantaloupe, they experience itching in their mouths and simply cannot eat the melon. Similarly, people who have severe birch pollen allergy also may react to apple peels. This is called the "oral allergy syndrome."
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Diagnosis and Treatment:
Unlike allergic rhinitis or asthma, there is no effective treatment for food allergies. All you can do is to find out what food you are allergic to and then avoid it. Allergy shots and oral desensitization have not proven to a safe or effective way to reduce food allergies. Sometimes your health care provider can't make a diagnosis solely on the basis of knowing your history. In that case, you may be asked to keep a record of the contents of each meal you eat and whether you have a reaction. There is a helpful Diet Diary log in the Allergy Triggers Checklist section that can help.  You might also be asked: 1. What was the timing of your reaction. 2. Did your reaction come on quickly, usually within an hour after eating the food? 3. Is your reaction always associated with a certain food?  4. Did allergy medicines help? Antihistamines should relieve hives, for example. 5. How much did you eat before you had a reaction? The severity of a reaction is sometimes related to the amount of food eaten.  6. Did anyone else who ate the same food get sick? 7. How was the food prepared? Some people will have a violent allergic reaction only to raw or undercooked fish. Complete cooking of the fish may destroy the allergen, and they can then eat it with no allergic reaction. 8. Did you eat other foods at the same time you had the reaction? Some foods may delay digestion and thus delay the start of the allergic reaction. Armed with your history and the diet diary from you, your provider may reach a diagnosis with no further testing.

The next step some health care providers use is an elimination diet. Your provider can almost always make a diagnosis if the symptoms go away after you remove the food from your diet. The diagnosis is then confirmed if you eat the food and the symptoms come back. Your Diet Diary will also help your provider during your elimination diet. You should do this only when the reactions are not significant and under health care provider direction. Your provider can't use this technique, however, if your reactions are severe or don't happen often. If you have a severe reaction, you should not eat the food again.
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Further Testing:
If your history, diet diary, or elimination diet suggests a specific food allergy is likely, your health care provider may use additional tests to further confirm the diagnosis. One of these is a scratch skin test, during which an extract of the food is placed on the skin of your lower arm. Your provider will then scratch this portion of your skin with a needle and look for swelling or redness which would be a sign of a local allergic reaction. If the scratch test is positive, it means that there is IgE on the skin's mast cells that is specific to the food being tested. Skin tests are rapid, simple and relatively safe.

If you are extremely allergic and have severe anaphylactic reactions or get severe skin rashes - your health care provider cannot use skin testing because causing an allergic reaction could be dangerous. Skin testing also cannot be done if you have eczema over a large portion of your body. In those cases, a health care provider may use blood tests such as the RAST (radioallergosorbent test) or the ELISA (enzyme-linked immunosorgent assay). These tests measure the presence of food-specific IgE in your blood. As with skin testing, positive test do not necessarily mean you have a food allergy. It takes about a week to get the results from this blood test. And unfortunately after you may have gone through all this, positive skin or RAST/ELISA tests don't always correlate with the reactions. Even a negative test can't be trusted, because it may be that you have a non-IgE allergy, the wrong food was tested, or the the test wasn't sensitive enough. Death and taxes still remain about the only 'sure things in life'.
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Concluding:
Food allergy is treated by avoiding the foods that trigger the reaction. As has been said, food allergies should not be treated lightly, they can be life-threatening. Once you and your health care provider have identified the food(s) to which you are sensitive, you must remove them from your diet. To do this, you must read the detailed ingredient lists on each food you are considering eating. If you are highly allergic, even the tinniest amounts of a food allergen (for example, a small portion of a peanut kernel) can prompt an allergic reaction. If you have severe food allergies, you must be prepared to treat unintentional exposure. Even people who know a lot about what they are sensitive to occasionally make a mistake. To protect yourself if you have had allergic reactions to a food, you should: 1. Wear a medical alert bracelet or necklace stating that you have a food allergy and are subject to severe reactions. 2. Carry a syringe of adrenaline (epinephrine), obtained by prescription, and be prepared to give it to yourself if you think you are getting a food allergic reaction. 3. Seek medical help immediately by either calling ambulance emergency medics or by getting transported to an emergency room. Anaphylactic allergic reactions can be fatal even when they start off with mild symptoms such as a tingling in the mouth and throat or GI discomfort.

There are several medicines that you can take to relieve food allergy symptoms that are not part of an anaphylactic reaction. They include: 1. Antihistamines to relieve GI symptoms, hives, or sneezing and a runny nose. 2. Fast acting bronchodilators to relieve asthma symptoms. 3. Corticosteroid medication. You should take these medicines if you have accidentally eaten a food to which you are allergic. They do not prevent an allergic reaction when taken before eating the food. No medicine in any form will reliably prevent an allergic reaction to that food before eating it.

Schools and day care centers must have plans in place to address any food allergy emergency. Parents and caregivers should take special care with children and learn how to: 1. Protect children from foods to which they are allergic. 2. Manage children if they eat a food to which they are allergic. 3. Give children epinephrine. One study by the Johns Hopkins Children's Center showed that simply washing your hands with soap and water will remove peanut allergens. Also, most household cleaners will remove them from surfaces such as food preparation areas at the home as well as day care facilities and schools. These easy-to-do measures will help prevent peanut allergy reactions in children and adults. Educating people, including patients, health care providers, school teachers, and day care workers about the importance of food allergy should also be an important focus.
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