Food Allergy

Reproducible, adverse reaction to a specific food (not psychological)

Evidence of abnormal immunological reaction to food

Rare - before age 5 Antibody response to allergen e.g. peanuts, eggs, protein Rapid reaction after ingestion - min to hrs Nausea, vomiting, abdominal pain, diarrhoea

2-7% are allergic to cows milk Allergic reaction = formula containing cow’s milk protein or from mother’s milk (cow’s milk protein from diet) Soya-based formula: soya can also cause allergic reaction Nutramigen - used for children allergic to both cow’s milk + soy (cow’s ,ilk free)

Classified as allergy due to abnormal immune response to food IgE antibodies not produced (not a classic allergic reaction) Autoimmune disease - body produces antibodies against tissue proteins - triggered by gluten

Increased risk of lymphoma and small bowel cancer Still a risk even if symptomless or is tolerated Important to adhere to gluten-free diet

Weight loss Flatulence Abdominal distension Diarrhoea with large amount of fat - steatorrhoea Micronutrient deficiency’s Abdominal distension Avoid: • Wheat • Rye • Barley • Oats • Processed food

Defects in enzymes / pharmacological reaction to substances in food E.g. lactose intolerance, alcohol dehydrogenase

sweating palpitations dyspepsia withdrawal headache depression anxiety

Salicylate found in herbs, spices, fruits + veg GI disturbances

Vasoactive amines are histamine, tyramine + serotonin Found in cheese, chocolate, citrus fruit, yeast + red wine Migraines

Not being able to breakdown the amino acid phenylalanine; increasing levels in the blood Requires special diet + supplements Avoid aspartame or high protein foods Failure to treat within 20 days results in neurodevelopmental (brain) delay Fitting may occur (every baby born has blood test within 6-10 days)

Require reduced protein diet Limit phenylalanine (still required Supplement with Phe-free amino acid mix to provide adequate protein Need to maintain Phe-free diet into adulthood so that neurological problems do not occur - especially in pregnant women

Calcium-containing foods contain protein - calcium supplement Iron supplements - little meat in diet Aspartame sweetener - source of Phe (alternative needed)

Deficiency in lactase - cannot digest lactose

Flatulence Diarrhoea Bloated stomach Stomach cramps + pains

Colief - lactase drops Engamil acto-free powder

Skin prick test Elimination diets (remove particular foods + see if conditions improves) In children, it is failure to thrive ( not growing ) • skin rashes (eczema) • asthma • urticaria • mood alterations • GI disturbances In adults: • allergic symptoms • migraine • IBS

Thickening agents