u True food allergy

u Food intolerance 

Imagine a child eating a peanut butter sandwich and within minutes complaining of swollen tongue, hives, difficulty in breathing and collapse needing resuscitation - an anaphylactic attack.   

This is true food allergy where a tiny amount of the food can cause a catastrophic allergic attack with possible lethal consequences.  Because the time interval between eating the food and getting symptoms is very short – perhaps minutes – the diagnosis is straightforward.

The mechanism of the reaction is clearly understood - an allergy-inducing protein in the food meets specialised white blood cells and causes them to rapidly release histamine.   Blood tests and skin tests can confirm the diagnosis; but as often as not this is all too clear from the outset.

Imagine someone with constant diarrhoea or constipation, with gas, bloating and stomach pain – irritable bowel syndrome.  

Imagine someone with frequent migraine, nausea and vomiting, or a hyperactive child who is at one moment wild, argumentative and impossible and at another moment calm happy and co-operative. In all of these cases, a diet investigation may show that particular foods or food additives are triggering symptoms.

This is then food intolerance but the underlying mechanisms that cause it are unknown and no blood or skin tests have been properly validated.  There is a need for a test that will take the guess work out of an elimination diet – at present the only true diagnostic test – time consuming and difficult to undertake.

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