Recognizing Food Allergy Reactions

Food allergies have become increasingly common in recent decades. Many grandparents and parents cannot recall even one other child they knew growing up who had a food allergy! Recognizing food allergy reactions early can make a big difference in the outcome by keeping a reaction more limited.

Reactions to pollen in food

Food allergy reactions can occur in several different ways. They are usually easily recognized, but simpler reactions may be harder to detect.

The mildest is the “oral allergy syndrome” or “pollen food syndrome.” Some people with pollen allergies experience itching or burning sensations of the lips, mouth and/or throat caused by certain raw fruits and vegetables. Interestingly, this allergic reaction occurs because IgE antibodies developed against inhaled pollens bind to very similar proteins consumed in foods.

In western Washington, the usual culprit pollens are alder, birch, or grasses and the most common food triggers are apples, melons, pitted fruits, lettuce, peas, and carrots.

Normally, no specific treatment is needed with this type of mild reaction.

Recognizing a reaction

Traditional food allergy reactions can range in severity from a mild nuisance to life-threatening or even fatal severe allergic reactions.

Symptoms are usually seen within seconds to minutes, involve the skin and gastrointestinal tract, and may include:

• Itching or burning sensations in the mouth or throat
• Hives on the face and neck
• Swelling of the lips or around the eyes
• Nausea and limited vomiting

In stronger reactions, symptoms can include:

• A “sense of impending doom”
• Hives all over the body
• Swelling of the tongue, mouth, and throat
• Persistent vomiting or retching
• Abdominal pain and diarrhea
• Coughing, choking, and wheezing

If very severe, sufferers may experience dizziness and disorientation from decreased blood pressure and impaired heart pumping.

What to do

The best way to manage allergy symptoms is to avoid culprit foods. Consistency is critical in asking about food contents and reading food packaging labels, as these can change anytime without notice.

If you do experience a reaction, you will want to act quickly:

1. The most common first line treatment for a suspected reaction is epinephrine, usually by autoinjector (i.e. EpiPen, AuviQ).
2. After the injection, call 911 immediately to bring in emergency medical help.
3. After calling, diphenhydramine (Benadryl) can be given.
4. Approximately 15 minutes after the first dose of epinephrine, a second dose can be given if symptoms are severe or not improved.
5. Unless there are unusual circumstances, stay put, so help comes with more epinephrine, oxygen, and other supportive treatments.

The greatest risk of a reaction becoming fatal is a marked delay in starting treatment, especially after 20-30 minutes from onset of symptoms.

You can find more information on living with food allergies through FARE at www.foodallergy.org.

If you have any questions or concerns about a possible food allergy, please talk with your child’s provider. Our specialists can help with diagnosis of food allergies and developing a proper treatment plan. For more information about specialty care at Pediatrics Northwest, visit our Allergy & Asthma Center.