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Allergies and intolerances


Allergies and intolerances —there's a lot of about allergies and intolerances, and it can all get quite confusing. What's the difference between the two, and why does it matter?
 
Allergies and intolerances may seem similar, but they're actually quite different! It's a good idea to know which is which, and the table below will help explain the main differences between food allergies and intolerances. (Important note: this information is intended as advice only; if you think your child may have a food allergy or intolerance, seek medical advice from your doctor right away.)

Food Allergy
Food Intolerance
What is it? An adverse immune response to a specific protein within a food. An adverse bodily response to a component within a food (not necessarily a protein) with no immune involvement.
Common or rare? Rare, but risk is higher in families with a history of allergy. Common or rare? Rare, but risk is higher in families with a history of allergy. More common than an allergy, but still unusual in children.
What causes it? The immune system thinks the protein in the food is harmful and reacts to it, causing symptoms (see below). There are a number of causes; sometimes a lack of enzymes means food can’t get digested, or sometimes foods can cause symptoms on their own.
Amounts A reaction can be caused by the smallest traces of the food. Usually a reaction only happens after consuming at least a teaspoon of the food.
Symptoms Redness, swelling, difficulty breathing, skin reactions including itching or urticaria (hives) and anaphylaxis, among others. Headache, bloating, stomachache, diarrhea, sickness. No anaphylaxis.
How is it diagnosed? Generally, looking at previous medical conditions to rule out other causes. Then either a skin prick test (SPT) or blood test (called a RAST) or skin patch test (performed by a your doctor or allergist). How is it diagnosed? Generally, looking at previous medical conditions to rule out other causes. Then either a skin prick test (SPT) or blood test (called a RAST) or skin patch test (performed by a your doctor or allergist). Could involve looking at previous medical conditions and ruling out other causes. Then either keeping a food and symptom diary, or trying an ‘exclusion diet’ where foods are avoided and then re-introduced to see if they cause symptoms.
Is there a cure? Avoiding the food completely is the only treatment – however, some children do ‘grow out’ of their allergies. If the intolerance is severe the food may need to be avoided for life, or limited to small amounts.
How is it managed? For some, mild symptoms can be controlled with anti-histamines. You may need to keep adrenaline (an EpiPen) on hand if the allergy is severe. If the food is a major part of the diet, nutritional advice may be needed. Reintroduction of food may be performed under medical supervision to see if the allergy persists into adulthood. How is it managed? For some, mild symptoms can be controlled with anti-histamines. You may need to keep adrenaline (an EpiPen) on hand if the allergy is severe. If the food is a major part of the diet, nutritional advice may be needed. Reintroduction of food may be performed under medical supervision to see if the allergy persists into adulthood. If the food is a major part of the diet, nutritional advice may be needed. Adrenaline is not required. As some children can ‘grow out of’ food intolerances, reintroduction of food may be performed under medical supervision.

Allergy & Intolerance FAQs
 
What should I do if I think my child has an allergy/intolerance?
 
If you suspect that your child may have an abnormal reaction to a food, it's important to discuss it with your doctor right away. Sometimes what looks like an allergy or an intolerance might be something different, so you don’t want to take things out of your child’s diet until you're certain of the cause.
 
If the symptoms were obviously related to one specific food (for example, an egg) then it may be wise to avoid giving your child egg until you have a chance to speak to your doctor. Even if you do this and the symptoms stop, you should still book an appointment to see your doctor so you can have your concerns confirmed and properly diagnosed.
 
It may help you to write down what your child ate and exactly what happened so that you don’t forget anything which may be important when you see your doctor; this will also help them to make the right diagnosis.
 
What sorts of foods are likely to trigger an allergy?
 
Any food containing protein has the potential to trigger an allergy; however, there some are more common culprits than others, including peanuts, tree nuts, fish and shellfish, cow’s milk, eggs, soya and wheat.
 
What sorts of foods are likely to cause intolerance?
 
We don't really know what makes a food likely to cause intolerance. However for some, dairy is the most common source. People with intolerance for dairy actually produce less of the enzyme the body needs to break down the food, which may lead to uncomfortable symptoms.
 
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