Is it a real food al­lergy?

Pakistan Observer - - LAHORE CITY -

OVER re­cent years we have been wit ness­ing a sig­nif­i­cant in­crease in food in­tol­er­ances and al­lergy. But when is it re­ally an al­lergy? Is it pos­si­ble to pre­vent by in­ter­ven­ing in the very first few months of life? When­ever you eat straw­ber­ries, does your throat start to swell and itch? Do you also get a burn­ing or prick­ling sen­sa­tion in your lips, gums, tongue or in­side your cheeks? Or per­haps drink­ing milk gives you ab­dom­i­nal bloat­ing, cramps in the lower belly and di­ar­rhoea half an hour later?

These two sim­ple cases are very ex­plica­tive of two dif­fer­ent sit­u­a­tions: al­lergy and in­tol­er­ance to a given pro­tein or other mol­e­cule in a food. “Food al­lergy is a real disease, with a preva­lence of 1-4% in the gen­eral pop­u­la­tion with chil­dren be­ing more af­fected than adults”, says En­rico Hef­fler, al­ler­gist and clin­i­cal im­mu­nol­o­gist at the Univer­sity of Cat­nia, Italy, as well as Gen­eral Sec­re­tary of the Ital­ian So­ci­ety of Al­lergy, Asthma and Clin­i­cal Im­munol­ogy (SIAAIC).

“An al­lergy oc­curs when our im­mune sys­tem re­acts to a spe­cific pro­tein, the “al­ler­gen”, present in a given food and wrongly con­sid­ered as an “in­vader”, and con­se­quently it trig­gers a pro­tec­tive re­sponse”, he ex­plains. The symp­toms of food al­lergy can range from mild to se­vere and the clin­i­cal man­i­fes­ta­tions mainly in­volve the skin, the gas­troin­testi­nal tract, the car­dio­vas­cu­lar sys­tem and the res­pi­ra­tory tract. Pos­si­ble man­i­fes­ta­tions range from skin rashes, or hives, to ana­phy­laxis, a life-threat­en­ing whole-body al­ler­gic re­ac­tion that can im­pair breath­ing, caus­ing a drop in blood pres­sure and af­fect­ing heart rate. “How­ever”, Hef­fler con­tin­ues, “food in­tol­er­ances iden­tify a num­ber of non-al­ler­gic dis­eases, usu­ally due to enzy­matic de­fi­cien­cies, char­ac­ter­ized by the in­abil­ity to com­pletely di­gest some food com­po­nents. The two most com­mon in­tol­er­ances con­cern, re­spec­tively, lac­tose, due to the lack or re­duced ac­tiv­ity of the en­zyme that breaks the milk sugar (lac­tose), and celiac disease, where the in­com­plete di­ges­tion of gluten, a pro­tein found in wheat, rye and bar­ley, dam­ages the small in­tes­tine”. The preva­lence of food al­lergy has been in­creas­ing in the same way as that of other al­ler­gic dis­eases.

The last decades have shown that pa­tients are more and more likely to per­ceive their disease as re­lated to eat­ing. This has added to the con­fu­sion be­tween al­lergy and in­tol­er­ance, and has led to in­ap­pro­pri­ate al­lergy con­sul­tancy and test­ing, as well as to greater health-re­lated costs. In this con­text there has been a par­al­lel in­crease of the busi­ness be­hind tests for sus­pected in­tol­er­ances and mar­keted prod­ucts free from spe­cific al­ler­gens. In ad­di­tion to the “of­fi­cial” and val­i­dated tests, in fact, we are see­ing the growth of “non-con­ven­tional” di­ag­nos­tic tests per­formed in pri­vate med­i­cal fa­cil­i­ties, whose re­li­a­bil­ity and ef­fi­cacy in iden­ti­fy­ing al­ler­gic dis­eases or food in­tol­er­ances have been brought into doubt by sev­eral sci­en­tific stud­ies.

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