DEAR MAYO CLINIC: I'm a grandmother to three wonderful grandchildren. My oldest grandchild is lactose intolerant. Recently, my youngest grandchild was diagnosed with a peanut allergy. What is the difference between food intolerance and allergy?

ANSWER: Life at the dinner table is different for thousands of people in the U.S. living with a food allergy. Recent studies show that approximately 5% of children under the age of 5 and 3% of adults have food allergies.

Food allergies and intolerances often are confused for one another. The symptoms can be similar.

If you have a food allergy, your body overreacts to a specific food as if it were a threat. This can occur when you ingest even the smallest amount of the food. For some people, the allergy may be triggered by smelling or coming into contact with the food.

When you come into contact with the food, your immune system releases an antibody called immunoglobulin E to neutralize the food allergen.

The immunoglobulin antibodies tell your immune system to release a chemical called histamine, which causes many allergic symptoms, such as itching, swelling, hives and difficulty breathing.

The top eight most common food allergens are egg, milk, peanuts, shellfish, tree nuts, soy, fish and wheat.

Unlike an allergic reaction, the symptoms of food intolerance are typically gastrointestinal. An intolerance means your body does not have the correct mechanisms to digest certain foods properly.

A common food intolerance is lactose — the main sugar in milk products. If you have lactose intolerance, your body has difficulty digesting lactose, causing symptoms of bloating, abdominal pain and sometimes diarrhea.

Other intolerances that are sometimes confused with food allergy include:

• Irritable bowel syndrome — a condition causing frequent diarrhea, constipation, bloating and other gastrointestinal symptoms when excess short-chain carbohydrates are consumed
• Celiac disease — a condition where the body sustains damage at a microscopic level from ingesting gluten, which is found in wheat, barley or rye products
• Food poisoning caused by bacteria that contaminate food

An allergist is the best qualified professional to diagnose a food allergy. Your allergist will begin by taking a detailed medical history to find out whether your symptoms are an allergic reaction, an intolerance or another health problem.

Other food allergy tests include:

• Skin test
  A skin test may determine which foods, if any, trigger your allergic symptoms. In skin testing, a small extract of the food is placed on your forearm or back by a tiny pinprick just below the skin. You'll develop a small bump if you're allergic to the substance.
• Blood test
  Your allergist also may take a blood sample to measure the levels of food-specific immunoglobulin E. Positive blood tests do not necessarily mean that you have a food allergy, but they can help put together the pieces of the puzzle.
• Food diary
  You may be asked to keep a food diary of what you eat and whether you have a reaction.
• Elimination diet
  A limited elimination diet is removing the suspected food allergen from your diet under the direction of your health care professional for a few weeks. You then add the food item back into your diet to see if the symptoms return.
• Oral food challenge
  During this test, conducted in your allergist's office, you are given small, but increasing amounts of the suspect food. Your health care professional watches you to see whether a reaction occurs. A reaction only to suspected foods confirms the diagnosis of a food allergy. If you don't react, you may be able to include that food in your diet again.

Unfortunately, those with food allergies cannot be cured. You can only prevent the symptoms by avoiding the foods that cause a reaction. If you come into contact with a food that causes a minor allergic reaction, you often can use an antihistamine to reduce the symptoms. For severe reactions, you may need an emergency epinephrine injection or a trip to the emergency department. You should always wear a medical alert bracelet or necklace. Seek medical care if you suspect you are having an allergic reaction. —Kjersten Nett, R.D.N., Clinical Nutrition, Mayo Clinic Health System, Albert Lea and Austin, Minnesota

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Related Article 

• Mayo Clinic Q and A: Testing for food allergies and sensitivities published 4/13/22

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Listen: Mayo Clinic Radio 4/27/19

On the Mayo Clinic Radio podcast, Dr. Edward Loftus Jr., a Mayo Clinic gastroenterologist, discusses diagnosing inflammatory bowel disease and treatment options. Also on the podcast, Dr. Avni Joshi, a pediatric allergy and immunology specialist at Mayo Clinic, shares the latest research on the incidence of food allergies in different age groups. And Dr. Charles Bruce, medical director of the Life Sciences Incubator on Mayo Clinic's Florida campus, explains a new collaboration between Mayo Clinic and Georgia Tech. The Convergence Science Program pairs Georgia Tech's engineering expertise with a Mayo physician's ideas to tackle a clinical problem in need of a solution.

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On the next Mayo Clinic Radio program, Dr. Edward Loftus Jr., a Mayo Clinic gastroenterologist, will discuss diagnosing IBD and treatment options. Also on the program, Dr. Avni Joshi, a pediatric allergy and immunology specialist at Mayo Clinic, will share the latest research on the incidence of food allergies in different age groups. And Dr. Charles Bruce, medical director of the Life Sciences Incubator on Mayo Clinic's Florida campus, will explain a new collaboration between Mayo Clinic and Georgia Tech. The Convergence Science Program pairs Georgia Tech's engineering expertise with a Mayo physician's ideas to tackle a clinical problem in need of a solution.

Here's your Mayo Clinic Radio podcast.

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Inflammatory bowel disease (IBD) is an umbrella term used to describe disorders that involve chronic inflammation of the digestive tract. There are two common types: ulcerative colitis, which causes ulcers, or sores, in the lining of the large intestine and rectum, and Crohn’s disease, which causes inflammation of the lining of any part of the digestive tract. Symptoms of IBD usually involve severe diarrhea, abdominal pain, fatigue and weight loss. IBD can be debilitating and sometimes lead to life-threatening complications. While there is no cure for IBD, treatment can reduce the inflammation that triggers your signs and symptoms, and, in the best cases, lead to long-term remission.

On the next Mayo Clinic Radio program, Dr. Edward Loftus Jr., a Mayo Clinic gastroenterologist, will discuss diagnosing IBD and treatment options. Also on the program, Dr. Avni Joshi, a pediatric allergy and immunology specialist at Mayo Clinic, will share the latest research on the incidence of food allergies in different age groups. And Dr. Charles Bruce, medical director of the Life Sciences Incubator on Mayo Clinic's Florida campus, will explain a new collaboration between Mayo Clinic and Georgia Tech. The Convergence Science Program pairs Georgia Tech's engineering expertise with a Mayo physician's ideas to tackle a clinical problem in need of a solution.

To hear the program, find an affiliate in your area.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post What is inflammatory bowel disease? appeared first on Mayo Clinic News Network.

On the next Mayo Clinic Radio program, Dr. Edward Loftus Jr., a Mayo Clinic gastroenterologist, will discuss diagnosing IBD and treatment options. Also on the program, Dr. Avni Joshi, a pediatric allergy and immunology specialist at Mayo Clinic, will share the latest research on the incidence of food allergies in different age groups. And Dr. Charles Bruce, medical director of the Life Sciences Incubator on Mayo Clinic's Florida campus, will explain a new collaboration between Mayo Clinic and Georgia Tech. The Convergence Science Program pairs Georgia Tech's engineering expertise with a Mayo physician's ideas to tackle a clinical problem in need of a solution.

To hear the program, find an affiliate in your area.

Miss the show? Here's your Mayo Clinic Radio podcast.

Use the hashtag #MayoClinicRadio, and tweet your questions.

Mayo Clinic Radio is on iHeartRadio.

Access archived shows or subscribe to the podcast.

Mayo Clinic Radio produces a weekly one-hour radio program highlighting health and medical information from Mayo Clinic.

The post Mayo Clinic Radio: IBD / food allergies / Convergence Science Program appeared first on Mayo Clinic News Network.

Watch: The Mayo Clinic Minute

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Again, how common are peanut and other food allergies? Until a recent study, no one really knew.

"This is the first study which has found the true incidence and prevalence of food allergies in the United States," says Dr. Joshi.

She says their study shows that food allergies vary based on age. So as an infant, milk is the most common food allergy because that’s the most common first food introduced for a baby. The second most common, between ages 1 and 4, is peanuts. And, in adults, to our surprise, we found shellfish allergy was the most common food allergy in adult patients.

They also found that food allergies are more common in males of all ages, and, for most healthy kids, introducing potential allergenic foods, such as peanuts, early may help prevent allergies from developing.

"This will help pave the way for our governing bodies to make recommendations for introduction of allergenic food," says Dr. Joshi.

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Thanksgiving may get your mouth watering in anticipation for turkey and stuffing, but it can be an anxious time for parents of kids with food allergies. With so many food options, it's too easy for a problematic food to accidentally end up on an allergic child's plate, says Dr. Ravi.

"Family members and relatives, they have the best of intentions, but they may forget that they used almond extract or some other allergenic food because, like, for example, we forget that butter contains milk. And somebody might put butter in a recipe and forget that there is dairy, or when a child has a milk allergy," Dr. Ravi says.

Someone might take a utensil from one item and scoop something else," Dr. Ravi adds. "So even that cross-contamination is very significant."

The result can be allergic reactions ranging from itchy hives, and tongue and lip swelling to throat closing and trouble breathing. Any of these reactions can be dangerous to a child.

So this holiday season, Dr. Ravi recommends parents of kids with food allergies remove all risk and doubt, and just bring foods they know are safe to family feasts.

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There’s been a major shift in strategy for preventing potentially deadly peanut allergies. After a decade and a half of being told to keep peanuts away from small children, parents now are being told the opposite. The National Institute of Allergy and Infectious Diseases, a division within the National Institutes of Health, now recommends exposing infants to peanut protein as young as 4 to 6 months old.

Research shows the prevalence of peanut allergies among U.S. children multiplied roughly four-fold in the 10 years following a 2000 recommendation of peanut avoidance for infants and toddlers. Two percent of U.S children now are believed to be allergic to peanuts.

“I think the initial guidelines back in 2000 were based on people thinking, ‘well, let’s try this,’ without a lot of scientific evidence to support it,” says Martha Hartz, M.D. , the division chair of Pediatric Allergy and Immunology in the Mayo Clinic Children's Center. The latest revisions to the guidelines were influenced by the 2015 Learning Early About Peanut Allergy study, which concluded that regular peanut exposure before age 5 reduced the threat of developing an allergy by more than 80 percent in high risk infants.

Dr. Hartz praises the new recommendations for offering very specific instructions for safely introducing peanut exposure, depending on a child’s degree of allergy risk. “Any parent with a child that already has a food allergy, if they can prevent it in their other children, they’re going to be interested.” 

If your child tests positive for a peanut allergy, Dr. Hartz says to ask for a referral to see an allergist. She says she's hopeful the revised guidelines will lead to a dramatic reduction in peanut allergies in the years to come. Dennis Douda reports.

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