FOOD ALLERGIESReactions to food are common. These reactions range from mild to severe, and may result from your body's negative response to certain foods or from a true food allergy.Common allergic foods in our Indian children based on personal experience are Nuts ,Milk, Shell fish, Eggs, Chicken,Brinjal,Lemon, Chickpea, Moong dhal. Some people also have oral allergy syndrome(OAS) , they have itching of lips and palate after eating apple or bananas. If allergic to apple or pear, we look for cross allergy to pollens . In banana allergy, we have to also rule out latex allergy. Latex is present in natural rubber products even balloons. There are also some cases with food dependent exercise induced anaphylaxis. A severe allergy reaction to food occurs after eating the suspect food and exercising or physical exertion soon after. The common culprit foods can be shell fish, wheat, tomatoes, seasame, ground nuts. If there is an allergy suspicion, they need to get evaluated by an allergist and food allergy test should be done. The most conclusive is oral food challenge. But oral food challenge should be done only in a hospital setting. It is also important to carry emergency medications like epipen. Unfortunately, epipen is not marketed in India. In India, we allergists, equip the patients with emergency medication. Food allergy should be taken seriously. It can present with a severe anaphylactic reaction. Community awareness and other general physician awareness is lacking very much in India. Schools should also conduct food allergy management program for their staff. The time to emergency treatment is critical.From 3 percent to 8 percent of children have reactions to some foods. Only 1 percent to 2 percent have true food allergies. Some children seem to grow out of their sensitivity to certain foods, often by age 4. Allergies to peanuts, tree nuts and shellfish usually do not go away, though.From 1 percent to 2 percent of adults have true food allergies. But people of any age can have sudden allergic reactions to a food that had previously not been a problem for them.Severe, life-threatening reactions are more common with allergies to peanuts, tree nuts, shellfish, fish and eggs. These life-threatening reactions are more common in people who also have asthma.What are the Symptoms?The signs to suspect food allergy in children are hives or swelling and redness in the whole body, swelling of lips, itching around the mouth. Vomiting, abdominal pain and wheezing associated with skin hives are indicative of serious allergy reaction which requires emergency medical attention.Reactions can affect different body systems:The digestive tract, which first comes into contact with food. Some symptoms, such as swelling and itching of the lips, the lining of the mouth as well as throat tightness and hoarseness may occur quickly. When the food enters the stomach and then the intestines, nausea, cramping, pain, vomiting and diarrhea may occur.Body systems, such as the skin, lungs and blood vessels that are affected after the food leaves the digestive tract. These reactions can occur in minutes or within two hours. Often, hives and swelling of the skin occur. Anaphylaxis, the most dangerous and life-threatening result of a food allergy, usually occurs within minutes after consuming the food. When this happens, blood vessels widen so much that blood pressure falls. Symptoms include wheezing, difficulty breathing, throat tightness, nausea, rapid pulse, flushing, faintness, itching of the palms and sole of the feet and even passing out. Without speedy treatment, this intense allergic reaction can cause death. The first severe reaction to a food may be unexpected. Sometimes the patient may at first have minor symptoms such as stomach cramping or hivesHow is a Food Allergy Diagnosed?If your doctor suspects you may have a food allergy, the first step is to take a detailed medical history and physical exam. Other tests are used to confirm that you are allergic to certain foods. Some tests use extracts of the suspected foods:Ig E Antibodies to FOOD ALLERGENS by IMMUNOCAP ELISA test is done in a laboratory. It is used to test a sample of blood for antibody to a specific food. While more costly and less sensitive than skin testing, it is particularly useful when eczema and other skin conditions make skin testing difficult.Allergy skin prick test- The skin test involves scratching or pricking your skin with one or more extracts. Another test is the oral food challenge. This test provides the most convincing results. It is required if the relationship between the eating a specific food and symptoms is still unclear after skin tests. Your doctor will explain that all oral challenges -- giving patients the suspected foods -- carry a risk of causing an allergic reaction. They should be done with a specialist physician present and in a setting where allergic reactions can be treated promptly. If the diagnosis is still unclear, you may be put on an elimination diet. The first step is to follow the usual diet for 10 to 14 days. You keep a record of what and how much you eat, when a reaction occurred, and what the reaction was. The foods suspected of causing the reaction are then removed from your diet. Make sure that the foods are not in other foods you eat. For example, egg or milk may be in mayonnaise or salad dressings. Elimination diet should only be used for a limited period of time such as 10-14 days. What are Some Tips to Follow to Prevent an Allergic Reaction?Do not consume foods that cause a reaction. People with a severe allergy can go into anaphylactic shock from trace amounts of the food to which they are allergic. Touching foods cause some people to have a severe reaction.Read the ingredients lists on food labels to make sure allergy-causing foods are not mixed in. Read the list even if you have had the product before. Ingredients may change.When eating out, always ask restaurant staff about ingredients in food and how it was prepared. Cooking oils can have allergens. Peanut oil is often used in cooking indian savouries.Management of Food AllergyIf you have a severe reaction, take medication and seek medical care promptly. Injectable epinephrine should always be at hand for treating anaphylactic shock. Get medical care promptly after using epinephrine, even if you feel better. Symptoms may reoccur in a few hours. Antihistamines and steroids also management of food allergies in children: First and foremost is that the children should be educated on food allergies and read food labels. Any food with suspicion must be avoided, especially sharing food with class mates or accidental ingestion of allergenic food.]There was a case of a boy with severe egg allergy but not chicken allergy reacting badly to chicken in a food outlet. Apparently, egg was a hidden ingredient in the spices.Children with food allergy should carry emergency medicine like epipen and anti histamine tablets. Schools should also equip themselves with emergency medication like epipen as the time to treatment is critical.