What is the most common food allergy in the us

A food allergy occurs when the body’s immune system sees a certain food as harmful and reacts by causing symptoms. This is an allergic reaction. Foods that cause allergic reactions are allergens.

Non-IgE Mediated Food Allergies

Most symptoms of non-IgE mediated food allergies involve the digestive tract. Symptoms may be vomiting and diarrhea. The symptoms can take longer to develop and may final longer than IgE mediated allergy symptoms.

Sometimes, a reaction to a food allergen occurs up 3 days after eating the food allergen.

When an allergic reaction occurs with this type of allergy, epinephrine is generally not needed. In general, the best way to treat these allergies is to stay away from the food that causes the reaction. Under are examples of conditions related to non-IgE mediated food allergies.

Not every children who react to a certain food own an allergy. They may own food intolerance. Examples are lactose intolerance, gluten intolerance, sulfite sensitivity or dye sensitivity. Staying away from these foods is the best way to avoid a reaction.

Your child’s doctor may propose other steps to prevent a reaction. If your kid has any food allergy symptoms, see your child’s doctor or allergist. Only a doctor can properly diagnose whether your kid has an IgE- or non-IgE food allergy. Both can be present in some children.

Eosinophilic Esophagitis (EoE)

Eosinophilic (ee-uh-sin-uh-fil-ik) esophagitis is an inflamed esophagus. The esophagus is a tube from the throat to the stomach. An allergy to a food can cause this condition.

With EoE, swallowing food can be hard and painful. Symptoms in infants and toddlers are irritability, problems with eating and poor weight acquire. Older children may own reflux, vomiting, stomach pain, chest pain and a feeling love food is “stuck” in their throat.

The symptoms can happen days or even weeks after eating a food allergen.

EoE is treated by special diets that remove the foods that are causing the condition. Medication may also be used to reduce inflammation.

Food Protein-Induced Enterocolitis Syndrome (FPIES)

FPIES is another type of food allergy. It most often affects young infants. Symptoms generally don’t appear for two or more hours.

Symptoms include vomiting, which starts about 2 hours or later after eating the food causing the condition. This condition can also cause diarrhea and failure to acquire weight or height. Once the baby stops eating the food causing the allergy, the symptoms go away. Rarely, severe vomiting and diarrhea can happen which can lead to dehydration and even shock. Shock occurs when the body is not getting enough blood flow. Emergency treatment for severe symptoms must happen correct away at a hospital. The foods most likely to cause a reaction are dairy, soy, rice, oat, barley, green beans, peas, sweet potatoes, squash and poultry.

Allergic Proctocolitis

Allergic proctocolitis is an allergy to formula or breast milk.

This condition inflames the lower part of the intestine. It affects infants in their first year of life and generally ends by age 1 year.

The symptoms include blood-streaked, watery and mucus-filled stools. Infants may also develop green stools, diarrhea, vomiting, anemia (low blood count) and fussiness. When properly diagnosed, symptoms resolve once the offending food(s) are removed from the diet.

Medical review December

Frequently Asked Questions about Food Protein-Induced Enterocolitis Syndrome (FPIES)

What is Shock and What are the Symptoms?

Shock is a life-threatening condition.

Shock may develop as the result of sudden illness, injury, or bleeding. When the body cannot get enough blood to the vital organs, it goes into shock.

Signs of shock include:
Weakness, dizziness, and fainting.
Cool, pale, clammy skin.
Weak, quick pulse.
Shallow, quick breathing.
Low blood pressure.
Extreme thirst, nausea, or vomiting.
Confusion or anxiety.

Does FPIES Require Epinephrine?

Not generally, because epinephrine reverses IgE-mediated symptoms, and FPIES is not IgE-mediated.

Based on the patient’s history, some doctors might prescribe epinephrine to reverse specific symptoms of shock (e.g., low blood pressure). However, this is only prescribed in specific cases.

How Do You Care for a Kid With FPIES?

Treatment varies, depending on the patient and his/her specific reactions. Often, infants who own reacted to both dairy and soy formulas will be placed on hypoallergenic or elemental formula.

Some children do well breastfeeding. Other children who own fewer triggers may just strictly avoid the offending food(s).

New foods are generally introduced extremely slowly, one food at a time, for an extended period of time per food. Some doctors recommend trialing a single food for up to three weeks before introducing another.

Because it’s a rare, but serious condition, in the event of an emergency, it is vital to get the correct treatment. Some doctors provide their patients with a letter containing a brief description of FPIES and its proper treatment. In the event of a reaction, this letter can be taken to the ER with the child.

Two Categories of Food Allergies

  • Immunoglobulin E (IgE) mediated.

    Symptoms result from the body’s immune system making antibodies called Immunoglobulin E (IgE) antibodies. These IgE antibodies react with a certain food.

  • Shortness of breath, trouble breathing, wheezing
  • Stomach pain, vomiting, diarrhea
  • Swelling of the lips, tongue or throat
  • Non-IgE mediated. Other parts of the body’s immune system react to a certain food. This reaction causes symptoms, but does not involve an IgE antibody. Someone can own both IgE mediated and non-IgE mediated food allergies.
  • Skin rash, itching, hives
  • Feeling love something terrible is about to happen

What are Some Common FPIES Triggers?

The most common FPIES triggers are traditional first foods, such as dairy and soy.

Other common triggers are rice, oat, barley, green beans, peas, sweet potatoes, squash, chicken and turkey. A reaction to one common food does not mean that every of the common foods will be an issue, but patients are often advised to proceed with caution with those foods. Note that while the above foods are the most prevalent, they are not exclusive triggers. Any food has the potential to trigger an FPIES reaction. Even trace amounts can cause a reaction.

What Does FPIES Stand For?

FPIES is Food Protein-Induced Enterocolitis Syndrome. It is commonly pronounced «F-Pies», as in «apple pies», though some physicians may refer to it as FIES (pronounced «fees», considering food-protein as one word).

What is the most common food allergy in the us

Enterocolitis is inflammation involving both the little intestine and the colon (large intestine).

How Do I know If My Kid Has Outgrown FPIES?

Together with your child’s doctor, you should determine if/when it is likely that your kid may own outgrown any triggers. Obviously, determining if a kid has outgrown a trigger is something that needs to be evaluated on a food-by-food basis. As stated earlier, APT testing may be an option to assess oral challenge readiness. Another factor for you and your doctor to consider is if your kid would physically be capable to handle a possible failed challenge.

When the time comes to orally challenge an FPIES trigger, most doctors familiar with FPIES will desire to schedule an in-office food challenge.

What is the most common food allergy in the us

Some doctors (especially those not practicing in a hospital clinic setting) may select to challenge in the hospital, with an IV already in put, in case of emergency. Each doctor may own his or her own protocol, but an FPIES trigger is something you should definitely NOT challenge without discussing thoroughly with your doctor.

Be aware that if a kid passes the in-office portion of the challenge, it does not mean this food is automatically guaranteed «safe.» If a child’s delay in reaction is fairly short, a kid may fail an FPIES food challenge while still at the office/hospital.

For those with longer reaction times, it may not be until later that day that symptoms manifest. Some may react up to three days later. Delay times may vary by food as well. If a kid has FPIES to multiple foods, one food may trigger symptoms within four hours; a diverse food may not trigger symptoms until six or eight hours after ingestion.

What is FPIES?

FPIES is a non-IgE mediated immune reaction in the gastrointestinal system to one or more specific foods, commonly characterized by profuse vomiting and diarrhea. FPIES is presumed to be cell mediated. Poor growth may happen with continual ingestion.

Upon removing the problem food(s), every FPIES symptoms subside. (Note: Having FPIES does not preclude one from having other allergies/intolerances with the food.) The most common FPIES triggers are cow’s milk (dairy) and soy. However, any food can cause an FPIES reaction, even those not commonly considered allergens, such as rice, oat and barley.

A kid with FPIES may experience what appears to be a severe stomach bug, but the «bug» only starts a couple hours after the offending food is given. Numerous FPIES parents own rushed their children to the ER, limp from extreme, repeated projectile vomiting, only to be told, «It’s the stomach flu.» However, the next time they feed their children the same solids, the dramatic symptoms return.

IgE Mediated Food Allergies

The IgE mediated food allergies most common in infants and children are eggs, milk, peanuts, tree nuts, soy and wheat.

The allergic reaction can involve the skin, mouth, eyes, lungs, heart, gut and brain. Some of the symptoms can include:

  1. Skin rash, itching, hives
  2. Shortness of breath, trouble breathing, wheezing
  3. Stomach pain, vomiting, diarrhea
  4. Swelling of the lips, tongue or throat
  5. Feeling love something terrible is about to happen

Sometimes allergy symptoms are mild. Other times they can be severe. Take every allergic symptoms seriously. Mild and severe symptoms can lead to a serious allergic reaction called anaphylaxis (anna-fih-LACK-sis).

This reaction generally involves more than one part of the body and can get worse quick. Anaphylaxis must be treated correct away to provide the best chance for improvement and prevent serious, potentially life-threatening complications.

Treat anaphylaxis with epinephrine. This medicine is safe and comes in an easy-to-use device called an auto-injector. You can’t rely on antihistamines to treat anaphylaxis. The symptoms of an anaphylactic reaction happen shortly after contact with an allergen. In some individuals, there may be a delay of two to three hours before symptoms first appear.

Cross-Reactivity and Oral Allergy Syndrome

Having an IgE mediated allergy to one food can mean your kid is allergic to similar foods.

For example, if your kid is allergic to shrimp, he or she may be allergic to other types of shellfish, such as crab or crayfish.

What is the most common food allergy in the us

Or if your kid is allergic to cow’s milk, he or she may also be allergic to goat’s and sheep’s milk. The reaction between diverse foods is called cross-reactivity. This happens when proteins in one food are similar to the proteins in another food.

Cross-reactivity also can happen between latex and certain foods. For example, a kid who has an allergy to latex may also own an allergy to bananas, avocados, kiwis or chestnuts.

Some people who own allergies to pollens, such as ragweed and grasses, may also be allergic to some foods. Proteins in the pollens are love the proteins in some fruits and vegetables. So, if your kid is allergic to ragweed, he or she may own an allergic reaction to melons and bananas.

That’s because the protein in ragweed looks love the proteins in melons and bananas. This condition is oral allergy syndrome.

Symptoms of an oral allergy syndrome include an itchy mouth, throat or tongue. Symptoms can be more severe and may include hives, shortness of breath and vomiting. Reactions generally happen only when someone eats raw food. In rare cases, reactions can be life-threatening and need epinephrine.

What is a Typical FPIES Reaction?

As with every things, each kid is diverse, and the range, severity and duration of symptoms may vary from reaction to reaction.

Unlike traditional IgE-mediated allergies, FPIES reactions do not manifest with itching, hives, swelling, coughing or wheezing, etc. Symptoms typically only involve the gastrointestinal system, and other body organs are not involved. FPIES reactions almost always start with delayed onset vomiting (usually two hours after ingestion, sometimes as tardy as eight hours after). Symptoms can range from mild (an increase in reflux and several days of runny stools) to life threatening (shock). In severe cases, after repeatedly vomiting, children often start vomiting bile.

Commonly, diarrhea follows and can final up to several days. In the worst reactions (about 20% of the time), the kid has such severe vomiting and diarrhea that s/he rapidly becomes seriously dehydrated and may go into shock.

What Does IgE vs Cell Mediated Mean?

IgE stands for Immunoglobulin E. It is a type of antibody, formed to protect the body from infection, that functions in allergic reactions. IgE-mediated reactions are considered immediate hypersensitivity immune system reactions, while cell mediated reactions are considered delayed hypersensitivity. Antibodies are not involved in cell mediated reactions. For the purpose of understanding FPIES, you can disregard every you know about IgE-mediated reactions.

How Do You Treat an FPIES Reaction?

Always follow your doctor’s emergency plan pertaining to your specific situation.

Rapid dehydration and shock are medical emergencies. If your kid is experiencing symptoms of FPIES or shock, immediately contact your local emergency services (). If you are uncertain if your kid is in need of emergency services, contact or your physician for guidance. The most critical treatment during an FPIES reaction is intravenous (IV) fluids, because of the risk and prevalence of dehydration. Children experiencing more severe symptoms may also need steroids and in-hospital monitoring.

Mild reactions may be capable to be treated at home with oral electrolyte re-hydration (e.g., Pedialyte®).

How is FPIES Diagnosed?

FPIES is hard to diagnose, unless the reaction has happened more than once, as it is diagnosed by symptom presentation. Typically, foods that trigger FPIES reactions are negative with standard skin and blood allergy tests (SPT, RAST) because they glance for IgE-mediated responses. However, as stated before, FPIES is not IgE-mediated.

Atopy patch testing (APT) is being studied for its effectiveness in diagnosing FPIES, as well as predicting if the problem food is no longer a trigger.

Thus, the outcome of APT may determine if the kid is a potential candidate for an oral food challenge (OFC). APT involves placing the trigger food in a metal cap, which is left on the skin for 48 hours. The skin is then watched for symptoms in the following days after removal. Please consult your child’s doctor to discuss if APT is indicated in your situation.

When Do FPIES Reactions Occur?

FPIES reactions often show up in the first weeks or months of life, or at an older age for the exclusively breastfed kid.

Reactions generally happen upon introducing first solid foods, such as baby cereals or formulas, which are typically made with dairy or soy. (Infant formulas are considered solids for FPIES purposes.) While a kid may own allergies and intolerances to food proteins they are exposed to through breastmilk, FPIES reactions generally don’t happen from breastmilk, regardless of the mother’s diet. An FPIES reaction typically takes put when the kid has directly ingested the trigger food(s).

Is FPIES A Lifelong Condition?

Typically, no. Numerous children outgrow FPIES by about age three.

Note, however, that the time varies per individual and the offending food, so statistics are a guide, but not an absolute. In one study, % of children with FPIES reactions to barley had outgrown and were tolerating barley by age three. However, only 40% of those with FPIES to rice, and 60% to dairy tolerated it by the same age.

How is FPIES Diverse From MSPI, MSPIES, MPIES, Etc.?

MPIES (milk-protein induced enterocolitis syndrome) is FPIES to cow’s milk only. MSPIES (milk- and soy-protein induced enterocolitis syndrome) is FPIES to milk and soy. Some doctors do create these subdivisions, while others declare that milk and soy are simply the two most common FPIES triggers and give the diagnosis of «FPIES to milk and/or soy.»

MSPI is milk and soy protein intolerance.

Symptoms are those of allergic colitis and can include colic, vomiting, diarrhea and blood in stools. These reactions are not as severe or immediate as an FPIES reaction.

References

Fogg MI, Brown-Whitehorn TA, Pawlowski NA, Spergel JM. (). Atopy Patch Test for the Diagnosis of Food Protein-Induced Enterocolitis Syndrome. Pediatric Allergy and Immunology – Retrieved on December 31, from

Burks, AW. (). Don’t Feed Her That! Diagnosing and Managing Pediatric Food Allergy. Pediatric Basics. Gerber Products Company: Retrieved on December 31, from

Moore, D.

Food Protein-Induced Enterocolitis Syndrome. (, April 11). Retrieved on December 31, from

Sicherer, SH. (). Food Protein-Induced Enterocolitis Syndrome: Case Presentations and Management Lessons. Journal of Allergy and Clinical Immunology Vol. , Retrieved on December 31, from

Nowak-Wegrzyn, A., Sampson, HA, Wood, RA, Sicherer, SH. MD, Robert A. Wood, MD and Scott H. Sicherer, MD. (). Food Protein-Induced Enterocolitis Syndrome Caused by Solid Food Proteins. Pediatrics. Vol. 4: Retrieved on December 31, from #T1.

Nocerino, A., Guandalini, S.

(, April 11). Protein Intolerance. Retrieved on December 31, from WebMD Medical Reference from Healthwise. (, May 31). Shock, Topic Overview. Retrieved on December 31, from

American Academy of Allergy, Asthma and Immunology. (). Tips to Remember: What is an Allergic Reaction? Retrieved on December 31, from

Sicherer, SH. (). Understanding and Managing Your Child’s Food Allergies. A Johns Hopkins Press Health Book.

Medical Review February

This is a list of allergies, which includes the allergen, potential reactions, and a brief description of the cause where applicable.

What are Some Common FPIES Triggers?

The most common FPIES triggers are traditional first foods, such as dairy and soy. Other common triggers are rice, oat, barley, green beans, peas, sweet potatoes, squash, chicken and turkey. A reaction to one common food does not mean that every of the common foods will be an issue, but patients are often advised to proceed with caution with those foods. Note that while the above foods are the most prevalent, they are not exclusive triggers.

Any food has the potential to trigger an FPIES reaction. Even trace amounts can cause a reaction.

What Does FPIES Stand For?

FPIES is Food Protein-Induced Enterocolitis Syndrome. It is commonly pronounced «F-Pies», as in «apple pies», though some physicians may refer to it as FIES (pronounced «fees», considering food-protein as one word). Enterocolitis is inflammation involving both the little intestine and the colon (large intestine).

How Do I know If My Kid Has Outgrown FPIES?

Together with your child’s doctor, you should determine if/when it is likely that your kid may own outgrown any triggers.

Obviously, determining if a kid has outgrown a trigger is something that needs to be evaluated on a food-by-food basis. As stated earlier, APT testing may be an option to assess oral challenge readiness. Another factor for you and your doctor to consider is if your kid would physically be capable to handle a possible failed challenge.

When the time comes to orally challenge an FPIES trigger, most doctors familiar with FPIES will desire to schedule an in-office food challenge.

Some doctors (especially those not practicing in a hospital clinic setting) may select to challenge in the hospital, with an IV already in put, in case of emergency. Each doctor may own his or her own protocol, but an FPIES trigger is something you should definitely NOT challenge without discussing thoroughly with your doctor.

Be aware that if a kid passes the in-office portion of the challenge, it does not mean this food is automatically guaranteed «safe.» If a child’s delay in reaction is fairly short, a kid may fail an FPIES food challenge while still at the office/hospital. For those with longer reaction times, it may not be until later that day that symptoms manifest.

Some may react up to three days later. Delay times may vary by food as well. If a kid has FPIES to multiple foods, one food may trigger symptoms within four hours; a diverse food may not trigger symptoms until six or eight hours after ingestion.

What is FPIES?

FPIES is a non-IgE mediated immune reaction in the gastrointestinal system to one or more specific foods, commonly characterized by profuse vomiting and diarrhea. FPIES is presumed to be cell mediated. Poor growth may happen with continual ingestion. Upon removing the problem food(s), every FPIES symptoms subside. (Note: Having FPIES does not preclude one from having other allergies/intolerances with the food.) The most common FPIES triggers are cow’s milk (dairy) and soy.

However, any food can cause an FPIES reaction, even those not commonly considered allergens, such as rice, oat and barley.

A kid with FPIES may experience what appears to be a severe stomach bug, but the «bug» only starts a couple hours after the offending food is given. Numerous FPIES parents own rushed their children to the ER, limp from extreme, repeated projectile vomiting, only to be told, «It’s the stomach flu.» However, the next time they feed their children the same solids, the dramatic symptoms return.

IgE Mediated Food Allergies

The IgE mediated food allergies most common in infants and children are eggs, milk, peanuts, tree nuts, soy and wheat.

The allergic reaction can involve the skin, mouth, eyes, lungs, heart, gut and brain. Some of the symptoms can include:

  1. Skin rash, itching, hives
  2. Shortness of breath, trouble breathing, wheezing
  3. Stomach pain, vomiting, diarrhea
  4. Swelling of the lips, tongue or throat
  5. Feeling love something terrible is about to happen

Sometimes allergy symptoms are mild. Other times they can be severe. Take every allergic symptoms seriously. Mild and severe symptoms can lead to a serious allergic reaction called anaphylaxis (anna-fih-LACK-sis). This reaction generally involves more than one part of the body and can get worse quick.

Anaphylaxis must be treated correct away to provide the best chance for improvement and prevent serious, potentially life-threatening complications.

Treat anaphylaxis with epinephrine. This medicine is safe and comes in an easy-to-use device called an auto-injector. You can’t rely on antihistamines to treat anaphylaxis. The symptoms of an anaphylactic reaction happen shortly after contact with an allergen. In some individuals, there may be a delay of two to three hours before symptoms first appear.

Cross-Reactivity and Oral Allergy Syndrome

Having an IgE mediated allergy to one food can mean your kid is allergic to similar foods. For example, if your kid is allergic to shrimp, he or she may be allergic to other types of shellfish, such as crab or crayfish.

Or if your kid is allergic to cow’s milk, he or she may also be allergic to goat’s and sheep’s milk. The reaction between diverse foods is called cross-reactivity. This happens when proteins in one food are similar to the proteins in another food.

Cross-reactivity also can happen between latex and certain foods. For example, a kid who has an allergy to latex may also own an allergy to bananas, avocados, kiwis or chestnuts.

Some people who own allergies to pollens, such as ragweed and grasses, may also be allergic to some foods.

Proteins in the pollens are love the proteins in some fruits and vegetables. So, if your kid is allergic to ragweed, he or she may own an allergic reaction to melons and bananas. That’s because the protein in ragweed looks love the proteins in melons and bananas. This condition is oral allergy syndrome.

Symptoms of an oral allergy syndrome include an itchy mouth, throat or tongue. Symptoms can be more severe and may include hives, shortness of breath and vomiting. Reactions generally happen only when someone eats raw food. In rare cases, reactions can be life-threatening and need epinephrine.

What is a Typical FPIES Reaction?

As with every things, each kid is diverse, and the range, severity and duration of symptoms may vary from reaction to reaction.

Unlike traditional IgE-mediated allergies, FPIES reactions do not manifest with itching, hives, swelling, coughing or wheezing, etc. Symptoms typically only involve the gastrointestinal system, and other body organs are not involved. FPIES reactions almost always start with delayed onset vomiting (usually two hours after ingestion, sometimes as tardy as eight hours after). Symptoms can range from mild (an increase in reflux and several days of runny stools) to life threatening (shock). In severe cases, after repeatedly vomiting, children often start vomiting bile.

Commonly, diarrhea follows and can final up to several days. In the worst reactions (about 20% of the time), the kid has such severe vomiting and diarrhea that s/he rapidly becomes seriously dehydrated and may go into shock.

What Does IgE vs Cell Mediated Mean?

IgE stands for Immunoglobulin E. It is a type of antibody, formed to protect the body from infection, that functions in allergic reactions. IgE-mediated reactions are considered immediate hypersensitivity immune system reactions, while cell mediated reactions are considered delayed hypersensitivity.

Antibodies are not involved in cell mediated reactions. For the purpose of understanding FPIES, you can disregard every you know about IgE-mediated reactions.

How Do You Treat an FPIES Reaction?

Always follow your doctor’s emergency plan pertaining to your specific situation. Rapid dehydration and shock are medical emergencies. If your kid is experiencing symptoms of FPIES or shock, immediately contact your local emergency services (). If you are uncertain if your kid is in need of emergency services, contact or your physician for guidance. The most critical treatment during an FPIES reaction is intravenous (IV) fluids, because of the risk and prevalence of dehydration.

Children experiencing more severe symptoms may also need steroids and in-hospital monitoring. Mild reactions may be capable to be treated at home with oral electrolyte re-hydration (e.g., Pedialyte®).

How is FPIES Diagnosed?

FPIES is hard to diagnose, unless the reaction has happened more than once, as it is diagnosed by symptom presentation. Typically, foods that trigger FPIES reactions are negative with standard skin and blood allergy tests (SPT, RAST) because they glance for IgE-mediated responses. However, as stated before, FPIES is not IgE-mediated.

Atopy patch testing (APT) is being studied for its effectiveness in diagnosing FPIES, as well as predicting if the problem food is no longer a trigger.

Thus, the outcome of APT may determine if the kid is a potential candidate for an oral food challenge (OFC). APT involves placing the trigger food in a metal cap, which is left on the skin for 48 hours. The skin is then watched for symptoms in the following days after removal. Please consult your child’s doctor to discuss if APT is indicated in your situation.

When Do FPIES Reactions Occur?

FPIES reactions often show up in the first weeks or months of life, or at an older age for the exclusively breastfed kid.

Reactions generally happen upon introducing first solid foods, such as baby cereals or formulas, which are typically made with dairy or soy. (Infant formulas are considered solids for FPIES purposes.) While a kid may own allergies and intolerances to food proteins they are exposed to through breastmilk, FPIES reactions generally don’t happen from breastmilk, regardless of the mother’s diet. An FPIES reaction typically takes put when the kid has directly ingested the trigger food(s).

Is FPIES A Lifelong Condition?

Typically, no. Numerous children outgrow FPIES by about age three. Note, however, that the time varies per individual and the offending food, so statistics are a guide, but not an absolute.

In one study, % of children with FPIES reactions to barley had outgrown and were tolerating barley by age three. However, only 40% of those with FPIES to rice, and 60% to dairy tolerated it by the same age.

How is FPIES Diverse From MSPI, MSPIES, MPIES, Etc.?

MPIES (milk-protein induced enterocolitis syndrome) is FPIES to cow’s milk only. MSPIES (milk- and soy-protein induced enterocolitis syndrome) is FPIES to milk and soy. Some doctors do create these subdivisions, while others declare that milk and soy are simply the two most common FPIES triggers and give the diagnosis of «FPIES to milk and/or soy.»

MSPI is milk and soy protein intolerance.

Symptoms are those of allergic colitis and can include colic, vomiting, diarrhea and blood in stools. These reactions are not as severe or immediate as an FPIES reaction.

References

Fogg MI, Brown-Whitehorn TA, Pawlowski NA, Spergel JM. (). Atopy Patch Test for the Diagnosis of Food Protein-Induced Enterocolitis Syndrome. Pediatric Allergy and Immunology – Retrieved on December 31, from

Burks, AW. (). Don’t Feed Her That! Diagnosing and Managing Pediatric Food Allergy.

Pediatric Basics. Gerber Products Company: Retrieved on December 31, from

Moore, D. Food Protein-Induced Enterocolitis Syndrome. (, April 11). Retrieved on December 31, from

Sicherer, SH. (). Food Protein-Induced Enterocolitis Syndrome: Case Presentations and Management Lessons. Journal of Allergy and Clinical Immunology Vol. , Retrieved on December 31, from

Nowak-Wegrzyn, A., Sampson, HA, Wood, RA, Sicherer, SH. MD, Robert A.

Wood, MD and Scott H. Sicherer, MD. (). Food Protein-Induced Enterocolitis Syndrome Caused by Solid Food Proteins. Pediatrics. Vol. 4: Retrieved on December 31, from #T1.

Nocerino, A., Guandalini, S. (, April 11). Protein Intolerance. Retrieved on December 31, from WebMD Medical Reference from Healthwise. (, May 31). Shock, Topic Overview. Retrieved on December 31, from

American Academy of Allergy, Asthma and Immunology. (). Tips to Remember: What is an Allergic Reaction? Retrieved on December 31, from

Sicherer, SH.

(). Understanding and Managing Your Child’s Food Allergies. A Johns Hopkins Press Health Book.

Medical Review February

This is a list of allergies, which includes the allergen, potential reactions, and a brief description of the cause where applicable.


Allergens

Food

Main article: Food allergy

Name Potential reaction(s) Remarks
Balsam of Peru Redness, swelling, itching, allergiccontact dermatitis reactions, stomatitis (inflammation and soreness of the mouth or tongue), cheilitis (inflammation, rash, or painful erosion of the lips, oropharyngealmucosa, or angles of their mouth), pruritus, hand eczema, generalized or resistant plantardermatitis, rhinitis, conjunctivitis, and blisters.

Present in numerous foods, such as coffee, flavored tea, wine, beer, gin, liqueurs, apéritifs (e.g. vermouth, bitters), soft drinks including cola, juice, citrus, citrus fruit peel, marmalade, tomatoes and tomato-containing products, Mexican and Italian foods with red sauces, ketchup, spices (e.g. cloves, Jamaica pepper (allspice), cinnamon, nutmeg, paprika, curry, anise, and ginger), chili sauce, barbecue sauce, chutney, pickles, pickled vegetables, chocolate, vanilla, baked goods and pastries, pudding, ice cream, chewing gum, and candy.

Egg Anaphylaxis, swelling, sometimes flatulence and vomiting An allergic individual may not own any reaction to consuming food only prepared with yolk and not glair, or vice versa.
Fish Respiratory reactions, Anaphylaxis, oral allergy syndrome, sometimes vomiting One of three allergies to seafood, not to be conflated with allergies to crustaceans and mollusks.[1] Fish allergy sufferers own a 50% likelihood of being cross reactive with another fish species,[2] but some individuals are only allergic to one species, such as; tilapia,[3] salmon, [1] or cod.

A proper diagnosis is considered complicated due to these cross reactivity between fish species and other seafood allergies. [4] Hazard extends to exposure to cooking vapors or handling.

Fruit Mild itching, rash, generalized urticaria, oral allergy syndrome, abdominal pain, vomiting, anaphylaxis Mango, strawberries, banana, [5]avocado, and kiwi are common problems.[6] Severe allergies to tomatoes own also been reported. [7][8]
Garlic Dermatitis, asymmetrical pattern of fissure, thickening/shedding of the outer skin layers,[9]anaphylaxis
Hot peppers Skin rash, hives, throat tightness, tongue swelling, possible vomiting
Oats Dermatitis, respiratory problems, anaphylaxis
Maize Hives, pallor, confusion, dizziness, stomach pain, swelling, vomiting, indigestion, diarrhea, cough, tightness in throat, wheezing, shortness of breath, anaphylaxis Often a hard allergy to manage due to the various food products which contain various forms of corn.

Milk[10] Skin rash, hives, vomiting, diarrhea, constipation, stomach pain, flatulence, nasal congestion, dermatitis, blisters, anaphylaxis Not to be confused with lactose intolerance.[11]
Peanut[12] Anaphylaxis and swelling, sometimes vomiting Includes some cold-pressed peanut oils. Distinct from tree nut allergy, as peanuts are legumes.
Poultry Meat[13] Hives, swelling of, or under the dermis, nausea, vomiting, diarrhea, severe oral allergy syndrome, shortness of breath, rarely anaphylactic shock Very rare allergies to chicken, turkey, squab, and sometimes more mildly to other avian meats.

Not to be confused with secondary reactions of bird-egg syndrome. The genuine allergy has no causal relationship with egg allergy, nor is there any shut association with red meat allergy. Prevalence still unknown as of [14]

Red Meat[15] Hives, swelling,[16] dermatitis, stomach pain, nausea, vomiting, dizziness, fainting, shortness of breath,[17], rarely anaphylaxis Allergies to the sugar carbohydrate found in beef, venison, lamb, and pork called alpha-gal.

It is brought on by tick bites.[18][19] Allergic reaction to pork is an exception, as it may also be caused by pork-cat syndrome instead of alpha-gal allergy.

Rice Sneezing, runny nose, itching, stomachache, eczema. People with a rice allergy can be affected by eating rice or breathing in rice steam.
Sesame Possible respiratory, skin, and gastrointestinal reactions which can trigger serious systemic anaphylactic responses.[20][21] By law, foods containing sesame must be labeled so in European Union, Canada, Australia, and New Zealand.[20]
Shellfish Respiratory symptoms, Anaphylaxis, oral allergy syndrome, gastrointestinal symptoms, rhinitis, conjunctivitis Shellfish allergies are highly cross reactive, but its prevalence is generally higher than that of fish allergy.

As of six allergens own been identified to prawn alone; along with crab it‘s the major culprit of seafood anaphylaxis.[1] In reference to it as one of the “Big 8” [22] or “major 14” allergens it is sometimes specified as a “crustacean shellfish” allergy, or more simply, a “crustacean allergy”.[23][24] Sometimes it is conflated with an allergy to molluscan shellfish but finish tolerance to one but not the other isn’t unusual. Most generally, a mono-sensitive individual will experience a crustacean allergy alone with tolerance to mollusks, rather than vice versa.[1]

Soy Anaphylaxis, sometimes vomiting
Sulfites Hives, rash, redness of skin, headache (particular frontal), burning behind eyes, breathing difficulties (anaphylaxis) Used as a preserving agent in numerous diverse foods, such as raisins, dried peaches, various other dried fruit, canned or frozen fruits and vegetables, wines, vinegars and processed meats.

Tartrazine Skin irritation, hives, rash Synthetic yellow food coloring, also used for bright green coloring
Tree nut[25] Anaphylaxis, swelling, rash, hives, sometimes vomiting Hazard extends to exposure to cooking vapors, or handling. Distinct from peanut allergy, as peanuts are legumes.
Wheat[26] Eczema (atopic dermatitis), Hives, asthma, hay fever, angioedema, abdominal cramps, Celiac disease, diarrhea, temporary (3 or 4 day) mental incompetence, anemia, nausea, and vomiting[27] Not to be confused with Celiac Disease or NCGS (Non Celiac Gluten Sensitivity).

While wheat allergies are «true» allergies, Celiac Disease is an autoimmune disease.[28]

medical

Main article: Drug allergy

Name Possible reaction(s) Remarks
Balsam of Peru Redness, swelling, itching, allergiccontact dermatitis reactions, stomatitis (inflammation and soreness of the mouth or tongue), cheilitis (inflammation, rash, or painful erosion of the lips, oropharyngealmucosa, or angles of their mouth), pruritus, hand eczema, generalized or resistant plantardermatitis, rhinitis, conjunctivitis, and blisters. Present in numerous drugs, such as hemorrhoid suppositories and ointment (e.g.

Anusol), cough medicine/suppressant and lozenges, diaper rash ointments, oral and lip ointments, tincture of benzoin, wound spray (it has been reported to inhibit Mycobacterium tuberculosis as well as the common ulcer-causing bacteria H. pylori in test-tube studies), calamine lotion, surgical dressings, dental cement, eugenol used by dentists, some periodontal impression materials, and in the treatment of dry socket in dentistry.

Tetracycline Many, including: severe headache, dizziness, blurred vision, fever, chills, body aches, flu symptoms, severe blistering, peeling, dark colored urine[29][30][31]
Dilantin Many, including: swollen glands, simple bruising or bleeding, fever, sore throat[32][33][34]
Tegretol (carbamazepine) Shortness of breath, wheezing or difficulty breathing, swelling of the face, lips, tongue etc., hives[35][36][37]
Penicillin Diarrhea, hypersensitivity, nausea, rash, neurotoxicity, urticaria
Cephalosporins Maculopapular or morbilliform skin eruption, and less commonly urticaria, eosinophilia, serum-sickness–like reactions, and anaphylaxis.[38]
Sulfonamides Urinary tract disorders, haemopoietic disorders, porphyria and hypersensitivity reactions, Stevens–Johnson syndrometoxic epidermal necrolysis
Non-steroidal anti-inflammatories (cromolyn sodium, nedocromil sodium, etc.) Many, including: swollen eyes, lips, or tongue, difficulty swallowing, shortness of breath, rapid heart rate[39]
Intravenous contrast dye Anaphylactoid reactions and contrast-induced nephropathy
Local anesthetics Urticaria and rash, dyspnea, wheezing, flushing, cyanosis, tachycardia[40]

Environmental

Main article: Allergy §Other environmental factors

Name Possible reaction(s) Remarks
Balsam of Peru Redness, swelling, itching, allergiccontact dermatitis reactions, stomatitis (inflammation and soreness of the mouth or tongue), cheilitis (inflammation, rash, or painful erosion of the lips, oropharyngealmucosa, or angles of their mouth), pruritus, hand eczema, generalized or resistant plantardermatitis, rhinitis, conjunctivitis, and blisters.

A number of national and international surveys own identified Balsam of Peru as being in the «top five» allergens most commonly causing patch test reactions in people referred to dermatology clinics.[41][42]
Pollen Sneezing, body ache, headache (in rare cases, extremely painful cluster headaches may happen due to allergic sinusitis; these may leave a temporary time period of 1 and a half to 2 days with eye sensitivity), allergic conjunctivitis (includes watery, red, swelled, itchy, and irritating eyes), runny nose, irritation of the nose, nasal congestion, minor fatigue, chest pain and discomfort, coughing, sore throat, facial discomfort (feeling of stuffed face) due to allergic sinusitis, possible asthma attack, wheezing
Cat Sneezing, itchy swollen eyes, rash, congestion, wheezing
Dog Rash, sneezing, congestion, wheezing, vomiting from coughing, Sometimes itchy welts.

Caused by dander, saliva or urine of dogs, or by dust, pollen or other allergens that own been carried on the fur.[43] Allergy to dogs is present in as much as 10 percent of the population.[43]
Insect sting Hives, wheezing, possible anaphylaxis Possible from bee or wasp stings, or bites from mosquitoes or flies love Leptoconops torrens.
Mold Sneeze, coughing, itchy, discharge from the nose, respiratory irritation, congested feeling,[44] joint aches, headaches, fatigue[45]
Perfume Itchy eyes, runny nose, sore throat, headaches, muscle/joint pain, asthma attack, wheezing, chest pain, blisters
Cosmetics Contact dermatitis,[46] irritant contact dermatitis, inflammation, redness,[47] conjunctivitis[48] ,sneezing
Semen Burning, pain and swelling, possibly for days, swelling or blisters, vaginal redness,[49] fever, runny nose, extreme fatigue[50][51][52][53][54] In a case study in Switzerland, a lady who was allergic to Balsam of Peru was allergic to her boyfriend’s semen following intercourse, after he drank large amounts of Coca-Cola.[55]
Latex Contact dermatitis, hypersensitivity
Water (see note) Epidermal itching Strictly aquagenic pruritus or aquagenic urticaria, but freezing urticaria may also be described as a «water allergy,» in which water may cause hives and anaphylaxis
House dust mite[56] Asthma Home allergen reduction may be recommended
Nickel (nickel sulfate hexahydrate) Allergic contact dermatitis, dyshidrotic eczema[57][58]
Gold (gold sodium thiosulfate) Allergic contact dermatitis
Chromium Allergic contact dermatitis
Cobalt chloride Allergic contact dermatitis
Formaldehyde Allergic contact dermatitis
Photographic developers Allergic contact dermatitis
Fungicide Allergic contact dermatitis, fever, anaphylaxis

Contact

Many substances can cause an allergic reaction when in contact with the human integumentary system.


References

  • ^Allergies From Antibiotics |
  • ^«Lactose Intolerance or Milk Allergy: What’s the Difference?». . Retrieved
  • ^Getting Pregnant and Fertility Problems: Sperm Allergy
  • ^Hemmer, W.; Klug, C.; Swoboda, I. (). «Update on the bird-egg syndrome and genuine poultry meat allergy». Allergo Journal International. 25 (3): 68– doi/s PMC PMID
  • ^«Rare Meat Allergy Caused By Tick Bites May Be On The Rise». . 27 November
  • ^Edward T.

    Bope; Rick D. Kellerman (). Conn’s Current Therapy Expert Consult. Elsevier Health Sciences. ISBN. Retrieved March 6,

  • ^ ab«Allergenic Foods and their Allergens, with links to Informall FARRP Nebraska».
  • ^Vien, Niels K.; Kaaber, Knud (). «Nickel cobalt and chromium sensitivity in patients with pompholyx (dyshidrotic eczema)». Contact Dermatitis. 5 (6): –4.

    doi/jtbx. PMID

  • ^National Institutes of Health, NIAID Allergy Statistics Archived at the Wayback Machine
  • ^Sicherer, Scott H.; Sampson, Hugh A. (). «Food allergy». Journal of Allergy and Clinical Immunology. (2): S–S doi/ ISSN PMID
  • ^«Lone Star Tick Bite Might Trigger Red Meat Allergy: Study». MedlinePlus. 9 November Archived from the original on 15 November
  • ^CarbamazepineArchived at the Wayback Machine
  • ^Akagawa M, Handoyo T, Ishii T, Kumazawa S, Morita N, Suyama K ().

    «Proteomic analysis of wheat flour allergens». J. Agric. Food Chem. 55 (17): – doi/jfa. PMID

  • ^Kaaber, K.; Veien, N. K.; Tjell, J. C. (). «Low nickel diet in the treatment of patients with chronic nickel dermatitis». British Journal of Dermatology. 98 (2): – doi/jtbx. PMID
  • ^
  • ^Allergies From Antibiotics |
  • ^September CDA Journal – Toxicity and Allergy to Local AnesthesiaArchived at the Wayback Machine
  • ^ abcdRuethers, Thimo; Taki, Aya C.; Johnston, Elecia B.; Nugraha, Roni; Le, Thu T.

    K.; Kalic, Tanja; McLean, Thomas R.; Kamath, Sandip D.; Lopata, Andreas L. (August ). «Seafood allergy: A comprehensive review of fish and shellfish allergens». Molecular Immunology. : 28– doi/ ISSN PMID

  • ^Thomas D. Horn (). Dermatology, Volume 2. Elsevier Health Sciences. p.

    What is the most common food allergy in the us

    ISBN.

  • ^
  • ^Mold allergies, allergic response, and allergy symptoms
  • ^«JIACI · Journal of Investigational Allergology and Clinical Immunology». . Retrieved
  • ^«Everything You Should Know About Wheat Allergy Diagnosis and Treatment». Verywell. Retrieved
  • ^«Allergy Society of South Africa – Wheat Allergy». Archived from the original on Retrieved
  • ^Dilantin Information from
  • ^«List of 14 Allergens | Food Information | Food Legislation | Legislation | The Food Safety Authority of Ireland».

    . Retrieved

  • ^MMS: Error
  • ^United States Public Law C. Food Allergen Labelling And Consumer Protection Act of Public Law ;
  • ^«Two Types of Cosmetic Allergy». Archived from the original on Retrieved
  • ^Tetracycline –
  • ^Grob, Martin; Reindl, Jürgen; Vieths, Stephan; Wüthrich, Brunello; Ballmer-Weber, Barbara K. (). «Heterogeneity of banana allergy: characterization of allergens in banana-allergic patients». Annals of Allergy, Asthma & Immunology. 89 (5): – doi/S(10)X. ISSN
  • ^Harlan Walker ().

    Oxford Symposium on Food & Cookery, Staplefoods: Proceedings. Oxford Symposium. ISBN. Retrieved March 7,

  • ^Semen Allergy Can Cause Flu-like Symptoms in Men |TopNews United States
  • ^Gottfried Schmalz; Dorthe Arenholt Bindslev (). Biocompatibility of Dental Materials. Springer. ISBN. Retrieved March 5,
  • ^Tong, Wai Sze; Yuen, Agatha WT; Wai, Christine YY; Leung, Nicki YH; Chu, Ka Hou; Leung, Patrick SC (). «Diagnosis of fish and shellfish allergies». Journal of Asthma and Allergy.

    11: – doi/JAA.S ISSN PMC PMID

  • ^Semen Allergy
  • ^ Zacharisen MC, Elms NP, Kurup VP. Severe tomato allergy (Lycopersicon esculentum). Allergy Asthma Proc. ;23(2)
  • ^«The Downside To Cosmetics – Cosmetic Allergy». Archived from the original on Retrieved
  • ^What are the most serious side effects of Dilantin?: Basic |hived at the Wayback Machine
  • ^
  • ^Trileptal CMI approved
  • ^Tegretol (carbamazepine)
  • ^Semen Allergy Can Be Treated, Study Shows |Daily Health Report
  • ^(99)/fulltext
  • ^Xavier Basagaña, Jordi Sunyer, Manolis Kogevinas, Jan-Paul Zock, Enric Duran-Tauleria, Deborah Jarvis, Peter Burney, Josep Maria Anto, and on behalf of the European Community Respiratory Health Survey ().

    «Socioeconomic Status and Asthma Prevalence in Young Adults. The European Community Respiratory Health Survey». American Journal of Epidemiology. (2): – doi/aje/kwh PMIDCS1 maint: multiple names: authors list (link)

  • ^«Tomato — allergy information (InformAll: Communicating about Food Allergies — University of Manchester)». . Retrieved
  • ^Non-Steroidal Anti-Inflammatory Medicines (NSAIDs)
  • ^«Allergenic Foods and their Allergens, with links to Informall | FARRP | Nebraska». . Retrieved
  • ^ abDog Allergy at American College of Allergy, Asthma & Immunology.

    References up to

  • ^Conjunctivitis – allergic and infectious – information, symptoms and treatment |Bupa UK
  • Bolognia, Jean L.; et al. (). Dermatology. St.

    What is the most common food allergy in the us

    Louis: Mosby. ISBN.

  • ^National Institutes of Health, NIAID Allergy Statistics
  • ^«Banana — allergy information (InformAll: Communicating about Food Allergies — University of Manchester)». . Retrieved
  • ^«Mold allergies, Mold allergy symptoms, What is mold allergy». Archived from the original on Retrieved
  • ^UPDATE 1-Semen allergy suspected in rare post-orgasm illness – AlertNetArchived at the Wayback Machine
  • ^Anticonvulsant Drug Therapy: Dilantin: Neurology: UI Health Topics
  • ^‘Flu-like symptoms actually semen allergy’ – Times LIVE
  • ^Permaul, P.; Stutius, L.

    M.; Sheehan, W. J.; Rangsithienchai, P.; Walter, J. E.; Twarog, F. J.; Young, M. C.; Scott, J. E.; Schneider, L. C.; Phipatanakul, W. (). «Sesame Allergy: Role of Specific IgE and Skin Prick Testing in Predicting Food Challenge Results». Allergy and Asthma Proceedings. 30 (6): – doi/aap PMC PMID

  • ^National Institutes of Health, NIAID Allergy Statistics «Archived copy». Archived from the original on Retrieved CS1 maint: archived copy as title (link)
  • James, William D.; et al.

    (). Andrews’ Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN.

  1. Bolognia, Jean L.; et al. (). Dermatology. St. Louis: Mosby. ISBN.
  2. James, William D.; et al. (). Andrews’ Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN.
  1. Bolognia, Jean L.; et al. (). Dermatology. St. Louis: Mosby. ISBN.
  2. James, William D.; et al.

    (). Andrews’ Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN.


Further reading

The health and safety needs of students must be met so that children can thrive and achieve their academic potential in a safe and inclusive environment. To date, given the lack of research on the most effective strategies to manage food allergy in the school setting and the subsequent lack of standardized national and local requirements, schools use a variety of approaches to manage food allergy and to minimize the risk of accidental exposures to food allergens.

To our knowledge, the present study was one of the first to report on school food allergy polices from the perspective of parents of children with food allergy. Importantly, approximately one in five parents in our study did not feel that their food allergic kid was safe while at school. Significant variations were reported in food allergy management and anaphylaxis preparedness strategies and appeared to be affected by the age of the student body, type of school (public versus private), and geographic location.

Additionally, while the majority of parents felt that the polices in put in their child’s school were helpful, most also believed that the implementation of additional polices was necessary, including policies related to epinephrine access, labeling of food items, and food allergy education and training.

Half of the parents in our study reported that their child’s school carried non-student-specific stock epinephrine, with an additional one-quarter being unaware of whether their child’s school had stock epinephrine available.

Over 90% of parents felt that this policy was either helpful or needed. Whereas most states own legislation allowing schools to voluntarily stock undesignated epinephrine auto-injectors (EAI), few states own legislative mandates requiring that schools do so [11, 12]. In states without a mandate, barriers to stock epinephrine availability may include istrative and staff resistance, lack of adequate staff education, and cost [13,14,15].

However, given that immediate istration of epinephrine is the only life-saving treatment for anaphylaxis and that 25% of cases of anaphylaxis in schools happen in children previously undiagnosed with a food allergy [9, 16, 17], improving the availability of stock epinephrine should be a priority in improving the management of food allergy in the school setting. The majority of parents also desired that stock epinephrine be available on school field trips and during after-school activities. Such policies may pose a challenge for schools, as they require the availability of additional EAIs. However, as up to 19% of anaphylactic reactions during the school day happen exterior the school building or on field trips, the availability of stock EAIs for these situations is an significant measure to consider [18].

Several policies were infrequently reported to be in put, but frequently deemed to be needed.

What is the most common food allergy in the us

Half of parents reported that food items sold at lunch and concessions after-school were not labeled with allergen information, though over 80% felt that such labeling should be implemented. Similarly, only 44% of parents indicated that lunch menus with allergen information were available to them, with 85% feeling that this policy was needed. Because thorough review of ingredients in every food and drink products prior to consumption is a core strategy for food allergen avoidance and anaphylaxis prevention [19] widespread implementation of ingredient labeling policies should be prioritized in order to protect students and prevent potential allergic reactions at school.

Similarly, policies related to food allergy training and education (i.e., student education, materials available in the lunchroom and classroom, and training of school bus staff) were among those least frequently reported to be in put, though approximately four in five parents felt that such policies should to be implemented. Educational programs own been shown to be effective in increasing food allergy knowledge as well as appropriate use of an EAI and may be an additional key area of policy on which to focus [20, 21].

Expectedly, several school food allergy polices appeared to be driven by the age of the student body.

For instance, parents of elementary and middle school students more frequently reported designated lunch areas and food allergy policies for classroom snacks and celebrations compared to parents of high school students. These differences are likely age-appropriate, as younger children are less developmentally and cognitively ready to self-manage and to minimize their risk of accidental food allergen ingestions. Similarly, middle and high school students were more frequently reported to be allowed to self-carry epinephrine, which is consistent with greater autonomy and food allergy self-management skills with age.

Importantly, adolescents remain at greatest risk of poor outcomes from food allergy [22,23,24]. This unique population may therefore particularly benefit from increased training and education on food allergy, a policy which was desired by the majority of survey respondents.

Differences in school policy also appeared to exist between public and private schools. Private schools provided their students with more food allergy training and education, had stricter food guidelines for field trips when food was not provided by the school, and were more likely to own epinephrine available in the classroom.

These differences may be based on variations in financial and time resources, staffing, and level of school nurse coverage. Parents of children with food allergy may also own more influence in shaping policy decisions at private as compared to public schools.

Although the majority of parents felt that their child’s school was generally safe, one in four were not certain or did not consider the school environment to be safe for their food allergic kid. Such anxiety about safety and the potential for allergic reactions may negatively impact quality of life for students and their families and adversely affect school attendance [25, 26].

Further study is warranted to investigate the reasons behind these negative perceptions and potential opportunities for improvement. For example, clear documentation of student-specific medical needs with medical forms (e.g. individualized health plan, anaphylaxis emergency plan, school plan), clear labeling of food items sold at school, an adequate supply of appropriate medications (including stock epinephrine), and food allergy/anaphylaxis education for school staff may improve parental perceptions of safety during the school day [4, 27,28,29].

It is also notable that parents were frequently unaware of whether certain food allergy policies were in put in their child’s school.

For instance, % were unsure about the availability of stock epinephrine for after-school activities and approximately 40% were uncertain of whether food items sold at lunch or after school were labeled with allergen information. It is possible that numerous parents were not affected by such policies (e.g., children brought their own food to school or did not participate in after-school activities). However, clear and timely communication and a collaborative approach between the student’s school and family may provide an chance to assist parents be more aware about policies that are in put and therefore feel that school is a safer environment for their food allergic kid [30].

Several limitations of our study should be mentioned.

The use of self-report in data collection includes inherent risk to internal validity related to inaccurate recall bias, selective recall bias and social desirability bias. Additionally, respondents were recruited through food allergy support and advocacy organizations and were predominantly Caucasian, college-educated, and high-income individuals. Additionally, the survey was distributed exclusively online, in English. Such limitations propose that these findings may not be generalizable to the broader U.S. population of families with food allergies.

For example, parents with higher household income may be more likely to own children at schools in excellent financial standing and with more resources available for food allergy management. Future efforts should be made to include underrepresented groups from a more diverse socioeconomic background, in hopes of having a more representative population. Lastly, given the nature of the survey, our results are undoubtedly affected by the potential lack of parental awareness regarding specific food allergy policies. This lack of awareness, however, is also a notable finding.

Further reading

The health and safety needs of students must be met so that children can thrive and achieve their academic potential in a safe and inclusive environment.

To date, given the lack of research on the most effective strategies to manage food allergy in the school setting and the subsequent lack of standardized national and local requirements, schools use a variety of approaches to manage food allergy and to minimize the risk of accidental exposures to food allergens. To our knowledge, the present study was one of the first to report on school food allergy polices from the perspective of parents of children with food allergy.

Importantly, approximately one in five parents in our study did not feel that their food allergic kid was safe while at school. Significant variations were reported in food allergy management and anaphylaxis preparedness strategies and appeared to be affected by the age of the student body, type of school (public versus private), and geographic location. Additionally, while the majority of parents felt that the polices in put in their child’s school were helpful, most also believed that the implementation of additional polices was necessary, including policies related to epinephrine access, labeling of food items, and food allergy education and training.

Half of the parents in our study reported that their child’s school carried non-student-specific stock epinephrine, with an additional one-quarter being unaware of whether their child’s school had stock epinephrine available.

Over 90% of parents felt that this policy was either helpful or needed. Whereas most states own legislation allowing schools to voluntarily stock undesignated epinephrine auto-injectors (EAI), few states own legislative mandates requiring that schools do so [11, 12]. In states without a mandate, barriers to stock epinephrine availability may include istrative and staff resistance, lack of adequate staff education, and cost [13,14,15]. However, given that immediate istration of epinephrine is the only life-saving treatment for anaphylaxis and that 25% of cases of anaphylaxis in schools happen in children previously undiagnosed with a food allergy [9, 16, 17], improving the availability of stock epinephrine should be a priority in improving the management of food allergy in the school setting.

The majority of parents also desired that stock epinephrine be available on school field trips and during after-school activities. Such policies may pose a challenge for schools, as they require the availability of additional EAIs. However, as up to 19% of anaphylactic reactions during the school day happen exterior the school building or on field trips, the availability of stock EAIs for these situations is an significant measure to consider [18].

Several policies were infrequently reported to be in put, but frequently deemed to be needed. Half of parents reported that food items sold at lunch and concessions after-school were not labeled with allergen information, though over 80% felt that such labeling should be implemented.

Similarly, only 44% of parents indicated that lunch menus with allergen information were available to them, with 85% feeling that this policy was needed. Because thorough review of ingredients in every food and drink products prior to consumption is a core strategy for food allergen avoidance and anaphylaxis prevention [19] widespread implementation of ingredient labeling policies should be prioritized in order to protect students and prevent potential allergic reactions at school. Similarly, policies related to food allergy training and education (i.e., student education, materials available in the lunchroom and classroom, and training of school bus staff) were among those least frequently reported to be in put, though approximately four in five parents felt that such policies should to be implemented.

Educational programs own been shown to be effective in increasing food allergy knowledge as well as appropriate use of an EAI and may be an additional key area of policy on which to focus [20, 21].

Expectedly, several school food allergy polices appeared to be driven by the age of the student body. For instance, parents of elementary and middle school students more frequently reported designated lunch areas and food allergy policies for classroom snacks and celebrations compared to parents of high school students. These differences are likely age-appropriate, as younger children are less developmentally and cognitively ready to self-manage and to minimize their risk of accidental food allergen ingestions.

Similarly, middle and high school students were more frequently reported to be allowed to self-carry epinephrine, which is consistent with greater autonomy and food allergy self-management skills with age. Importantly, adolescents remain at greatest risk of poor outcomes from food allergy [22,23,24]. This unique population may therefore particularly benefit from increased training and education on food allergy, a policy which was desired by the majority of survey respondents.

Differences in school policy also appeared to exist between public and private schools.

Private schools provided their students with more food allergy training and education, had stricter food guidelines for field trips when food was not provided by the school, and were more likely to own epinephrine available in the classroom. These differences may be based on variations in financial and time resources, staffing, and level of school nurse coverage. Parents of children with food allergy may also own more influence in shaping policy decisions at private as compared to public schools.

Although the majority of parents felt that their child’s school was generally safe, one in four were not certain or did not consider the school environment to be safe for their food allergic kid.

Such anxiety about safety and the potential for allergic reactions may negatively impact quality of life for students and their families and adversely affect school attendance [25, 26]. Further study is warranted to investigate the reasons behind these negative perceptions and potential opportunities for improvement. For example, clear documentation of student-specific medical needs with medical forms (e.g. individualized health plan, anaphylaxis emergency plan, school plan), clear labeling of food items sold at school, an adequate supply of appropriate medications (including stock epinephrine), and food allergy/anaphylaxis education for school staff may improve parental perceptions of safety during the school day [4, 27,28,29].

It is also notable that parents were frequently unaware of whether certain food allergy policies were in put in their child’s school.

For instance, % were unsure about the availability of stock epinephrine for after-school activities and approximately 40% were uncertain of whether food items sold at lunch or after school were labeled with allergen information. It is possible that numerous parents were not affected by such policies (e.g., children brought their own food to school or did not participate in after-school activities). However, clear and timely communication and a collaborative approach between the student’s school and family may provide an chance to assist parents be more aware about policies that are in put and therefore feel that school is a safer environment for their food allergic kid [30].

Several limitations of our study should be mentioned.

The use of self-report in data collection includes inherent risk to internal validity related to inaccurate recall bias, selective recall bias and social desirability bias. Additionally, respondents were recruited through food allergy support and advocacy organizations and were predominantly Caucasian, college-educated, and high-income individuals. Additionally, the survey was distributed exclusively online, in English. Such limitations propose that these findings may not be generalizable to the broader U.S. population of families with food allergies. For example, parents with higher household income may be more likely to own children at schools in excellent financial standing and with more resources available for food allergy management.

Future efforts should be made to include underrepresented groups from a more diverse socioeconomic background, in hopes of having a more representative population. Lastly, given the nature of the survey, our results are undoubtedly affected by the potential lack of parental awareness regarding specific food allergy policies. This lack of awareness, however, is also a notable finding.

What is food allergy?

Food allergy, which affects % of adults and % of children in the US, is defined as an immediate adverse reaction to components found in food products.

The allergic reaction is caused by pre-formed antibodies to food components which bind to special cells in the bloodstream, releasing chemicals which cause symptoms of an allergic reaction.

What are some common food allergens for children and adults?

The most common allergenic foods for young children are milk, egg, soy, and wheat. Food allergy in adults is most commonly caused by peanut, tree nut, fish and shellfish. Approximately 80% of young children outgrow allergies to milk and egg; however, only 20% of patients with nut and shellfish allergies lose their allergic reactions over time.

How is food allergy diagnosed?

Since reactions can be life-threatening, immediate diagnosis and treatment of food allergy is extremely significant.

Allergies to food can be diagnosed at your allergist’s office by skin prick testing. This painless method involves putting a extremely little quantity of each food allergen just under the skin, with results available in 15 minutes. Sometimes, physicians measure allergy antibodies in the blood to diagnose and follow patients with food allergy. The best test for food allergy, however, is to act out a “food challenge”, where the suspected food is eaten in increasing amounts under shut supervision at an allergist’s office. It is significant to note that allergies change over time, and new allergies can appear at any time regardless of age, so it is best to consult your allergist if you own any new reactions or concerns about food.

What are the symptoms of food allergy?

Symptoms of food allergy can include hives, vomiting, stomach pain, dizziness, mouth/tongue and throat itching, and can even manifest as difficulty breathing, throat swelling, and in severe cases, coma and death.

How is food allergy treated?

Currently, treatment for food allergy is strict avoidance of the offending food.

This involves reading ingredient labels and being extremely careful when dining exterior of the home. Symptoms of an allergic reaction should be treated with injectable epinephrine, also known as an EpiPen, which should be carried at every times. In some cases, Benadryl can be used for mild reactions. There is new and exciting research in the field of food allergy which may eventually lead to a cure for both children and adults, however none of these therapies are approved at the present time.

If you suspect that you or your kid may own a food allergy, come and visit your allergist — we can help!

By Dr.

Katharine S. Nelson


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