Food Allergies

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For some people, a meal or a snack can be dangerous. In about 5 percent of children under age 5 and about 4 percent of adults, proteins in certain food types can cause a range of reactions. Symptoms are triggered when your immune system overreacts to the food and treats it as an enemy.  The first time you eat a certain food, your body produces an antibody called IgE (immunoglobulin E) to try to counteract it. The next time you eat the same food, that antibody triggers the release of histamine and other chemicals into your bloodstream.

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Your body’s reaction to these chemicals is usually what causes common symptoms including:

  • Tingling or itching in the mouth
  • A skin rash, hives, itching, or eczema
  • Swelling of the tongue, throat, lips, face, or other body part
  • Wheezing, nasal congestion, or difficulty breathing
  • Abdominal pain, nausea, diarrhea, or vomiting
  • Dizziness or fainting

Anaphylaxis, which happens very quickly after exposure to certain foods, particularly peanuts, is the most serious reaction and can even lead to death if not treated. While many people associate anaphylactic shock with closure of the airways due to swelling, according to the National Institutes of Health, it actually affects tissues in all parts of the body and can cause:

  • Abdominal pain
  • Abnormal (high-pitched) breathing sounds
  • Anxiety
  • Chest discomfort or tightness
  • Cough
  • Diarrhea
  • Difficulty breathing
  • Difficulty swallowing
  • Dizziness or light-headedness 
  • Hives, itchiness
  • Nasal congestion
  • Nausea or vomiting
  • Palpitations
  • Skin redness
  • Slurred speech
  • Swelling of the face, eyes, or tongue
  • Unconsciousness
  • Wheezing

Common causes

The following food groups account for nearly 90 percent of all food allergy reactions:

  • Tree nuts (almonds, pecans, etc.)
  • Peanuts, which are a legume, not a nut
  • Shellfish including shrimp, crab, and lobster
  • Fish
  • Eggs
  • Soy
  • Dairy
  • Wheat

Children may grow out of their food allergies, particularly to dairy and wheat.

Diagnostic tests

If you have an allergic reaction after ingesting any food, Dr. Esham may recommend a series of tests to determine if you do have an allergy and how severe it is.

She may first advise you to keep a food diary, in which you write down everything you eat and when, noting any symptoms that result and when. That can help identify what types of foods might be causing your problem. The next step is to follow an elimination diet, which means avoiding the suspected culprit(s) and seeing if your symptoms improve or go away.

Dr. Esham also may recommend a skin or blood test to definitively identify any food allergies. A skin test involves putting a small amount of the suspected food on your forearm or back and then pricking your skin to introduce the food beneath your skin. If a raised bump, hives or other reaction occurs, it’s likely that you are allergic to that food. A blood test measures the amount of IgE (immunoglobulin), the antibody you produce to try to fight the “harmful” food. If the test is negative but there is high suspicion, your physician will do a food challenge in the office. 

Treatment and alternatives

Once you’ve been diagnosed with a food allergy, you should alter your diet to avoid the offending food. If you need assistance coming up with alternatives, Dr. Esham or her nurse can recommend resources or refer you to an Adena nutritionist who can help you choose healthy options.

If you are concerned about an allergic reaction, Dr. Esheam may recommend that you carry an EpiPen, which allows you to receive an immediate dose of epinephrine to relax the muscles around your airways. Any time you experience symptoms, seek immediate medical care–even if you’ve used an Epi-pen. Emergency treatment may include additional epinephrine, antihistamines to address hives and swelling, bronchodilators to treat wheezing, or corticosteroids.


For most food allergies, education is key. Be sure you know how to read labels and are able to identify all the ingredients that might cause a reaction. It’s also essential to be diligent when eating out to ensure your server knows exactly what you’re allergic to and how to instruct the chef.

There are many useful websites and apps available to help you make educated decisions about your grocery and restaurant choices.

You may also choose to wear a medical alert bracelet or carry a card in your wallet that identifies your allergies in case of emergency.


If you have questions or would like to request an appointment please call 740-779-4393

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