Food Allergies

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At UT Southwestern, our doctors have in-depth knowledge of common and complex food allergies affecting patients of all ages. We work with patients to develop a customized plan for avoiding allergic reactions and handling food allergy emergencies if they arise.

Personalized Treatment for Food Allergies

A food allergy is an abnormal reaction produced by the body's immune system to a certain food (allergen). Common food allergens include cow’s milk, peanuts, tree nuts, and eggs. In some people, food allergies can cause severe or even life-threatening symptoms.

At UT Southwestern, our multidisciplinary team of allergists and dietitians work with patients to create effective, customized treatment plans to manage the whole spectrum of food allergies, including:

  • Immunoglobulin E (IgE)-mediated food allergy, which causes symptoms such as hives, swelling, or anaphylaxis (a sudden and potentially life-threatening allergic reaction) within minutes to a couple hours of ingestion
  • Eosinophilic esophagitis (EoE), which causes vomiting or feeding problems in infants or young children and difficulty swallowing in older children and adolescents, and other eosinophilic gastrointestinal diseases (EGIDs)
  • Food protein-induced enterocolitis syndrome (FPIES), which causes repetitive delayed vomiting two to four hours after food ingestion, usually in infants or young children

Through Children’s Health, we have North Texas’s only academic-affiliated allergy and immunology program for children from birth to age 18. Our researchers conduct instrumental, pioneering research to develop new therapies for children with food allergies.

Causes and Risk Factors of Food Allergies

As the body’s natural defense network, the immune system fights infections and other diseases. A food allergy occurs when the immune system treats a certain food as though it’s harmful, causing the body to release chemicals such as histamine. This leads to allergic symptoms that can affect all parts of the body.

Risk factors for food allergies include:

  • Allergic reactions from other types of food or from other allergens such as pollen
  • Asthma
  • Family history of conditions such as allergies, asthma, or eczema
  • Young age (food allergies are more common in children, particularly infants and toddlers)

Food Allergies in Children

Although they can appear at any age, food allergies most commonly present in babies and children. In the U.S., it’s estimated that one in every 13 children is diagnosed with a food allergy – and that number appears to be increasing.

It’s unclear exactly why food allergies in children are on the rise, but experts think it could be because:

  • Improved hygiene has led to a lack of early life exposure to bacteria and other microbes that shift the immune system away from allergic inflammation (this is known as the hygiene hypothesis).
  • Delayed introduction of allergenic foods based on past recommendations may have actually increased risk of food allergy.
  • Children might be lacking sunlight and vitamin D.

Recent evidence has shown, and guidelines now recommend, that for high-risk infants (those with eczema severe enough to need topical steroid medications and/or those with a known allergy to eggs), early testing at age 4 to 6 months to facilitate peanut introduction might prevent the development of a peanut allergy.

Eight food allergens are responsible for 90% of reactions in children:

  • Milk
  • Eggs
  • Peanuts
  • Tree nuts
  • Wheat
  • Soy
  • Fish

Allergies to milk, eggs, wheat, and soy tend to disappear as children get older, while serious cases and allergies related to seafood and nuts are more likely to be permanent.

The UT Southwestern Pediatric Group has the only academic-affiliated pediatric food allergy center in North Texas. Our allergists/immunologists – all of whom have been certified by the American Board of Allergy and Immunology – have extensive experience evaluating and treating food allergies and other immunologic conditions.

Our allergists work closely with their colleagues in the gastroenterology division to personalize management of gastrointestinal food allergies such as EoE.

Symptoms of Food Allergies

Food allergy symptoms can differ from person to person and range from mild to severe and potentially fatal. They can also change for one person over time.

Symptoms, which usually appear within a few minutes to two hours after eating the problem food, can include:

  • Abdominal cramps or diarrhea
  • Itching or tingling in the mouth
  • Itchy skin
  • Large, itchy bumps on the skin (hives)
  • Swelling of the tongue, lips, or throat
  • Wheezing, coughing, or difficulty breathing
  • Vomiting

In some people, food allergies can cause anaphylaxis, which triggers the release of a flood of chemicals that can cause someone to go into shock.

Signs of anaphylactic shock include:

  • Low blood pressure
  • Nausea and vomiting
  • Skin rash
  • Trouble breathing
  • Quick, weak pulse

Diagnosing Food Allergies

Because these symptoms may have other causes and not all symptoms that occur after eating are due to food allergy, it’s important to see an experienced allergist for a proper diagnosis.

At UT Southwestern, we begin with a thorough evaluation, which includes a:

  • Detailed review of symptoms suspected to represent allergy and detailed dietary history
  • Discussion of personal and family medical history
  • Discussion of any associated atopic conditions (nasal allergies, asthma, eczema, etc.)
  • Physical exam

If our immunologist suspects a food allergy, we may perform:

  • Blood tests: We’ll measure a blood sample for IgE (allergy-related antibodies) against specific food allergens.
  • Skin prick tests: Liquid extracts of food allergens are placed on the patient’s forearm or back, and the skin is pricked; if reddish, raised wheals appear, the patient might be sensitized to that food.

Depending on the results of those tests, we may recommend a food challenge, during which the patient eats incremental amounts of the potential food allergen while being monitored by the doctor.

Treatment for Food Allergies

The most effective treatment is avoiding the problem food.

When patients do come in contact with a problem food, it may require:

  • Minor allergic reactions: Over-the-counter or prescribed antihistamines to help ease symptoms
  • Severe allergic reactions: Emergency injection of epinephrine (through an EpiPen, for example) and an emergency room visit

Dietitians play an essential role in managing food allergies, and we work closely with them

at our clinics. We also collaborate with a psychologist who specializes in helping children who have anxiety related to food allergies such as EoE.

Clinical Trials for Food Allergies

As an academic medical institution, UT Southwestern is at the forefront of research for food allergy treatment.

Current clinical trials include:

  • The OUtMATCH Study: Our researchers are trying to determine if a study medication called omalizumab alone or combined with oral immunotherapy might help people with multiple food allergies.

See all food allergy clinical trials at UT Southwestern.