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Food Allergy vs. Intolerance: Knowing the Difference

Food allergies affect roughly five to eight percent of all children. A food allergy diagnosis can dramatically alter one’s life as it requires constant vigilance during meals and snacks and preparation in case a severe allergic reaction occurs. While many people experience various symptoms after eating certain foods, it is important to understand the differences between food allergy and intolerance.

What is an allergy?

An allergy is a response by the immune system to a food allergen, which causes symptoms that occur immediately (within a few hours) and with every exposure to that allergen.

While any food can potentially cause an allergy; peanuts, tree nuts, eggs, milk, wheat, soy and fish/ shellfish cause more than 90 percent of allergic reactions

What is an intolerance?

An intolerance is a non-immunologic response to a food that mainly causes gastrointestinal symptoms with exposure.

Common food intolerances include lactose (milk), wheat, gluten, fruits and vegetables.

Allergy Symptoms vs. Intolerance Symptoms

So how do you know if your child has an allergy or an intolerance? The good news is, for the most part, signs and symptoms vary between the two. The lists below illustrate the different reactions you might see in your child if they have a food allergy or intolerance.

Allergy Intolerance
Hives Not always reproducible
Swelling More subjective complaints
Difficulty breathing Not always immediate
Difficulty swallowing Bloating
Vomiting Gassiness
Hypotentions (passing out) Heartburn
Anaphylaxis Vomiting
Constipation
Diarrhea

How will a doctor test if my child has an allergy?

The history is the most important part of the evaluation. Allergy testing may be indicated when the history suggests a possible food allergy. If the history does not suggest a food allergy, then testing may not be necessary.

Testing options include:

  • Skin prick testing
  • Serum specific IgE testing
  • Oral food challenge

Some studies show that up to one in three people report having a food allergy. However, only one in 20 actually do. This discrepancy often comes from an incomplete understanding of the differences between food allergy vs. intolerance, or even normal response to some foods. If you have concerns, talk to your Allergist.

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