An allergic response
to food can show itself in a number of ways, as indicated in
Figure 40.
It is important that possible causes of the disorder other than allergy
be considered. A wheezing patient could have asthma due to an allergy,
but the wheezing could also be due to bronchitis, infection, heart
disease or cancer. Diagnosis of food allergy needs careful medical
interpretation of the patient's history. This should include dietary
background and the effects of 'elimination' diets, in which the suspected
food(s) have first been excluded, and then reintroduced to the patient
to compare the results. Although there may be improvement after the
elimination diet, with a return of symptoms when the food is reintroduced,
there can still be some doubt whether food allergy is the cause of
the condition.
There are many
causes of intolerances or sensitivities to food, and not all of them
are due to allergy. For example, coeliac disease (see
Chart 50 (Gluten) ) can produce effects similar to cow's
milk allergy.
The foods most commonly responsible for allergic reactions are listed
in Figure
41. Food
additives
have occasionally been thought to cause allergic reactions. The additives
most commonly implicated are tartrazine, a yellow dye used in many
foods, beverages and pharmaceuticals; also, benzoic
acid
and sulphur dioxide, which are used as preservatives in some fruit
drinks, cordials, soft drinks and wines.
