Food allergies: clinical manifestations, diagnosis, and management.

i m m r m ( w m f k T i i h a I t a i f I f t r h n R eactions to foods are extremely common and the etiology of these reactions determines their correct management. Adverse food reactions re not all allergic. The management of food adverse eactions ranges from complete avoidance of minute mounts of food to ingesting milk after lactase suplementation. It is, therefore, important to accurately lassify reactions to foods. Adverse food reactions can e categorized into the 2 following groups: nonimmuologic and immunologic. Immunologic reactions to ood are mediated by the immune system, while all ther reactions fall into the nonimmunologic category. onimmunologic reactions are grouped into either oxic or nontoxic reactions. A toxic reaction results from the pharmacologic ctions of a substance within a food. These reactions an occur in anyone who is exposed to the food and do ot depend on host factors. These substances may be nzymes or any agent that could cause reactions in the ody. Examples of toxic reactions include nausea from acterial food poisoning, heavy metal poisoning, and tching and flushing from histamine ingestion as seen n scombroid fish poisoning. The consumption of oods containing caffeine, such as coffee or tea, can ause jitteriness. Tyramine in aged cheeses can cause igraine headaches and alcohol ingestion is associated ith a variety of well-known symptoms. All other nonimmunologic reactions to foods can be haracterized as food intolerances. These are depenent on the host and the host-environment interaction. he nomenclature of the World Allergy Organization ses the term “hypersensitivity” to refer to a reproducble symptom or sign to a stimulus tolerated at the ame dose by normal persons apart from an immuno-