To answer this question, we first need to clarify the terminology between food allergy and food intolerance. They are very different immune responses and should be managed with a different approach.
Food allergy triggers a series of specific immune responses that have been scientifically identified and better understood. The allergic reaction is usually faster and occurs within a few minutes to hours. Severity can be from mild to life-threatening.
Some of the common symptoms we see are:
- Itchy eyes
- Running nose
- Shortness of breath
- Joint pain
- Abdominal cramps
Testing options for food allergies include skin prick testing, performed in an allergist’s office or IgE antibody testing through blood work. Diagnosis can be clearly made based on test results.
Food intolerance is also called food sensitivity. How it is triggered is not well understood and has been debated for many years. With food intolerances, reactions are usually slower to appear, ranging from hours to days. Therefore, it is particularly confusing for parents to discern whether food is the problem. Severity is based on the level exposure and varies from mild to severe, however food intolerances are never life-threatening.
Some of the common systems for pediatric patients include:
- Skin rash
- Abdominal pain
- Joint or muscular pain
- Diarrhea and constipation
- Headache and migraine
Symptoms of food intolerances can vary.
One or two symptoms may be initially present, but over time symptoms of food intolerance can increase and affect multiple areas of the body if the exposure is chronic. Children with food allergy or intolerance also often have lower weight or height. If parents have food allergies, the likelihood of food intolerance in the child is higher. Formula fed infants also have higher incidents of food intolerance.
With food intolerances, IgE antibodies are not elevated to allergens, but IgG and IgA antibodies may be elevated. Blood tests for the IgG and IgA antibodies are available but they are not considered diagnostic. Elimination and re-challenging of the food is often needed to confirm intolerance.
Assessing for and managing food intolerances can help improve your child’s symptoms, especially if the symptoms recur or persist. If your child has any symptoms that keep recurring, it is worth looking into food intolerance as a potential cause even with a negative allergy test result in the past.