What is the difference between food allergy and food sensitivity intolerance?

Food allergies, sensitivity to foods and food intolerance are often used interchangeably and incorrectly. In fact, in scientific and medical communities, there is a debate on how to properly define and use these three terms. It seems that it is the most appropriate to use the terms „food allergy” with respect to IgE-dependent reactions, „intolerance” – the enzyme deficiency, and „food hypersensitivity” to all delayed food reactions IgE independent and not due to enzyme deficiency. Note that there may be adverse reactions to food caused by pharmacological substances (nicotine, caffeine) or toxic substances (eg fish toxin).
Immediate food allergy – IgE-dependent
Perhaps the best known, though quite rare and very dangerous example of immediate food allergy reaction is anaphylaxis. It is acute reaction of the immune system caused by huge quantity of histamine released from basophils and mast cells of tissue under the influence of IgE antibodies against a particular food allergen. The most well-known products that cause an immediate allergic reaction are peanuts, other nuts, fish and seafood, eggs, milk, soy, dairy, wheat. As a result of anaphylactic shock, a person can die within a minute, eating only one molecule of sensitizing food. Immediate food allergy affects about 1-2% of the population and concerns only a small part of all allergic food reactions. Most of the immediate reaction is not life threatening, but causes unpleasant symptoms. People suffering from immediate food allergies, usually can identify allergenic foods without the help of a doctor and tests because of the immediate reaction after ingestion. Note also that the foods that are natural sources of histamine can cause symptoms similar to IgE-dependent allergies without increased levels of IgE.
Delayed food reactions (hypersensitivity)
Delayed food reactions are a different story.
They manifest themselves in many different ways and can concern any internal organ (wherever the blood flows), and symptoms can appear from 45 minutes to 3 days after ingestion and are dependent on the amount of food eaten. The delay in symptoms and a set of mechanisms makes them extremely difficult puzzle to solve, regardless of the diagnostic methods used. Therefore, food hypersensitivity often remains undiagnosed or diagnosed incorrectly. The treatment usually brings temporary relief, which masks the symptoms rather than eliminates the cause of the problems. Food hypersensitivity concerns over 40 % of population.

Food intolerance
Food intolerance can cause symptoms similar to food hypersensitivity but it is not caused by the body’s immune response. Ingested non-tolerable food is not properly digested. The best example of food intolerance is lactose intolerance, which is characterized by bloating, diarrhea, or diarrhea and gas. Lactose intolerance is caused by a deficiency or absence of the main sugar degrading enzyme of fresh milk. Avoiding fresh milk or lactase supplementation is the best way to get rid of the problem of lactose intolerance. Another example of food intolerance is phenylketonuria caused by an inherited deficiency of phenylalanine hydroxylase (PACH), an enzyme that breaks phenylalanine down. No conversion of phenylalanine causes its accumulation in the brain, and leads to irreversible damage to the central nervous system (mental retardation and neurological disorders). Detection of phenylketonuria in the neonatal period and an appropriate very strict diet allows the normal development of the nervous system.

Posted in: Adverse food reactions

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