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The subject becomes less confusing if we use a simple classification for all Adverse Reactions to Food This Food Hypersensitivity includes all reproducible food related reactions and may be both Allergic and Non-allergic.

I however divide Adverse Reactions to Food into four distinct groups.

The antibody called Immunoglobulin E (Ig E) accounts for 90% of True Food Allergic reactions.

A reaction can occur to minute traces of the offending allergen and in exquisitely sensitive individuals, even airborne food allergen can trigger anaphylaxis – as in fish and peanut allergy.

Increasingly we see Delayed T-cell mediated food allergic reactions – these take over 24 hours to evolve and are typically seen with Contact Dermatitis in adults and Coeliac Disease in children.

We refer to these as Non-Ig E Allergic Hypersensitivity reactions Classical Ig E Mediated food allergy presents with immediate Urticarial rashes, tissue angioedema of the face and neck and even anaphylaxis with shock and circulatory collapse.

The prospect of a life-threatening anaphylactic reaction is always a major public concern.

Patients may present with urticaria that they attribute to food allergy.

Histamine may even occur naturally in foods and when absorbed in the GI tract, the histamine content triggers an allergic-like reaction.There may be some very serious and life threatening consequences of food allergy.Consider the dire results of Fish and Peanut Anaphylaxis.Here the enzyme Lactase is depleted resulting in cramps, flatulence and frothy diarrhoea after drinking cows milk.It is an inherited trait and affects up to 10% of the population, beginning in teenage years and gets worse with advancing age.

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