In recent years, clinicians and patients alike have experienced both significant interest in and confusion around food allergies/sensitivities and their manifestations in the gastrointestinal tract. A lack of clarity has led to frustration, inappropriate testing, and missed diagnoses.
Clifford Bassett, MD
Medscape contributor Akash Goel, MD, a clinical assistant professor of medicine at Weill Cornell Medicine, spoke with Clifford Bassett, MD, the founder and medical director of Allergy & Asthma Care of New York, a clinical assistant professor at NYU Grossman School of Medicine, a faculty member of the Weill Cornell Medical College in New York City, and author of The New Allergy Solution, about working toward a framework with which to approach diagnostic dilemmas around these food-related conditions.
Getting the Terminology Right
What defines a food allergy, and what kind of gastrointestinal symptoms do they produce?
Food allergies are due to an immunologic response to a food antigen culminating in a characteristic set of symptoms, ranging from mild to severe, with severe being multiorgan system anaphylaxis.
In the context of food, "allergies" traditionally suggest immediate-type hypersensitivity (type 1)involving antigen-specific immunoglobulin E (IgE) antibodies and histamine (among other mediators) release from mast cells and/or basophils. Type 1 food allergy signs/symptoms usually start within minutes to 1 hour after food ingestion and may include hives; itchiness; lip or tongue swelling; difficulty swallowing; throat tightening; chest tightness; trouble breathing; wheezing; and abrupt abdominal discomfort that may be associated with nausea, vomiting, and/or
