It’s a common scene during summer and fall: Guests gathered around a picnic table filling plates from plastic bowls and slow cookers holding salads, sandwich fixings, dips, pastas, baked goods and more, all made from different guests —with a gigantic potential for cross contamination.

It’s also a virtual nightmare for anyone with existing food allergies and it’s not uncommon for a setting like this to reveal new allergies in children and adults. About 15 million Americans are affected by food allergies so it’s a definite possibility one of these harmless gatherings could take a turn for the worse.

First, it’s important to differentiate between a food intolerance and a food allergy. A food intolerance involves a digestive response whereas an allergy involves an immune response.

Food intolerance

A food intolerance can happen when a person doesn’t have the digestive enzymes needed to fully digest a food. It can include irritable bowel syndrome, lactose intolerance, and food poisoning, sensitivity to food additives, recurring stress, and celiac disease. Symptoms of food intolerance include:

  • Gas, cramps or bloating
  • Headaches
  • Heartburn
  • Irritability or nervousness
  • Stomach pain
  • Nausea or vomiting

Food intolerance is not as serious as food allergies, but can become serious if not addressed.

Food allergy

A food allergy happens when your immune system targets a food protein as a potential threat and essentially, attempts to attack it. During this process, your immune system produces abnormally large amounts of an antibody called immunoglobulin E (IgE). These antibodies fight the allergens by releasing histamine, which is a chemical that can trigger many symptoms that can range from mild to severe. We always recommend being seen if you suspect a food allergy, and seek immediate emergency attention if symptoms are severe. We see many patients presenting with varying degrees of allergic reactions. We are able to get them diagnosed and treated right away.

When a food allergy is an emergency

The most severe type of allergic reaction is anaphylaxis. This is life threatening and is a combination of symptoms that may include some or all of the following: trouble breathing, rash, facial swelling, mouth or airway swelling, vomiting, abdominal pain or fainting due to low blood pressure. The signs of anaphylaxis can vary from patient to patient and can develop over hours or within minutes. Generally, the most common signs and symptoms of an allergic reaction include the following:

  • Cough, difficulty or irregular breathing, wheezing, itchy throat or mouth, and difficulty swallowing
  • Nausea, vomiting, abdominal pain, and diarrhea
  • Itchiness, red bumps or welts on the skin (hives), and skin redness
  • Dizziness, lightheadedness, heart palpitations, chest discomfort or tightness, mental confusion, weakness, lower blood pressure, rapid pulse, loss of consciousness, and fainting

An allergic reaction is considered a medical emergency when any of the signs or symptoms are particularly severe, such as loss of consciousness or difficulty breathing, or if different parts or systems of the body are involved, such as having the combination of hives and vomiting. It is important to see a doctor immediately if your reaction is severe.

When can you develop an allergic reaction?

You can develop allergies at any time in your life. In order to have a true allergic response, you must have been exposed to the allergen at least two times. The first episode will prime the immune system for the response and the second time, the allergy can occur. During pregnancy, the body's immune system is less active and has a less robust response to allergens. After the baby is born, the immune system returns to normal and may produce a more robust response to allergens. Women may see an increase in seasonal allergies and food sensitivities after pregnancy.

What should we know about children and allergic reactions?

As children try new things (foods, lotions, etc.), watch carefully for allergic reactions. If you have any concerns consult a medical provider. If your child has a known allergy, be sure to discuss this with all care providers and provide an EpiPen to have on hand, if your child’s doctor recommends for the type of allergy. Use extra precaution with children with known allergies, especially when at large picnics, barbecues and other parties. If you leave your child with allergies in the care of another adult, be sure the allergy is discussed right away. As your child gets older, continue to educate them on the importance of understanding their allergy and precautions to take to make sure they stay safe.

Treatment options

The treatment for the allergic reaction depends on the severity of the reaction. Mild symptoms can be treated with antihistamines such as Benadryl or Zyrtec. Some people with more serious symptoms need steroid medications such as prednisone. Those with life threatening reactions that involve the airway or circulatory system (low blood pressure or fainting) need epinephrine or an EpiPen. Talk with your doctor about any concerns you have about an allergy for yourself or a family member.

Should you need medical attention for allergic reactions, go to nearest medical provider for assistance.