Summary about Disease
Non-IgE mediated food allergy (also called food intolerance or food sensitivity) is a type of adverse food reaction that does not involve the immunoglobulin E (IgE) antibody, a key player in classic, immediate-onset food allergies. Instead, it involves other parts of the immune system or non-immune mechanisms. It often results in delayed symptoms, making diagnosis more challenging. Common examples include food protein-induced enterocolitis syndrome (FPIES), food protein-induced allergic proctocolitis (FPIAP), and celiac disease.
Symptoms
Symptoms vary greatly depending on the specific type of non-IgE mediated food allergy and the individual. Common symptoms include:
Gastrointestinal issues: Diarrhea, vomiting, abdominal pain, bloating, constipation, reflux, blood in stool
Skin problems: Eczema flares, rashes
Respiratory symptoms: Runny nose, cough
General symptoms: Fatigue, poor growth (in children), irritability, fussiness
Causes
The exact causes are not fully understood, but several factors are believed to contribute:
Immune system involvement: Certain types of immune cells (other than those involving IgE) may react to food proteins.
Gut permeability: Increased permeability of the intestinal lining (leaky gut) may allow food proteins to enter the bloodstream and trigger an immune response.
Enzyme deficiencies: Lack of enzymes to properly digest certain foods (e.g., lactose intolerance).
Food additives: Sensitivities to food additives or preservatives.
Medicine Used
There is no single medication to "cure" non-IgE mediated food allergies. Treatment primarily focuses on:
Elimination diets: Removing the offending food(s) from the diet.
Symptom management: Medications to relieve specific symptoms (e.g., antacids for reflux, anti-diarrheals).
In severe cases (e.g., FPIES): Intravenous fluids and supportive care may be necessary.
Is Communicable
No, non-IgE mediated food allergies are not communicable or contagious. They are not caused by infections and cannot be spread from person to person.
Precautions
Strict avoidance: Meticulously avoid the identified trigger foods.
Label reading: Carefully read food labels to identify hidden sources of allergens.
Cross-contamination: Prevent cross-contamination in food preparation.
Emergency plan: For conditions like FPIES, have an emergency plan in place with guidance from a healthcare provider.
Dietary guidance: Work with a registered dietitian to ensure a nutritionally balanced diet while avoiding allergens.
How long does an outbreak last?
The duration of an outbreak varies depending on the specific type of non-IgE mediated food allergy and the individual. Symptoms can last from a few hours to several days after exposure to the trigger food. With proper elimination of the offending food, symptoms should resolve. However, chronic exposure or accidental ingestion can lead to prolonged or recurrent symptoms.
How is it diagnosed?
Diagnosis can be challenging because of the delayed and variable symptoms. Common diagnostic methods include:
Detailed medical history: Thorough assessment of symptoms, dietary habits, and family history.
Elimination diet: Removing suspected foods and observing for symptom improvement.
Food challenge: Reintroducing suspected foods under medical supervision to monitor for reactions.
Stool tests: To check for blood or inflammation.
Endoscopy and biopsy: In some cases, to examine the lining of the esophagus, stomach, or intestines.
Timeline of Symptoms
The timeline of symptoms varies greatly. Unlike IgE-mediated allergies, where reactions typically occur within minutes to two hours, non-IgE mediated reactions are delayed.
Onset: Symptoms may appear hours to days after ingesting the trigger food.
Duration: Symptoms can last for several hours to days.
Resolution: Symptoms usually resolve within a few days to weeks after eliminating the trigger food.
Important Considerations
Consult a healthcare professional: Accurate diagnosis and management require the expertise of a doctor, allergist, or registered dietitian.
Nutritional adequacy: Ensure a balanced diet when eliminating foods, especially in children.
Long-term management: Some non-IgE mediated allergies can resolve over time, while others may require long-term dietary management.
Impact on quality of life: Non-IgE mediated food allergies can significantly impact quality of life, requiring careful management and support.
Reintroduction of foods: Attempts to reintroduce foods should be done under the guidance of a healthcare professional.