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Understanding food allergies, sensitivities

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By Dr. Jeff Daniels EBS Medical Columnist

Reactions to food, ranging from insignificant to life threatening, are more common in the U.S. than ever. From indigestion to anaphylactic shock, these health effects are changing the way we consider, eat and handle food.

As a former allergist, I’ll admit that food allergies and sensitivities are some of the most puzzling, difficult to diagnose, and difficult-to-treat problems I’ve dealt with. Some people have life-threatening reactions, while myriad food faddists, food sensationalists, and others label themselves “allergic.”

Many health professionals, for one reason or another, misdiagnose people as being allergic to certain foods. Testing isn’t exact and misconceptions about the complexities of real conditions are often difficult to understand. Also, many people who feel poorly latch on to a diagnosis of a food allergy or sensitivity because it makes them feel psychologically better.

Take for example gluten sensitivity and intolerance. Gluten is a composite protein – made up of gliaden and glutenin – found in wheat, rye and barley. A small but significant percentage of the U.S. population – between 0.5-1 percent, or up to 3 million Americans – can develop severe gastrointestinal problems by eating foods containing gluten. There are also dermatologic and neurologic conditions blamed on an immune reaction to this common protein. These are people with real gluten sensitivity.

A common diagnosis made in the U.S. is gluten intolerance, a condition with a diverse set of symptoms. A lab test is often used to confirm that antibodies are being produced against gluten. As many as 30 million people in the U.S. call themselves gluten intolerant, yet there are no scientific data to confirm that gluten is hurting them at all. Since a gluten-free diet is the only treatment for all of these conditions, the gluten-free food industry is thriving.

People can be desensitized to pollen, animal dander, and even insect sting allergies, but there are no successful treatments for food sensitivity. Luckily, for food allergies other than peanuts – which is more complex than other food allergies – most people will lose their sensitivity over time, stop having bad reactions, and start enjoying the food that at one time might have killed them.

Aside from avoiding any offending food – a daunting task when it comes to certain things, such as peanuts – the only treatment available are medications to reverse an allergic reaction. The most efficacious of these is epinephrine – also known as adrenalin – which most people have in a device called an EpiPen. Since epinephrine has to be administered via needle, EpiPens make it easy, and have saved many lives. Other medications we use include Benadryl and prednisone.

Most people and businesses are now “sensitive” to those with food allergies. In many restaurants, if a person claims he or she is allergic or sensitive to a food, a clean set of utensils, pots, and plates are used to prepare and serve the meal. It puts pressure on the kitchen staff, wait staff and management, but it can avoid disaster.

Dr. Jeff Daniels has been practicing medicine in Big Sky since 1994, when he and his family moved here from New York City. A unique program he implements has attracted more than 700 medical students and young doctors to train with the Medical Clinic of Big Sky.

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