Management of food allergies

Worldwide, approximately 8 and 2% of children and adults, respectively, suffer from food allergy. Cow's milk, egg, peanut, soy, wheat, fish, shellfish and tree nuts are responsible for the majority of allergic reactions to foods. Allergic reactions to food can occur by a variety of immune mechanisms including: IgE-mediated; non-IgE-mediated (T-cell-mediated); and combined IgE- and T-cell-mediated. Food allergies can affect any organ system, but most frequently involve the gastrointestinal system, the skin and the respiratory system. Knowledge of the spectrum of food allergies is important in order to identify patients at risk for severe or life-threatening allergic reactions. This article will review the mechanisms of specific food allergy disorders. It will also summarise the diagnosis of food allergy including the history of a food reaction, skin tests and laboratory tests. The management of food allergy will also be discussed with particular emphasis on the avoidance of food allergens and the pharmacotherapy of allergic reactions. Future therapy for food allergies will also be discussed.