Beyond Food Allergies: Intolerance, FPIES, EoE, and OAS

Beyond Food Allergies: Intolerance, FPIES, EoE, and OAS

When you’re living with food allergies, you learn very quickly that one person’s experience with allergies doesn’t necessarily mirror the way other people respond to the same allergy. It can be easy, however, to assume that folks who experience health-related complications because of food all fall into a single category – allergic. That’s not exactly true. Not only can the way we experience food allergies vary, there are a variety of related medical conditions that may be triggered by everyday foods.

Before we take a look at some of these, let’s be clear. This blog is not a substitute for medical advice. If you suspect you or someone you know may be dealing with one of the conditions highlighted here, make an appointment with your physician.

Food Allergies

Allergies involve your immune system. As an example, if you are allergic to eggs and consume something that contains them, your immune system incorrectly identifies the egg proteins as something dangerous and reacts to it. Consuming foods with your allergen can trigger an allergic reaction; symptoms can range from hives and abdominal discomfort to trouble breathing, dramatic drop in blood pressure and loss of consciousness. Food allergies can be potentially life-threatening. You may also see this referred to as an IgE-mediated food allergy.

Food Intolerance

An intolerance is a digestive system disorder. As an example, a person who is lactose intolerant lacks lactase, the enzyme that breaks down the sugar in milk, also known as lactose. For most of us, these sugars are normally broken down in our stomach. For those who lack lactase, the lactose is broken down in the colon by bacteria and can result in uncomfortable bloating, gas, nausea, and diarrhea. It can be incredibly uncomfortable but not life-threatening.

FPIES (Food Protein-Induced Enterocolitis Syndrome)

FPIES is a form of food allergy that affects the gastrointestinal tract, inflaming both the small and large intestines. Typical food allergy reactions appear in seconds up to an hour after exposure. A FPIES response, however, is delayed and may appear between 2-4 hours after consumption. Individuals with this medical condition are likely to respond to their allergens with profuse vomiting. They may also become pale, lethargic, and unresponsive. FPIES reactions don’t typically involve skin and respiratory responses, according to Dr. Anna Nowak-Wegrzen in this Allergic Living article. Patients may outgrow FPIES by the time they start kindergarten, although some children may continue to deal with FPIES longer.

EoE (Eosinophilic Esophagitis)

This is another allergic condition that presents differently than typical food allergies. Food triggers for patients with EoE can cause damaging inflammation of the esophagus. Eosinophils (white blood cells) can build up in the esophagus in response to exposure of allergens. This not only causes the inflammation, but it can also lead to severely scarred esophageal tissues, as well as other painful symptoms. Symptoms can vary by patient and age, which can make it difficult to diagnose. In addition to a thorough medical history, a physician will perform an endoscopy and biopsy pieces of tissue to help diagnose the disease. Identifying which foods trigger inflammation can become a process of trial and error, explains Dr. Jonathan Spergel in this article.

Oral Allergy Syndrome

Individuals with oral allergy syndrome are unlikely to experience life-threatening responses to food, but they can experience localized responses to consuming or holding raw fruits and vegetables. Their reactions may include a rash, itching, swelling, and sneezing. Likely culprits include apples, cherries, kiwis, celery, tomatoes, melons, and bananas. Individuals who deal with this allergic disorder typically also experience hay fever when exposed to environmental allergens.

Celiac Disease

Celiac disease affects the small intestine and is caused by an abnormal immune response to gluten. It can cause malnutrition and intestinal damage if not managed properly. Those with celiac see a gastroenterologist to diagnose and help manage their condition. This is not to be confused with a wheat allergy. They are different things.

Make an Appointment

It may sound easy enough to distinguish these different conditions, but that’s not necessarily the case. Similar symptoms may occur not only among the different allergic conditions, but with other disorders and illness. The only way to know for sure if you’re dealing with one of these conditions is to see a doctor for a formal diagnosis.

That said, it’s important to highlight one particular commonality among these different conditions: For each of them, individuals will need to avoid consuming the foods that trigger symptoms. Whether you (or someone else) is managing an intolerance, celiac disease, EoE, OAS, FPIES, or IgE-mediated food allergy, being aware of what you eat, and avoiding foods that trigger a response is crucial.

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