You eat a meal at a nice seafood restaurant and feel "wrong" afterwards. Is it an allergy or just indigestion? Your child had a snack two hours ago, took a nap, and woke up with hives on his belly. Should you call the doctor or should you give him a dose of Benadryl and wait and see?
Here are some general guidelines to help you determine which symptoms are likely to be associated with food allergies or severe food intolerances and when you need to call the doctor. In general, if you think you might be experiencing an allergic reaction, err on the side of caution: have your doctor check it out.
Call 911 or your local emergency number if:
- You experience hives or swollen lips or tongue along with difficulty breathing,
- You experience changes in consciousness after eating,
- You experience two or more of hives, swollen lips, low blood pressure (which may make you feel woozy or cause changes in heart rate when sitting upright or standing), or abdominal symptoms (vomiting, severe nausea, or diarrhea) after eating, or
- You have an asthma attack after eating that doesn't respond to your normal rescue medication, especially if you are also experiencing skin symptoms or swelling.
These symptoms can indicate a severe allergic reaction called anaphylaxis. Anaphylaxis, or anaphylactic shock, is a life-threatening reaction sometimes triggered by food allergens. Severe asthma attacks also require immediate attention from a medical professional if they do not respond to rescue medication.
Call your general practitioner or pediatrician as soon as possible if:
- You experience swelling of the lips or tongue after eating,
- You wheeze or have difficulty breathing after eating,
- You have itchy hives over a large area of your body that appear soon after eating,
- An infant is experiencing severe difficulty with feeding (such as painful or bloody diarrhea, vomiting, or frantic crying after meals), or
- You have gastrointestinal symptoms (diarrhea or vomiting) after eating that are severe enough to cause symptoms of dehydration.
These symptoms often indicate a food allergy that has the potential to develop into an anaphylactic allergy on further exposure. Your doctor is likely to recommend further testing as soon as possible and may want to prescribe emergency medication in case of another, more severe reaction. Infant feeding difficulties need to be resolved quickly for the proper growth and comfort of the baby.
Severe gastrointestinal symptoms can indicate food allergies or several other acute conditions (like food poisoning), but if these symptoms are severe enough to prevent you from replacing fluids, you may need treatment for dehydration in addition to an evaluation for food allergies or intolerances. Your doctor may prescribe anti-vomiting or anti-diarrhea medication or may recommend you go to the hospital for rehydration treatments.
Call your general practitioner or pediatrician to make an appointment if:
- You have restricted foods from your diet because you believe you may have an allergy or intolerance to them;
- Your mouth itches after you eat certain foods;
- You regularly experience gastrointestinal symptoms (nausea, abdominal cramps, vomiting, or diarrhea) after eating;
- You regularly experience rhinitis (hay fever) symptoms after eating;
- An infant does not seem to be gaining weight or growing well;
- You have difficulties in swallowing or reflux-like symptoms with eating; or
- You regularly experience any troublesome symptoms that you believe may be associated with food.
These symptoms could indicate food allergies (including oral allergy syndrome), food intolerances, eosinophilic esophagitis, or other conditions that may be triggered by food (such as irritable bowel syndrome). Expect a physical exam, discussion of your history and symptoms, and potentially in-office testing or referral to an allergist, immunologist, or gastroenterologist for further examination.
If your baby doesn't seem to be gaining weight (or if she seems to be losing weight), her pediatrician will want to examine her growth curve and may consider physical causes.
Try home treatment if:
- You have hives over a small area of your body that aren't associated with other allergy symptoms (such as breathing difficulties, changes in heart rate, or wheezing).
Many people assume that food allergies are the only cause of hives, but hives can be caused by many triggers -- heat, cold, stress, medications, infections, and exercise are others. Mild cases of hives that don't cover much of the body and don't appear with other symptoms of a severe reaction can be treated with over-the-counter antihistamines such as Benadryl (diphenhydramine) to reduce itching and swelling. If hives do not respond to several doses of antihistamine, cause severe discomfort, or appear every time you eat a particular food, they warrant a call to your doctor.