One of the most frustrating things in the world can be finding a food allergy. After months of searching, usually with several doctors involved, a parent may find the culprit. But then the work is just beginning. For years (decades?) later the parents have to monitor all food for contamination.
The issue is particularly bad with something like a corn allergy. Eliminating all corn and corn products from your child’s diet may simply not be enough. We live in an age where cheap corn has permeated our culture. Even something like extra virgin olive oil can be contaminated with corn oil. So what is a parent to do?
A good start is to use observation rather than lab testing to define an allergy. In testing children with visible skin allergy, researchers found that almost half had a food allergy, but many of these were not significantly elevated in labs. Parents and children may have been avoiding those foods, so the child’s immune system wasn’t as responsive. Occasionally a child may have a gut only immune response, giving a delay of one to three hours before vomiting or having explosive diarrhea.
But children may have another response to allergy: chronic constipation. In children tested for chronic constipation which resisted common laxatives, more that half were found to be allergic to foods. Many had more than one food allergy. At six months after eliminating the food, only a few children could tolerate the food. By the first year, almost all the children could tolerate the food, and all could tolerate a food challenge without symptoms after two years. These children were tested by skin test, which researchers noted had no relationship to the child’s blood immune IgE tests.
In my own practice, I’ve seen parents dab a bit of food on a child’s cheek if they are unsure. More times than not, a reactive food will leave an inflamed red mark in the first minute. For adults, only the thinnest skin might be reactive, but with a child the skin is still thinner and more reactive overall.
In terms of treatment, it may be possible to engage in a trial of oral immunotherapy, which should with supervision and may speed a child’s ability to tolerate a food more quickly.
Without intervention, the old adage that a child “outgrows the allergy” simply doesn’t hold up under scrutiny. Researchers found that around ten percent of U.S. adults had an allergic skin response, and guessed that far more children must have been reactive. But they found that the number of children with an allergic skin response was again around ten percent. So rather than outgrowing an allergic skin reaction: “childhood eczema could follow a chronic relapsing and remitting course throughout a patient’s lifetime, with flares triggered by changes in the environment, skin care, stress, or other factors.”