There are many foods that can cause true allergies. These can be lifethreatening and are quite common. A food allergy occurs through an IgE-mediated response similar to what I have previously described.

The most common symptoms of a food allergy are vomiting; stomach pain; asthma attack; breathing difficulties; headaches; joint swelling and pain; hives; itchiness; diarrhea; and, in the worst cases, anaphylaxis. Some minor food allergy symptoms can be a tingling sensation in the mouth or a swelling of the tongue.

Some people are so allergic to certain foods that they will get a reaction if the food is simply in the room, or if their skin comes into contact with the food. Sometimes patients may even have reactions to food residue on restaurant tables and chairs.

Ninety percent of all food allergies are to milk, peanuts, soy, eggs, nuts such as cashews, almonds, or walnuts (peanuts are actually legumes), shellfish, fish, or wheat. Peanuts, fish, shellfish, and nuts usually cause the most severe reactions.

Peanut allergies are increasingly common, and this is especially important in school-age children because peanuts are in so many foods. It is not just the peanut itself that can cause the allergy but also peanut oil, peanut sauce, and anything that contains peanuts.

Peanut oil is so commonly used that it may be one of the ingredients in your food, so check labels. Peanut allergies are usually so severe that if a pot had peanut oil in it prior to your use, a reaction may occur. Peanut allergies are very common, and the reactions tend to be the most severe. Peanuts are responsible for 63 percent of all food-allergyrelated deaths.

For this type of severe food allergy, I recommend three things:

1. Prepare for an emergency. Should a situation arise where the allergy occurs, you and/or your child should know immediately what to do. In the case of a young child, let the school or sitter know exactly what to do and send written instructions with the child so there is no confusion.

2. Very careful shopping. Read food labels very carefully. Know what is in everything that you buy or that your child is buying at school or in a store. If you don’t know what is in a particular item and the school or store can’t tell you, do not buy it. Always carry a snack for yourself or your child in case there is nothing else available. This especially holds true for airline travel. Never get caught unprepared.

3. Carry an Epi-pen. This is a disposable cartridge that carries the drug epinephrine. Learn how to use it, and teach anyone, including your child, in its proper use. This is something you get a prescription for from your doctor.