Last reviewed: July 2024
Introduction
The human immune system is very complex and protects us from harmful toxins and foreign bodies, keeping us healthy. Most of the time, it works well, and we are oblivious to it. Like most complex systems, though, it can develop glitches. This is when allergies, food intolerances, and auto-immune conditions can develop.
This resource is the first part of our three-part factsheet on food sensitivities:
The first in a series of three factsheets:
- Introduction to food sensitivities
- Supporting customers with food sensitivities
- Supporting employees with food sensitivities.
This resource gives an overview of:
- The different and most common types of adverse immune reactions
- Signs and symptoms
- Treatments.
While the factsheet does not specifically cover dietary restrictions due to other health conditions, many of the challenges and adjustments will be similar.
Types of food sensitivities
There are different types of reactions that people can experience due to ingredients in food.
For the purposes of this factsheet, the term food sensitivity will cover the following immune reactions:
- Food intolerances
- Autoimmune reactions (for example, coeliac disease)
- Food allergies (including anaphylaxis).
Food intolerances
These are common in the general population, and most frequently caused by milk or wheat. They are not life-threatening but are often very uncomfortable and disruptive for the individual.
Common symptoms of food intolerance
- Bloating
- Pain
- Nausea
- Diarrhoea
- Constipation
- Migraines
- Skin conditions.
Treatments of food intolerance
- Avoidance of trigger ingredient
- Medication to treat symptoms.
Autoimmune reactions
The most well-known is coeliac disease (autoimmune response to gluten). This affects one per cent of the population.
A person with coeliac can experience severe damage to the lining of their gut if exposed to gluten. If left undiagnosed and untreated, it can produce symptoms anywhere in the body – for example:
- Skin rashes
- Liver problems
- Nerve damage
- Deficiency in key vitamins and minerals.
Common symptoms of autoimmune reactions
- Diarrhoea
- Constipation
- Vomiting
- Abdominal pain
- Bloating and wind
- Indigestion
- Fatigue – from symptoms and poor absorption on essential minerals and vitamins
- Weight loss
- Skin rashes
- Tingling and numbness in the hands and feet (peripheral neuropathy)
- Balance, co-ordination and speech difficulties
- Infertility.
Treatment of autoimmune reactions
- Strict avoidance of any food containing gluten and cross-contamination
- Supplements to replace lost essential vitamins and minerals
- Treatment of any symptoms.
Food allergy
Food allergies can present in different ways:
- Anaphylaxis – the most severe type of reaction and is life-threatening
- The ‘classic’ immediate reaction – less severe but can progress to anaphylaxis
- Oral allergy – usually restricted to the mouth and ears caused by reaction to raw plant-based foods
- Delayed reaction – can occur hours or days after ingestion, for example, eczema and nausea.
Anaphylaxis
This is an immediate, rapidly progressing and life-threatening reaction. If you suspect someone is having an anaphylactic reaction, you must treat the situation as an emergency.
Signs of anaphylaxis include:
- Swelling and a feeling of ‘tightness’ of the throat and tongue
- Itchy mouth or skin
- Difficulty breathing and/or swallowing
- Wheezing, coughing or noisy breathing
- Cool and pale, grey or blue skin, especially the lips and tongue, fingernails (for people who have brown or black skin, this may be easier to spot on the palms of their hands)
- Dizziness, feeling faint, fatigue or confusion.
Refer to NHS guidance on anaphylaxis for more information.
Common symptoms of an allergic reaction
Signs and symptoms will vary in severity and appearance for each person and each allergen. They include:
- Sneezing, coughing, wheezing, chest tightness and difficulty breathing
- Itchy mouth, eyes, ears and skin
- Swelling, especially of lips and throat
- Nausea and vomiting
- Diarrhoea
- Abdominal pain
- Feeling faint or dizzy
- Rashes, hives, eczema.
Treatment of an allergic reaction
This will depend on the severity of symptoms, but may include:
- Strict avoidance of trigger food in all cases
- Antihistamine
- Asthma-type inhalers
- Steroids – oral or topical to skin
- Adrenaline – for example, EpiPens for anaphylaxis
- Intervention by paramedics and emergency departments for life-saving treatments.
Getting diagnosed with a food sensitivity
It is vital that people who react to certain foods receive an accurate diagnosis. This is rarely easy or quick because:
- Delayed reactions can make it difficult to pinpoint
- We usually consume several ingredients when we eat and drink (think about the number of ingredients in your last meal)
- Symptoms are often mild initially and not recognised as a reaction
- Symptoms can be mistaken for other conditions that are less serious
- Long waiting times for medical referrals
- Types and scope of available tests
- A lack of specialists in this area. A person may be referred to a dermatologist, gastroenterologist, or ENT specialist before a diagnosis is found.
Further information
Business Disability Forum
- Supporting customers with food sensitivities
- Supporting employees with food sensitivities
- Blog: We’re all going on a summer holiday (and food allergies won’t stop us.
- Advice Service – Members and Partners can contact us for guidance on specific questions.
NHS
Other sources
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