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Food allergies: the invisible illness


Many people live with invisible illnesses everyday. The month of May is known as the Food Allergy Awareness Month and Celiac Awareness Month in the attempt to bring attention to those living with these health concerns.

While each of these illnesses can differ in severity, they affect the daily lives of those who live with them.

“A food allergy is an adverse food reaction, which is a general term for a negative response from the immune system overreacting to a particular protein found in that food,” said Prairie Mountain Health (PMH) Dietitian Jennie Cowan.

PMH Dietitian Laurie Evans added that not all adverse responses to food are allergic responses.

“Many people have food intolerances that are not immune responses to that food but instead digestive responses, when your body is unable to properly digest the food,” she said.

When someone ingests an allergen, symptoms may develop quickly and have the potential to progress rapidly from a mild reaction to a severe one.

“An allergic reaction usually happens within minutes of being exposed to an allergen, but sometimes it can take place several hours after exposure,” said Cowan.

An allergic reaction can involve any number of symptoms, and they may differ depending on the allergen for each person.

“Some of the symptoms involve the:

• skin: hives, swelling, itching, warmth, redness and rashes;

• respiratory system (breathing): coughing, wheezing, shortness of breath, chest pain/tightness, throat tightness, hoarse voice, nasal congestion, itchy, runny nose, watery eyes, sneezing, trouble swallowing;

• gastrointestinal system (stomach): nausea, pain/cramps, vomiting, diarrhea;

• cardiovascular system (heart): pale/blue colour, weak pulse, passing out, dizzy, lightheadedness, shock; and

• other: anxiety, feeling of ‘impending doom’, headache, uterine cramps, metallic taste.

“The most dangerous symptoms of an allergic reaction are trouble breathing caused by swelling of the airways, and a drop in blood pressure causing dizziness, light-headedness, feeling faint or weak, or passing out,” said Cowan. “Both of these can lead to death if untreated.”

While it is unknown exactly how many people live with food allergies, there are certain foods that have a higher prevalence of allergies – eggs, milk, mustard, peanuts, tree nuts, seafood, sesame, soy, sulphites and wheat.

Celiac disease is not the same as a food allergy, however, it is similar in the way that those living with it must avoid their triggers so as not to have a serious medical reaction.

“Celiac disease is a hereditary autoimmune disorder in which the consumption of a protein called gluten causes the body to attack the cells of the small intestine,” said Cowan. “This results in the inability of the body to absorb nutrients.”

Evans notes that celiac disease is easier to diagnose than a food allergy, but many people who live with the illness still never receive a proper diagnosis.

“Non-celiac gluten sensitivity (NCGS) is frequently a self-diagnosis, which is when people have similar symptoms to celiac disease and Irritable Bowel Syndrome when they consume gluten,” said Cowan. “Because of the self-diagnosis, the true prevalence of celiac disease and gluten sensitivity is difficult to establish.

“It is estimated that only five to 10 percent of people who have the disease are ever properly diagnosed.”

A study from the Canadain Celiac Association reports that 1 in 133 persons in Canada are affected by celiac disease.

“A study of more than 13,000 people in the United States in 2003 found that the prevalence was much higher, 1 in 22, if you have a first-degree relative, or 1 in 39, if you have a second-degree relative with celiac disease,” added Evans.

Those who suffer from celiac disease can be affected in all aspects of their life, including abdominal pain, bloating, gas, nausea, vomiting, diarrhea, constipation, vitamin deficiencies, dental enamel defects, short growth, osteoporosis, bone and joint pain, arthritis, mouth ulcers, headaches, depression, delayed puberty, infertility and miscarriage.

“Symptoms can occur singularly or in combination,” noted Cowan. “Many new diagnosed adults often have no gastrointestinal symptoms.”

Evans added that some patients have symptoms of celiac disease but their blood test and endoscopic results are negative or normal.

“This condition, known as NCGS, is controversial because there are no tests for it,” she said, adding that some people report symptom improvement when gluten is removed from their diet.

“If someone chooses to eat a gluten-free diet, it is hard to meet all of the nutrient requirements, so they should contact a dietitian.”

Those who have to eat modified diets due to food allergies or celiac disease often face difficulties when eating at restaurants or even at friends’ homes due to the unknown nature of what is truly in their food.

However, some Manitobans can receive assistance if they must eat a modified diet.

“All Manitobans currently enrolled with Employment Income Assistance may be eligible for a therapeutic diet if they are living with a health condition that has diet as part of the treatment for their health condition,” said Cowan. “Celiac disease and wheat allergies are included in this, but will only be eligible if a person has medical documentation of the condition.”

Evans noted that it is also possible to receive rebates through the Canadian Revenue Agency.

“There are guidelines for claiming gluten-free products and your accountant will help you with that process, however, you must have a diagnosis of celiac disease from a doctor in order to qualify,” she said.

Cowan noted there has been an increase in the prevalence of celiac disease but there are no definite reasons for the increase.

“Celiac disease is noted to be four times more common now, and some reasons for this may include the addition of more vital gluten to bread manufacturing and increased C-section deliveries,” Cowan concluded.

For more information about celiac disease or food allergies, or to connect with local programs, visit www.celiac.ca, or call Dial-a-Dietitian at 1·877·830·2892 or Prairie Mountain Health Chronic Disease Education Program/Outpatient Dietitian Services at 1·877·509·7852.

Jessica Bergen