Different Types of Allergies & Intolerances
Non IgE Mediated Gastrointestinal Food Allergies — Link to full-text PDF article in the Journal of Clinical Immunology
Food Allergies: IgE
IgE (immunoglobulin E):
Most of us recognize the following allergy symptoms: rash, hives, swelling, breathing difficulties, etc.
This type of allergy is caused by IgE (immunoglobulin E) in the body. This is the type of allergy that is being tested for in the common skin prick or scratch test.
Please read: Food Allergies and Testing for a more in-depth explanation.
Non IgE mediated (Formerly known as: IgG / immunoglobulin G):
The other type of allergy is less obvious, and the symptoms can appear many hours (even days) after exposure. This type of allergy, non IgE mediated food allergy (which also used to, up to very recently, be referred to as an intolerance or IgG intolerance) can present with many different symptoms, and the symptoms can vary from person to person. These present with delayed reactions and mostly manifest with inflammation in (gastrointestinal) tissue. It may take up to 72 hours after consumption of the food for symptoms to be observed. Symptoms can vary widely. Some examples: stomach pain, gas, cramping, eczema, delayed gastric emptying, diarrhea and/or constipation. Other symptoms may include: nasal congestion, wheezing or asthma type symptoms, congestion in the ears often leading to recurrent ear infections, and eczema. In some children, non IgE mediated food allergies can cause brain inflammation resulting in behavioural issues resembling ADHD and autism. Many allergists are still using the older terminology of “IgG intolerances” aren’t even aware of this new terminology.
Please read: Food Allergies and Testing for a more in-depth explanation
Testing for Allergies and Intolerances
Allergists & non IgE Reactions
Unfortunately most allergists do not think outside the box; if it’s not something they can see physically, like on the skin prick test, then it can’t be related to allergies of any sort. In their mind, there’s just no possibility that non IgE mediated food allergies can produce unseen effects on the body and brain. Also, it’s such new and cutting-edge research that the information isn’t widely known or accepted yet. Since non IgE mediated food allergies produce delayed effects (could be 8 hours later, could be 3 days later) it’s hard to link the two. However, since IgE allergies produce immediate effects it is easy to see, test, and prove.
How does all of this connect specifically to reflux?
Anke T. writes: In infants most of the time we do not see IgE mediated allergies so much; that would be immediate reaction with potential for anaphylaxis and a positive IgE blood result for a trigger such as cows milk protein. That is the “no brainer;” it’s obvious when this is the case that Baby can’t have cows milk. But what we see way more often is non IgE mediated allergies, which result in a delayed reaction presenting with tissue inflammation (in GI tract, either accompanied by skin eczema or only noticeable by GI symptoms). These in fact may also build up over time, once the body has enough quantity of the allergen consumed the symptoms set in then increase. The disposition was there since birth, so we do not “trigger” it with the wrong formula or so, but we notice late sometimes. This can be outgrown once the child is older, but for quite some time it will be best to avoid cows milk protein, or any other allergen that caused these reactions. It’s type IV in Gells and Coomb classification, a T-cell reaction in tissue. Many doctors are unaware of this, since for them only the “real deal” (IgE allergy with anaphylaxis) seem to exist.
What about other foods causing reflux?
Does ingesting foods with acid content (fruits etc) increase the acid content in the stomach or is it just irritating to the baby due to the damage that already exists? Acids from fruits, some veggies, etc are not really strong enough to do any harm. They aren’t even strong enough acids (with a few exceptions such as orange juice, spaghetti sauce, lemon or lime juice – which hopefully nobody is giving than infant) – to damage already damaged mucosa.