Which conditions are associated with (multiple) food allergies?

Question

Most people with food allergies are allergic to one or few foods, but allergies to more than three foods are relatively rare (PubMed, 2010). In some people who are allergic to several foods, an underlying condition is discovered, for example:

• Atopy
• Eosinophilic gastrointestinal disorders (EGID)

Question: Are there other known conditions that are associated with food allergies and are there any known triggers that trigger their onset?

To put the questions in the context: Does it make sense for someone with (multiple) food allergies to undergo investigations to find an eventual underlying disorder or trigger? Because, sometimes, treatment with desensitization may be possible.

The focus of the question is not on "multiple," but I was thinking it is more likely that multiple allergies have known underlying causes. So, I'm looking for a list of "underlying conditions," "related conditions," "risk factors" and "triggers" of food allergies.

Answer 1

1. Some individuals with pollen allergy experience mouth itching and swelling after eating certain raw fruits, vegetables and tree nuts. The condition is called oral allergy syndrome or pollen-food syndrome.

2. A certain food allergy as such may increase intestinal permeability (leaky gut syndrome) and allow additional allergens to enter the blood, which can result in multiple food allergies (PubMed, 2006 ; PubMed, 2016).

3. The use of antibiotics in infancy can increase the risk of food allergies later in life.

4. Orofacial granulomatosis (which may or may not be associated with Crohn's disease) increases the risk for food allergies. A cinnamon- and benzoate-free diet can help (PubMed, 2006).

5. Children with inflammatory bowel disease (Crohn's disease or ulcerative colitis) are at increased risk for food allergies. Another study has found an association between inflammatory bowel disease and food allergies.

6. Infections or stress may increase intestinal permeability and thus induce food allergies in susceptible individuals.

7. Due to cross-reactivity, certain non-food allergens can trigger food allergies: Alternaria (a common mold)-spinach syndrome, dust mite-shrimp syndrome, cat-pork syndrome and bird-egg syndrome.

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As a side note, food protein-induced enterocolitis syndrome (FPIES) can develop in infants after introducing solid foods and can present with multiple food allergies, which, unlike traditional IgE-mediated allergies, do not cause itching, hives, swelling, coughing or wheezing, but "only" gastrointestinal symptoms, such as diarrhea.

Answer 2

Experts believe having eczema increases the risk a child may develop food allergies and other allergic conditions later in life. About one-third of children with moderate to severe eczema have diagnosed food allergies. Likewise, about 30 to 40 percent of all people with eczema also have one or more food allergies. According to a recent study, young children with food allergies are more than twice as likely to develop asthma or rhinitis before age 5, compared to those without food allergies. The risk for respiratory allergies is higher in children who are allergic to milk, egg or peanut. This is also true for children with multiple food allergies (http://www.aaaai.org/).

Chronic respiratory symptoms are not thought to be caused by food allergies. When respiratory symptoms occur during allergic reactions to foods, they occur suddenly and usually are not the only symptom. Instead, they appear alongside other symptoms affecting the skin, gastrointestinal tract and other parts of the body (http://www.aaaai.org/)

People with both asthma and food allergies are at higher risk of experiencing life-threatening anaphylaxis during a food allergy reaction. Research has similarly shown that having a food allergy is linked to having worse asthma symptoms and more hospitalizations from asthma. Igg is the immune response to pathogens like bacteria, viruses, and fungi. It is not the type of response typical to allergens. In an Allergic March the typical sequence is patients develop allergic diseases; starting first with eczema, then followed by food allergy, asthma, and allergic rhinitis aka hay fever. I believe it is worthy to both look for an underlying cause and attempt desensitization. There may be an underlying condition that is linked to the food allergies. Yet, desensitization may also work and alleviate some of the person's suffering.