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Differential Diagnosis
Food Intolerance
Food intolerances are adverse reactions from foods or food components arising from non-immunologic mechanisms, which includes: Metabolic (Lactose intolerance); pharmacologic (caffeine); toxic (scombroid fish toxin); and undefined (sulfites, reactions from food additives [eg artificial color]).
Other Reactions
Allergic reactions presenting similarly to food allergies include insect stings, drugs, latex, and immunologic conditions (eg leukemia, lymphoma, mastocytosis, systemic lupus erythematosus). Irritant skin reactions (eg atopic dermatitis, eczema); gastrointestinal manifestations similar to food allergy (eg abdominal pain, bloating, diarrhea) caused by monosodium glutamate, nitrites, or sulfites; irritable bowel syndrome (IBS), gastroesophageal reflux, peptic ulcer and other dyspeptic disorders; and stress, anxiety or psychogenic reactions (factitious illness, food phobias/aversions) may also have a similar presentation to food allergy.