Irritating food allergies

In most cases, you are allergic to a specific type of ingredient contained in irritating foods. In a small part, highly irritating foods amplify the existing allergic reaction. In a considerable number of cases, it is not an allergy at all, but an anaphylactic reaction or mucosal damage caused by irritation.

Last week, when I accompanied a friend to the allergy department to get a report, I happened to meet a young man in his twenties who rolled up his sleeves and showed the doctor a rubella patch on his arm. He said that he had eaten spicy butter hot pot the day before and it made him so itchy that he couldn't sleep when he got home. He decided that he was allergic to chili peppers. The results of the allergen screening showed that the IgE indicators of chili peppers were all negative, but the swimming crabs boiled in the hot pot were strongly positive. The doctor who received the treatment put it very bluntly: Chili pepper was an "accomplice" at best, dilating subcutaneous blood vessels and amplifying the original allergic reaction caused by crab protein several times. If he had eaten steamed crab that was not spicy that day, he would most likely have developed a rash, but it might not have been as severe and it would have gone away faster.

This situation of treating irritants as allergens is really too common in outpatient clinics. Xiao Zhou, a nurse in the allergy department I know, complained to me that among the 10 patients who said they were allergic to spicy food, the allergens found in 9 of them had nothing to do with chili peppers - some were allergic to the crushed peanuts added to the hot pot, some were caused by eating spicy iced mangoes, and some were chronic urticaria patients themselves. Eating spicy food, staying up late, or even cooling down may trigger rashes, and the chili pepper just happened to hit the muzzle.

What many people think of as “allergy” is not even a true immune response. Just like my best friend, every time she eats the freshly ground mustard that is used in Thai raw pickling, her mouth will be red and itchy. She thought she was allergic to mustard, and all the allergens she checked were negative. The doctor said that the high concentration of isothiocyanates irritated the mucous membranes, which is an irritation. Irritant contact dermatitis is just like your hands getting hot when you touch hot peppers. There is no sensitization process at all. It may occur even if you eat it for the first time. It will disappear on its own in two hours. There is no need to eat taboos. At most, eat slowly and don't rub it outside your mouth.

But having said that, not all studies believe that irritating foods are completely unrelated to allergy. Scholars working on intestinal immunity now propose that long-term, high-frequency intake of high-concentration irritating foods, such as spicy hot pot every day and raw garlic-rich wine every meal, may destroy the barrier function of the intestinal mucosa, allowing food macromolecule proteins that are originally unable to penetrate the intestinal wall to enter the blood to leak in, and instead induce the body to produce new allergenic antibodies. I have encountered a case before. A girl who was not allergic to mango ate spicy crayfish as a late-night snack every night for a week in order to catch up on a project. Then one day when she ate mango, she suddenly developed a rash all over her body. After further inspection, she was allergic to mango. The doctor was not 100% sure whether it was related to eating too much spicy food during that time. He just suggested that if she is allergic, it is best not to do this for a long time.

However, most clinical doctors have reservations about this view. They feel that the current research is still in the animal experiment stage and there is not enough human clinical data to support it. Instead of worrying about irritating food inducing allergies, it is better to avoid the clear allergens first and don't regard irritating food as a scourge. For example, many people avoid spicy food, alcohol, and seafood as soon as they are allergic. In the end, the food intake and avoidance will lead to imbalanced nutrition, and the immunity will decline faster, and allergic attacks will occur more frequently. This is completely putting the cart before the horse.

Seriously, if you feel uncomfortable every time you eat a certain irritating food, don't rush to label yourself as "allergic", and don't stop eating all foods. Use a small notebook to write down what you eat every time, the symptoms of the attack, and how long it takes to get rid of it. If you have frequent attacks, take your food diary to the allergist for screening. It is much more useful than searching online for a long time to scare yourself. When I did a science popularization in the community last time, an auntie said that she had been drinking alcohol all her life and was fine. Last year, she started getting red all over as soon as she drank. She thought she was allergic to alcohol. It turned out that she was allergic to a mold in the koji. She drank distilled vodka without any problems. She was blind and dared not touch alcohol for most of half a year.

In fact, to put it bluntly, allergies are very individual in nature. Some people can eat spicy food all their lives without any problems, while others can go to the emergency room even if they touch a little pepper. There is no need to apply uniform standards. You know your own body best. When you are confused, it is better to seek help from a professional.