Some Psychosomatic Aspects of Food Allergy

Abstract

Some patients experience untoward idiosyncratic reactions when they eat certain wholesome foods. Such illness may be caused by psychogenic or allergenic mechanisms, or by both. This paper reports some of the author''s experiences with treatment of about 600 patients seen in the past 10 years who had certain food-induced syndromes, with or without associated primary neuropsychiatric disturbances. Foods become endowed with various dynamic emotional meanings according to one''s upbringing, cultural and religious training, and personal life experiences. Psychogenic food reactions may include anger, anxiety, anorexia, depression, euphoria, feelings of security, guilt, hostility, passive-dependent attitudes, pleasure, syncope, and relaxation. The most common untoward idiosyncratic psychosomatic reactions to food include nausea, vomiting, epigastric discomfort or pain, intestinal cramps, aerophagia, belching, and rarely diarrhea[long dash]all being part of the riddance reaction. Fixed food allergy is very well known, but relatively uncommon. Variable food allergy is very common, but not very well known. Here tolerance for a given food may vary so that at times small amounts of the offending food will cause an allergic reaction; but at other times the amount of this food which must be ingested to cause an allergic reaction may be very much greater than any amount the patient would ordinarily eat. Allergic reactions following ingestion of offending foods have certain characteristics: there is a latent period between ingestion of the food and appearance of signs and symptoms; the allergic syndrome has a certain pattern of development and regression of signs and symptoms; it has intensity and duration. These properties in part determine the nature of allergic reactions to repeated ingestion of subthreshold and threshold doses of offending foods. Each primary allergic reaction set off by ingestion of an unknown allergenic food actuates a secondary postnoxious pattern of behavior which becomes an important part of the patient''s reaction to the offending food, and may in fact become so incapacitating to the patient that it constitutes his chief health problem. Food-induced allergic mental, fatigue and pain syndromes may occur singly or in any combination, and may be associated with other allergic syndromes. The patient''s response to combined allergic and psychological therapy is illustrated by three case reports. The best management of all patients with food allergies requires both expert allergic therapy and expert psychotherapy.