DEAR DR. DONOHUE: How do you know if you’re allergic to food? I think I am. I believe I am allergic to peas and ice cream, but no other dairy products. Both of them make me sick to my stomach, and I often feel like throwing up after eating them, but I never do. Is this a food allergy? – L.C.

ANSWER: There’s a big difference between food allergy and food intolerance. An allergy is due to a reaction that takes place under the direction of the immune system. An allergen incites the production of antibodies, an immune system function. When allergen and antibody collide, the body releases a batch of chemicals that cause typical food-allergy symptoms: nausea, vomiting, diarrhea and stomach cramps.

Those symptoms are different from the symptoms of hay fever, but hay fever symptoms are due to the release of the same chemicals. Intolerance is a person’s unique reaction to a particular food without involving an antibody reaction.

Infrequently, food allergies cause hives and swelling. Most infrequently, they can give rise to a dangerous reaction, with great difficulty breathing and a drop in blood pressure. This kind of reaction is an emergency.

Milk, eggs, peanuts and other nuts are the foods that cause most allergic reactions in children. For adults, it’s fish, shellfish, nuts and peanuts that are most involved in food allergies.

You determine food allergy by the symptoms that the food brings on and by successfully putting an end to the symptoms by avoidance of the involved food. It’s true that avoidance is the treatment for food intolerance, too, but the symptoms of food intolerance are not as florid as are those of a true allergy. Skin tests are also available for detection of food allergies, and so are some blood tests.

DEAR DR. DONOHUE: I am a 52-year-old woman in a southern city about 60 miles from the Gulf of Mexico. For five years I have been getting bad staph infections. Often they are very large boils that ooze pus. This year I have had two episodes in three months. I had to be hospitalized for the first one. The staph are antibiotic-resistant.

Would the city’s changing from ground water to treated river water be a factor in this? We have just done this. Several residents of my city are having this problem. – D.G.

ANSWER: It’s difficult to almost impossible to implicate treated water as being the source of a staph infection. They’re usually passed from one person to the next.

Recurrent staph skin infections show themselves as furuncles or boils. They’re hard to eradicate.

Have all infected family members use separate towels and washcloths. Everyone in the family must change clothes daily, including underwear. Have the family wash with an antibacterial soap, like Hibiclens. This ritual should go until two months have elapsed from the last staph infection.

Bactroban ointment applied to the lower third of the inner nostrils can get rid of staph that often find a sanctuary there. From that site, they can be spread to other places in the body. People inoculate themselves with the germ.

Even though your staph germ is called resistant, there are antibiotics that can still attack it, so you aren’t left completely defenseless.

DEAR DR. DONOHUE: I have enjoyed reading your column for years. But now something annoys me.

You imply, more and more often, that the first and maybe only solution to any medical problem is the use of drugs – not diet, not exercise, not attitude, but drugs.

The drug mentality is a dangerous infectious disease. I hope you’ll be more careful about this. – R.I.

ANSWER: I am pushing too many drugs? I have to check myself. I am in your camp. I firmly believe that the fewer medicines people take the better off they are. However, there are many illnesses, particularly the more serious ones, for which medicines or surgery are the only answers.

I’ll keep closer tabs on myself in the future. You do the same. If you find an illness for which I mention a drug and you have a nondrug treatment, let me know, and I’ll put that in the paper.

DEAR DR. DONOHUE: My son is 16 years old, 6 feet tall, weighs 160 pounds and has gynecomastia. It is only in his left breast, and he has had it for about 14 months. We have been to numerous doctors, including an endocrinologist. No hormone abnormalities were evident. Some doctors say it will clear up on its own. Others say surgery will be necessary. We haven’t gotten an answer to “Why does it hurt?” and his nipple is very irritated. What is your opinion of options? – L.T.

ANSWER: During puberty, close to two-thirds of boys experience enlargement of one or both breasts – gynecomastia (GUY-nuh-coe-MASS-tee-uh). Some have concurrent breast pain and nipple irritation. Cold compresses can often take care of the nipple irritation, and simple analgesics like Tylenol can ease the pain.

It happens because during puberty there is an imbalance in the ratio of male to female hormones – a very normal condition. A slight excess of estrogen, the female hormone, causes breast growth. It takes two or more years for the growth to subside.

Antiestrogen medicines like raloxifene can reverse the effects of estrogen, but it takes a while before results are seen.

If your son is embarrassed by the growth or if it’s inhibiting his life, then I would opt for the immediate solution of surgical removal of the tissue by a skilled surgeon. The scars from such an operation are not seen, and the recovery is relatively fast. I would let the young man make his own decision about surgery.

A few illnesses lead to gynecomastia. An overactive thyroid gland, trouble with the pituitary gland and a decreased production of testosterone are examples. Liver cirrhosis, kidney failure and aging are other causes. Your son has been seen by a number of doctors, and he has none of these problems. He has the kind of gynecomastia that is all but expected at his age.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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