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Hi
I have an intermittent problem whereby I vomit around and 90 minutes to 2 hours after eating shellfish and certain types of fish. It started around 12 years ago and I'd experience the same symptoms each time. Dry mouth, bloating moving into nausea and light headedness followed by vomiting. Sometimes I'd just vomit once but usually it'd be 3 or 4 times until my stomach was empty. The first thing that caused the problem was prawns, then scollops and lobster, but then fish including plaice, halibut and sea bass. However other seafood (cod, haddock, squid, monkfish, lemon sole) has been OK. I've had skin prick tests which came back negative to shellfish, so am slightly mystified. I've cut out shellfish from my diet now but I like Thai food and there's often little on menus without some shellfish.
Is it an intolerance? Does the body retain some kind of memory of foods it has rejected in the past? Would appreciate any insight.
Thanks
John

Dear John,

Vomiting 1-4 hours after eating certain foods may be a delayed form of allergy however it may also be due to food poisoning. I presume it has happened enough times to be confident this is not just food poisoning though. In delayed allergies skin prick tests are often negative.

In children (my speciality is paediatric allergy) there is a condition called FPIES (Food protein induced enterocolitis syndsrome) which results in vomiting 1-4 hours after food consumption. However the children become very unwell often needing hospital attendance as they vomit for hours and get dehydrated. Again your symptoms do not seem to severe.

It is strange that you are able to tolerate certain types of white fish but not others as the allergen in white fish (Gad c 1) is usually present in all white fish.

Hopefully our adult allergist Dr Till will be able to give more insight to this as I know he has a special interest in fish and shell-fish allergy in adults.

Kind regards,

I do agree with Helen that this pattern is difficult to explain by allergy. Allergy to shellfish (e.g. scallops) and crustacea (e.g. prawns, lobster) is generally quite separate from allergy to finned fish. Also, as Helen points out, the major allergen causing allergy in white fish is similar so this pattern of reactivity would be unexpected. Finally, as you say, skin tests have been negative.
1-4 hrs is a bit early for food poisoning to these foods. Alas, it may not be possible to identify the reason for 'intolerance' to these foods .