Shrimp Allergy or Food Poisoning?

In 2002, I ate a cajun shimp Po-Boy approximately 1 hour before performing (which entailed jumping around and general rocking out) with my band under hot stage lights.  The performance left me feeling sweaty, dehydrated and exhausted.  Approximately 20-30 minutes after we had finished (2-2.5 hours after eating the shrimp) I felt nauseated, then had horrible diarrhea.  I did not vomit, but continued to feel nauseated the rest of the evening.  I experienced one episode of nausea following my lunch the next day, which seemed to be remedied by Pepto-Bismol.  Approximately 1 month later I became vegetarian and have been since.  I chalked up the gastrointestinal distress to "bad" shrimp.

Fast forward 6 years.  I have since been diagnosed with OCD.  One of my prime fears is anaphylaxis due to shrimp/shellfish/seafood allergy, fearing my experience in 2002 was an allergic reaction and not some sort of food poisoning.  I went to an allergist in 2008 who refused to skin test me because "he would hate for something to happen" to me.  I was CAP RAST tested and all tests came back negative for shrimp, ****, cod, etc.  However, to this day, I am terrified to eat at any restaurant that serves shellfish, and usually have panic attacks during or after any meal at such an eatery.  I've never had another episode like the one in 2002, despite eating several times at seafood restaurants, sushi houses, Chinese buffets, etc.  I do, however, frequently get the feeling like there is something stuck in my throat or that it is swollen, which is common to anxiety sufferers, but usually makes me think I'm suffering from angioedema.  I never have problems with breathing or wheezing.

I fear the possibility of a false negative on my CAP RAST test and wonder if I should have a skin ***** test done.  Or perhaps I should chalk up the original episode to food poisoning?  I'm unsure where to go from here.  Your advice is appreciated.

Thanks!

[National Jewish Health]

Your experience with the Cajun shrimp is plausibly explained by either allergy or bacterial endotoxin toxicity.  The opinion of the allergist who saw you in 2008 notwithstanding, you should definitely see another allergist, preferably one who specializes in food allergy, and have skin testing done.  This should be conducted under close medical supervision for at least 4 hours after the skin test.  Skin testing of people with significant food allergies resulting in a life threatening reaction is extremely rare, bordering on non-existent.  If the skin test is negative, a shrimp challenge should be performed, once again under close medical supervision.  This issue does need to be resolved with great certainty, so as to not have it continue to contribute to your chronic anxiety.

Good luck.