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Asthma Specialists JEFFREY TULIN-SILVER, M.D. ~ SUCHETHA KINHAL, M.D. BOARD CERTIFIED ADULT & PEDIATRIC ALLERGY, ASTHMA & IMMUNOLOGY www.michiganfoodallergy.net Comprehensive Food Allergy Clinic of West Bloomfield
(Adapted from The Food Allergy & Anaphylaxis Network: www.foodallergy.org
The immune system mistakenly believes that a harmless substance, in this case a food item, is harmful. In its attempt to protect the body, it creates specific IgE antibodies to that food. The next time the individual eats that food, the immune system releases massive amounts of chemicals and histamines in order to protect the body. These chemicals trigger a cascade of allergic symptoms that can adversely affect the lungs, the stomach and intestines, the skin and/or the heart and blood vessels. Symptoms can range from a tingling sensation in the mouth, swelling of the tongue and the throat, difficulty breathing, hives, vomiting, abdominal cramps, diarrhea, drop in blood pressure, loss of consciousness, and in very severe cases, even death. Symptoms typically appear within minutes to two hours after the person has eaten the food, although delayed reactions can occasionally occur (24 48 hours after the food is eaten). Strict avoidance of the allergy causing food is the only way to avoid a reaction. Reading ingredient labels for all foods is the key to maintaining control over the allergy. If a product doesn't have a label allergic individuals should not eat that food. If a label contains unfamiliar terms, shoppers must call the manufacturer and ask for a definition or avoid eating that food. Currently, there are no medications that cure food allergies. Strict avoidance is the only way to prevent a reaction. Some people, usually children, may outgrow their food allergies, although peanuts, nuts, fish and shellfish are usually considered life long allergies. Randomly eliminating foods from your diet can leave you with an unbalanced diet that can cause other health problems. Additionally, you may become frustrated because you reach a point where you believe that everything you eat is causing a reaction. Seek the help of a doctor before making significant changes in your diet. Epinephrine, also called adrenaline, is the medication of choice for controlling a severe reaction. It is available by prescription, and if you have a food allergy, you need to know how to inject yourself in the thigh in case of a life threatening emergency. A rapid acting antihistamine like Benadryl (diphenhydramine) is helpful if your reaction is an itchy rash or hives. Many people think the terms food allergy and food intolerance mean the same thing; however, they do not. A food intolerance is an adverse food induced reaction that does not involve the immune system. Lactose intolerance is one example of a food intolerance. A person with lactose intolerance lacks an enzyme that is needed to digest milk sugar. When the person eats milk products, symptoms such as gas, bloating, and abdominal pain may occur. A food allergy occurs when the immune systems reacts to a certain food. The most common form of an immune system reaction occurs when the body creates immunoglobulin E (IgE) antibodies to the food. When these IgE antibodies react with the food, histamine and other chemicals (called mediators) cause hives, asthma, or other symptoms of an allergic reaction. Keep a food diary for at least 2, and preferably 3 4 weeks, of everything you eat, what symptoms you experience, and how long after eating they occur. This information, combined with a physical examination and lab tests, will help the doctor determine what, if any, food is causing your symptoms. The prick skin test or a blood test, such as the BAST (or radioallergosorbent test), are commonly used to begin to determine if an allergy exists. A prick skin test is usually cheaper and can be done in the doctor's office. The doctor places a drop of the substance being tested on the patients' forearm or back and pricks the skin with a needle, allowing a tiny amount to enter the skin. If the patient is allergic to the substance, a wheal (mosquito bite like bump) will form at the site within about 15 minutes. A RAST requires a blood sample. The sample is sent to a medical laboratory where tests are done with specific foods to determine whether the patient has IgE antibodies to that food. The results are usually received within one week. Although both tests are reliable, there are instances where one is better than the other. Many doctors use a BAST for young children or patients who have eczema or other skin problems that would make it difficult to read the results of a prick skin test. The results of either test are combined with other information, such as a history of symptoms and a food challenge, to determine whether a food allergy exists.
Michigan Allergy, Sinus & Asthma Specialists
Web: www.michiganallergy.com Web: www.michiganfoodallergy.net Email: miallergy@comcast.net Please do not email confidential medical information.
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