Zyrtec Allergy Forecast – The European Academy of Allergy and Immunology EAACI), published the first European Guide on food reactions and anaphylaxis in 2014 (with access only for members of society).
It is based on the fact that, although it is estimated that between 6 and 17% of the European population has some type of food allergy, these remain a pending issue for patients and health professionals, which causes a negative impact on the quality of life, generates costs that could be avoided, and is a real life risk for some patients, since severe allergic reactions are potentially fatal.
Food allergies occur because, in contact with, ingestion or inhalation of a certain protein (allergen) present in a particular food, and which is harmless for non-allergic people, the immune system, which usually “defends” us from external aggressions , it responds in an abnormal and exaggerated way, producing antibodies or cells that trigger the allergic reaction.
As I have already mentioned here, these allergic reactions can be:
They are well-defined reactions that normally appear immediately after taking the food. The severity of the symptoms will be variable (mild, moderate, serious or very serious), and may involve one or several systems or organs at the same time.
Thus, the symptoms can be cutaneous, respiratory, acute gastrointestinal and even anaphylaxis, although none of them is exclusive of these reactions.
Produced by immunological mechanisms that have not been defined with such precision, with the participation of cells and antibodies other than IgE, even sometimes with mixed participation (cells and antibodies, in this case the symptoms are usually digestive). The response appears delayed or chronic.
The answers in this case will be very variable among people, and also in terms of the type of manifestations and the severity of the same, may appear generalized reactions, isolated or multiple symptoms, especially digestive and skin, but also respiratory or neurological, so that they can be great “simulators”, and sometimes patients go on pilgrimage for the consultations of different specialists until someone lights a light and thinks about food allergy not mediated by IgE.
They usually occur against large proteins, such as cow’s milk. In addition, there is a greater risk of developing new non-IgE allergies to other types of large proteins, such as those in soy, gluten, meat or fish, especially if there is some other basic digestive pathology that alters the microbiota (from acute gastroenteritis to intolerances or food allergies newly diagnosed or not treated)
Both the symptoms and the diagnosis, prognosis and treatment of these two types of allergy are, therefore, different:
IgE-mediated allergy usually gives more respiratory, skin or anaphylaxis symptoms, these symptoms are usually immediate (usually in less than 1 or 2 hours) and appear with minimal amounts of food
Non-IgE mediated allergy usually gives more digestive and cutaneous symptoms, and milder, the amount of food necessary to cause symptoms is greater, and these take longer to appear (more than two hours after ingestion, and until days later), being able to even to chronify and that they come to affect the nutritional state by alteration in the absorption of nutrients.
But do not forget that either of you can give any kind of symptom … and this is unpredictable.
As for the type of clinic that may appear, 90% will be focused on the skin and respiratory system, but the range, as described below, is very broad.
Gastrointestinal symptoms: increased mucous secretion and permeability of the epithelium to the antigen, decreased absorption of food components, abdominal pain, nausea, vomiting, diarrhea, intestinal bleeding, enteropathy and protein loss, persistent feeling of satiety with abdominal pain and chronic gastritis …
Cutaneous symptoms: urticarial rashes, eczema, inflammation of the skin, mouth, throat, tongue, redness, pruritus, edema …
Respiratory symptoms: bronchoconstriction, sneezing with mucus, nasal congestion, asthma, glottis edema …
Neurological symptoms: headaches, dizziness …
Cardiovascular symptoms: tachycardia, atrio-ventricular block, other arrhythmias …
Genito-urinary symptoms: nephritis
Osteoarticular symptoms: inflammation, joint pain, functional impotence …
Anaphylactic-anaphylactic reaction: this is a very serious condition, in which several organs and systems are involved at the same time, with cutaneous, respiratory and hemodynamic involvement, and which can lead to the development of an anaphylactic shock, which is potentially life-threatening.
What are the most frequent allergens?
Any food, ingredient or additive can be trigger of allergic reactions, being the most common:
Cow’s milk: rejection of milk proteins (casein)
Egg: the most problematic proteins before 2 years; Up to 2-5 years from start.
Fish and seafood: anisakis, proteins
Spices: by contact, ingestion or inhalation of dust
Nuts: especially in children (eczema)
Fruits: kiwi, papaya, avocado, banana, strawberries, raspberries, currants … are the most allergenic.
I will not talk about it in detail, because it is not the objective of this post and I would extend it too much, I only comment on some basic notions, since, in case of suspected food allergies, the best thing you can do is go to your doctor to refer you to the specialist, and he will explain in detail the tests to be performed.
IgE-mediated allergies can be diagnosed by classical allergy tests (skin or blood), in addition to other more complex procedures (elimination or provocation tests)
However, in non-IgE-mediated allergy, these tests will be normal, since IgE is not detected in either skin or blood, and there is currently no scientifically supported test of widespread use in clinical practice for the diagnosis of these reactions. , so the diagnosis is much more complex, and is based on the intake / symptoms ratio, proven by provocation tests, once IgE allergy has been ruled out in skin and / or blood tests.
In some cases the patch test is performed with food, classically used in the diagnosis of contact dermatitis, but neither the method nor the interpretation of the test is standardized for this type of allergy, so it should not be used routine.
There are other diagnostic methods under study, most of them very nonspecific and for which the reliability and clinical utility have not yet been proven or are not very profitable in daily practice.
There is no evidence or scientific studies to support the validity of the so-called “food intolerance test”.
These tests use different techniques, for example the measurement of specific IgG to multiple foods (but attention, the elevation of specific IgG antibodies does not indicate clinical reactivity to the food, but rather the opposite), and others are based on cytotoxic tests, based on in measuring changes in leukocytes after exposing them to a series of foods, however, it has been proven that the test results can vary from time to time if repeated in the same patient … very reliable do not seem, right?
These tests are used for other pathologies in addition to food allergy, such as chronic fatigue syndrome, irritable bowel syndrome, migraines … and as the Spanish Association of people with food and latex allergies points out, they are not reliable when detecting Adverse reactions to food or when assessing what foods fatten us.
Most patients who develop the picture in the first months of life, exceed it at 2-5 years, except in the case of potent allergens (peanuts, nuts, shellfish), for this it is very important to carry out very strict exclusion diet.
The allergy to cow’s milk or soy, usually disappears every year (in any case, before 3 years).
IgE-mediated allergy usually disappears more slowly than non-IgE allergy, and those developed in older children or adults tend to persist throughout life.
Treatment and prevention of allergic reactions:
When an allergic reaction takes place, and depending on the severity of the reaction, the treatment will be symptomatic, using antihistamines or corticosteroids (in case of cutaneous, respiratory or generalized reactions), fluid replacement, antiemetics, diet and probiotics that do not contain the allergen (in case of digestive symptoms), or adrenaline and other support measures in case of severe reactions or anaphylaxis.
The only way to prevent allergic reactions to food, whatever the type, is the exclusion diet, that is, to strictly eliminate the food or foods capable of triggering the reaction. In case of allergies to multiple foods, it may be necessary to look for substitute foods or even to use nutritional supplements to cover the requirements.
Be especially careful and pay attention to the labeling of all foods and medications that will be consumed by the allergic person, since many food allergens can appear in a multitude of processed foods, even masked or with unknown names.
In addition we must be very attentive to possible contamination, ie when handling or cooking a food for an allergic person, it is very important that it does not have any contact with instruments, containers, hands … that have previously contacted with an allergen, and, when in doubt, better not to consume it.
Finally, for some years, and only in the case of some IgE-mediated allergies, the desensitization or induction of oral tolerance is being used, which consists of the oral administration of small amounts of the food to which the patient is allergic, of guided, progressive and under medical control, until reaching the tolerance of a quantity appropriate for the child’s age, for more information, consult your allergist.
Prevention of allergies in predisposed people:
In the appearance of allergies, they influence genetic factors (family history of allergy are suggestive of the predisposition to it) and environmental (many unknown), but … can we prevent them from appearing in a person susceptible to develop them?
It has not been shown that the maternal restriction diet during pregnancy and lactation decreases the risk of food allergies in children.
The only measure that seems to have a protective effect (and not in all cases) is breastfeeding, which should be exclusive for 6 months and associated with complementary feeding until at least 2 years. Complementary feeding should be introduced between 17 and 26 weeks of life.
For babies with a documented allergy risk (father / mother and / or affected sibling) who can not be breastfed exclusively, dietetic products with reduced allergenicity are recommended.
There is no scientific evidence that the avoidance and delay in the introduction of potentially allergenic foods beyond 4-6 months reduces the development of allergic diseases.
Some people suffer what we know as false allergies or pseudo-allergies, which consist of the appearance of symptoms similar to an allergic reaction after contact with a food, without there being an immunological mechanism causing these symptoms.
These false allergies are caused by foods rich in biogenic amines (histamine, tyramine, histidine, phenylethylamine) substances capable of causing an inflammatory reaction similar to an allergic reaction, probably due to the existence of a functional alteration of the digestive mucosa with increased intestinal permeability in combination with a sensitive organism or hyperreactive to histamine, especially children and adolescents.
The triggered symptoms are usually cutaneous (urticaria, eczema, edema …) and occasionally respiratory (rhinitis or bronchospasm), no serious reactions have been observed.
What foods can trigger a false allergy?
Foods rich in histamine: Strawberries, chocolate in all its forms, tuna, sardine, salmon, anchovy, herring, dried fish, smoked fish, beer, wine, cider, liqueurs, dry sausage, ham, pork liver and all packaged sausages , Parmesan cheese, Camembert, Roquefort, Emmental, Gouda, egg white, cheddar, tomato, peas, spinach, sauerkraut, beans, lentils, hazelnuts, pineapple, beans, peanuts, grapefruit, orange, tangerine, lemon, papaya, clementine , mango.
Foods rich in tyramine: sausages, chocolate, red wine, white wine, beer, gruyere, brie, roquefort, cabbage, spinach, avocado, potato, herring, caviar, game meat …
They are relatively frequent, they are not usually serious but it is very important to differentiate them from real allergies, given that the diagnosis and implications will be very different.
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