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If you’re new to the world of allergies and intolerances it can all sound rather confusing. It’s important to talk in depth with your doctors to understand your, or your child’s reactions. This article can provide an overview and help to make easier to understand some of the terms being used and the symptoms you may be experiencing. As always, I need to point out that I’m an allergy sufferer, with an allergic daughter – not a doctor. So please do make sure you always take medical advice when dealing with reactions.
Allergies IgE reaction (or ‘classic’ allergy reaction) Allergic reactions are an immune reaction and, as such, can be proven and tested for. The body, for no known reason, creates an antibody (IgE) to fight off a specific food. This is called an IgE reaction. The release of these antibodies break down mast cells that contain chemicals such as histamine. Hence taking ‘anti-histamines’ for allergic reactions. Blood tests and skin prick tests (SPT) can confirm the reaction. So it’s a nice, straightforward diagnosis. You can be born with this reaction, or it can develop over time. The severity can also alter over time. So, everything with allergies is a moving feast. The release of histamine can cause different reactions depending on where in the body it is released, so if it’s in the gut…then you get a gastro reaction such as abdominal pain, vomiting and diarrhoea. If it’s in the skin then it’s a rash and itching, if the upper airways you react with a runny nose and eyes, sinus pain, sneezing. Finally if it’s in the lower airways then coughing or wheezing. So in summary…where the histamine is released directly affects that area of the body. I’ve got a tonne of these. I react nicely to skin prick test and swell up when tested for all manner of pollen, fur, feathers, wheat, soya, peanuts and nuts.
Anaphylaxis An anaphylactic response is a serious reaction that affects the entire body and as such can be life threatening even if only small amounts of the allergic substance is ingested. An anaphylactic reaction involves the swelling of the throat and mouth creating difficulty in breathing, swallowing and speaking. A rash with itching can also show up anywhere on the body and this is combined with weakness caused by a drop in blood pressure. Any swelling of mucus membranes needs to be taken seriously. Any suspected anaphylactic reaction needs urgent medical care. When calling for an ambulance it is advised that the emergency services are told that it is an anaphylactic reaction (or suspected anaphylactic reaction). Anyone with a diagnosis of anaphylaxis should have 2 epi pens prescribed and be taught how to use them. As for any allergic reaction the first action is to grab your anti-histamine.
Hay Fever (Allergic Rhinitis) Nothing to do with hay…heaven knows why it’s called this. The more formal term is allergic rhinitis. It’s an allergic reaction to pollen which caused sneezing, runny noses, itchy and watery eyes. It can be mild, or really quite sever. In our experience the standard hay fever medicine (loratadine, fexofenadine, cetirizine) aren’t as effective as prescription nose spray and eye drops. Be aware that chlorphenamine (known as Piriton) can cause drowsiness so try to get one of the newer antihistamines listed above. For us Nasobec Aqueous Nasal Spray and Sodium Cromoglicate Eye Drops work best. Both Molly and I suffer from hay fever, and I suffer with a similar reaction to moulds in the winter. Molly takes an antihistamine every day when we are abroad as she has an allergic reaction to an insect bite. We’ve been told that she needs to have the antihistamine in her system to limit the reaction. I just wish we could identify the insect responsible for large swollen, bruised reactions she gets.
Oral Allergy Syndrome (Pollen Food Allergy Syndrome) If you suffer from hay fever you may also suffer from oral allergy syndrome. If you have a pollen allergy some fresh fruits, vegetables and spices can cause the mouth to tingle or itch. This can develop into swelling and an anaphylactic reaction. This type of allergy is called a ‘cross reaction’. The proteins in the fruit and vegetables cause a reaction because they are similar to those in the proteins found in certain pollens. Cooking fruit and vegetables has been found to be a good way of avoiding a reaction. I get this – apples are a real problem for me! Apparently it’s related to my Birch allergy. Below are examples of cross reactions between fruit, vegetables and pollen. It is not a complete list so it you suffer from any itching or tingling in your mouth get thee to an allergist. Birch – Can cross react with apples, carrots, celery, hazelnuts, peaches, pears Ragweed – Can cross react with bananas, melons Grass – Can cross react with melons, orange, peanut, tomatoes, white potato One of my all-time favourite conversations with an allergist when along the following lines: Me – my mouth gets itchy when I eat apples Him – we will test you for oral allergy syndrome. Please bring with you samples of the fruit that makes your mouth itch. At the appointment: Him – Oral allergy syndrome is confirmed by those reactions to a spt Me – What does that mean? Him – It means your mouth itches when you eat apples Me – So glad I got that cleared up…ahem. Sometimes you have to ask the right question. I should have asked – why is this happening, and what can I do about it. Although I still think his response was the single most unhelpful answer ever.
Intolerances (non IgE) Food intolerances are not an antibody reaction and are sometimes be referred to as non IgE reactions. Intolerances can cause some of the same symptoms are allergies hence the mix up between the two. You may also be able to eat a small amount of the offending food without a bad reaction. However if you eat large quantities then you are likely to suffer. So if you are intolerant to a food you may suffer with abdominal swelling and pain, constipation or diarrhea, rashes, eczema, headaches and a general sense of feeling unwell. Unlike an allergic reaction intolerances aren’t life threatening, but still deeply unpleasant. The reactions tend to start several hours after eating the food you are sensitive to as your body can’t digest it properly. The reaction may last for hours, or even into the next day. There is no definitive test for intolerances, an exclusion diet is the best way to assess what is causing the problem. Some people who are lactose intolerant lack the enzyme needed to fully digest lactose. Just because it isn’t life threatening doesn’t mean it’s not a serious problem. Don’t be lead into thinking ‘it’s just an intolerance’, or it’s not serious because you can eat a little bit. Sure…intolerances aren’t life threatening but they cause a lot of pain and discomfort and need to be taken seriously.