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Sometimes We are Allergic to Some Food

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Sometimes, the food we eat leads to allergies, which are serious and dangerous. At the same time, highly restrictive diets can be tough on people.

For instance, there is food colouring even in some cheeses and gluten in soy sauce. They can also be unhealthy. To avoid malnutrition, fatigue or low bone density, doctors recommend people who start removing ingredients from their diets consult a nutritionist for advice.

What’s   food allergy ?
It is an abnormal response to a food triggered by your body’s immune system. Allergic reactions to food can sometimes cause serious illness and death. The FDA estimates that two per cent of adults and up to eight per cent of young children have some form of food allergies. Childhood allergies are a common and growing problem. Sometimes, a reaction to food is not an allergy. It is often called “food intolerance”.

The exact reason behind the rise of allergies is unknown. But evidence suggests that a combination of genetic and environmental factors is at the root of most allergies. Hence, it is advisable that a single new food should be introduced to a child rather than multiple new options.

“Food allergy symptoms can range from mild to life-threatening and may include, hives, itching, swelling of the face, lips, tongue and/or eyes, diarrhoea, vomiting, cramps, itching and tightness of throat, difficulty in breathing, wheezing, in extreme cases, anaphylactic shock,” says Dr Richa Anand, dietician, Dr L H Hiranandani Hospital, Mumbai.

In case you feel that you may be allergic to a certain food:
* Eliminate the food that you suspect from your diet and check if the reactions stop.
* Challenge the food by consuming it and check for adverse reactions.
* Do a skin allergy test.

Ensure that any of the above options are done after consulting a doctor. Also, once the allergic food has been found, make sure that the same is eliminated from your diet.

Some common food allergies :-

In adults, the most common foods to cause allergic reactions include: shellfish such as shrimp, crayfish, lobster, and crab; peanuts, a legume that is one of the chief foods to cause severe anaphylaxis, a sudden drop in blood pressure that can be fatal if not treated quickly; tree nuts such as walnuts; fish; and eggs.

In children, the pattern is somewhat different. The most common food allergens that cause problems in children are eggs, milk, and peanuts. Adults usually do not lose their allergies, but children can sometimes outgrow them. Children are more likely to outgrow allergies to milk or soy than allergies to peanuts, fish, or shrimp.
Peanuts: are the main source of severe allergic reactions. Peanut allergies can be so extreme that just being in the same room with one can cause someone to go into anaphylactic shock. Peanuts are found in so many items, as frying oils, flavoured nuts, etc.

Shellfish/fish: Allergy to shellfish is quite common and a number of different types of shellfish can cause reactions in people who are sensitive. For example, shrimps, prawns, lobster, crab, crayfish, oysters, scallops, mussels and clams. People who are allergic to one type of shellfish often find that they react to other types. Adults are more likely to have an allergic reaction to fish and shellfish than children, which is probably because adults will have eaten these foods more often. Shellfish allergy can often cause severe reactions, and some people can react to the vapours from cooking shellfish. Cooking doesn’t destroy fish allergens. In fact, some people with fish allergy can be allergic to cooked but not raw fish.

Milk: Lactose is a sugar found naturally in milk. It’s important to distinguish between lactose intolerance and milk allergy, because milk allergy can cause severe reactions. Lactose intolerance is actually an enzymatic problem where the enzyme lactase cannot split the milk protein lactose into glucose and galactose. This leads to digestive system pain more often than swollen or clogged airways. Milk products are obviously in and ice-cream, but can also appear in sauces and as butter on steaks and other meats. Adults with lactose intolerance can often have a small amount of milk without getting any symptoms.

Eggs: Egg allergy is more common in childhood and about half the children who have it will grow out of it by the age of three. In a few cases, egg allergy can cause anaphylaxis. Cooking can destroy some of these allergens, but not others. So some people might react to cooked eggs, as well as raw eggs. Occasionally, someone might react to egg because they have an allergy to chicken, quail or turkey meat, or to bird feathers. This is called bird-egg syndrome. Also, those with egg allergies should avoid most pastas and foamy products, as egg is occasionally used as a stabiliser for coffee foams, among others.

Soy: allergies are probably most difficult for vegetarians, as it is often used as a protein alternative in things such as tofu. One has to be especially careful about food cooked in soyabean oil or Chinese food cooked using soya sauce. It can also be found in peanut butters, soups, infant formulas, etc.

Wheat: For those with celiac, anything containing gluten, including wheat, can lead to adverse reactions. However, for those with wheat allergies, only wheat makes a person react. Wheat is often used as a stabiliser in everything — from soups to biscuits — and it can be difficult to dodge. People with wheat allergies need to abstain from everything — from wheat breads to soy sauce with wheat.

Resources:

The Times Of India & Allergy related internet sites

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Food Allergy

Definition:
Food allergy is an immune system reaction that occurs soon after eating a certain food. Even a tiny amount of the allergy-causing food can trigger signs and symptoms such as digestive problems, hives or swollen airways. In some people, a food allergy can cause severe symptoms or even a life-threatening reaction known as anaphylaxis

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Food allergy affects an estimated 6 to 8 percent of children under age 3, and about 4 percent of adults. While there’s no cure, some children outgrow their food allergy as they get older. It’s easy to confuse a food allergy with a much more common reaction known as food intolerance. While bothersome, food intolerance is a less serious condition that does not involve the immune system.

Food allergy is distinct from other adverse responses to food, such as food intolerance, pharmacologic reactions, and toxin-mediated reactions.

Food allergy :Adverse immune response to a food protein

Pharmacologic: Caffeine tremors, cheese/wine (tyramine) migraine, scombroid (histamine) fish poisoning

Toxins:Bacterial food poisoning, staphylotoxin

Intolerance: lactose intolerance (lactase deficiency)

The food protein triggering the allergic response is termed a food allergen. It is estimated that up to 12 million Americans have food allergies, and the prevalence is rising. Six to eight percent of children under the age of three have food allergies and nearly four percent of adults have them. Food allergies cause roughly 30,000 emergency room visits and 100 to 200 deaths per year in the United States. The most common food allergies in adults are shellfish, peanuts, tree nuts, fish, and eggs, and the most common food allergies in children are milk, eggs, peanuts, and tree nuts.

Treatment consists of avoidance diets, in which the allergic person avoids all forms of the food to which they are allergic. For people who are extremely sensitive, this may involve the total avoidance of any exposure with the allergen, including touching or inhaling the problematic food as well as touching any surfaces that may have come into contact with it. Areas of research include anti-IgE antibody (omalizumab, or Xolair) and specific oral tolerance induction (SOTI), which have shown some promise for treatment of certain food allergies. People diagnosed with a food allergy may carry an autoinjector of epinephrine such as an EpiPen or Twinject, wear some form of medical alert jewelry, or develop an emergency action plan, in accordance with their doctor.

Signs and symptoms:–
Classic immunoglobulin-E (IgE)-mediated food allergies are classified as type-I immediate hypersensitivity reactions. These allergic reactions have an acute onset (from seconds to one hour) and may include:

*Angioedema: soft tissue swelling, usually involving the eyelids, face, lips, and tongue. Angioedema may result in severe swelling of the tongue as well as the larynx (voice box) and trachea, resulting in upper airway obstruction and difficulty breathing.

*Hives

*Itching of the mouth, throat, eyes, skin

*Nausea, vomiting, diarrhea, stomach cramps, and/or abdominal pain. This group of symptoms is termed gastrointestinal hypersensitivity or anaphylaxis.

*Rhinorrhea, nasal congestion

*Wheezing, scratchy throat, shortness of breath, or difficulty swallowing

*Anaphylaxis: a severe, whole-body allergic reaction that can result in death (see below)

The reaction may progress to anaphylactic shock: A systemic reaction involving several different bodily systems including hypotension (low blood pressure),loss of consciousness, and possibly death. Allergens most frequently associated with this type of reaction are peanuts, nuts, milk, egg, and seafood, though many food allergens have been reported as triggers for anaphylaxis.

Food allergy is thought to develop more easily in patients with the atopic syndrome, a very common combination of diseases: allergic rhinitis and conjunctivitis, eczema and asthma.[8] The syndrome has a strong inherited component; a family history of allergic diseases can be indicative of the atopic syndrome.

Conditions caused by food allergies are classified into 3 groups according to the mechanism of the allergic response:

1. IgE-mediated (classic):

Type-I immediate hypersensitivity reaction (symptoms described above)
Oral allergy syndrome
2. IgE and/or non-IgE-mediated:

*Allergic eosinophilic esophagitis
*Allergic eosinophilic gastritis
*Allergic eosinophilic gastroenteritis

3. Non-IgE mediated:

*Food protein-induced Enterocolitis syndrome (FPIES)

*Food protein proctocolitis/proctitis

*Food protein-induced enteropathy. An important example is Coeliac disease, which is an adverse immune response to the protein gluten.

*Milk-soy protein intolerance (MSPI) is a non-medical term used to describe a non-IgE mediated allergic response to milk and/or soy protein during infancy and early childhood. Symptoms of MSPI are usually attributable to food protein proctocolitis or FPIES.

*Heiner syndrome – lung disease due to formation of milk protein/IgG antibody immune complexes (milk precipitins) in the blood stream after it is absorbed from the GI tract. The lung disease commonly causes bleeding into the lungs and results in pulmonary hemosiderosis.

Pathophysiology:-
For more details on this topic, see allergy.
Generally, introduction of allergens through the digestive tract is thought to induce immune tolerance. In individuals who are predisposed to developing allergies (atopic syndrome), the immune system produces IgE antibodies against protein epitopes on non-pathogenic substances, including dietary components.[citation needed] The IgE molecules are coated onto mast cells, which inhabit the mucosal lining of the digestive tract.

Upon ingesting an allergen, the IgE reacts with its protein epitopes and release (degranulate) a number of chemicals (including histamine), which lead to oedema of the intestinal wall, loss of fluid and altered motility. The product is diarrhea.

Any food allergy has the potential to cause a fatal reaction.

Causes:-
The immune system’s Eosinophils, once activated in a histamine reaction, will register any foreign proteins they see. One theory regarding the causes of food allergies focuses on proteins presented in the blood along with vaccines, which are designed to provoke an immune response. Influenza vaccines and the Yellow Fever vaccine are still egg-based, but the Measles-Mumps-Rubella vaccine stopped using eggs in 1994. However large scientific studies do not support this theory, especially as it applies to autoimmune disease.

Another theory focuses on whether an infant’s immune system is ready for complex proteins in a new food when it is first introduced.

One hypothesis at this time is the Hygiene hypothesis. While there is no proof for the hygiene hypothesis, people speculate that in modern, industrialized nations, such as the United States, food allergies are more common due to the lack of early exposure to dirt and germs, in part due to the over use of antibiotics and antibiotic cleansers. This hypothesis is based partly on studies showing less allergy in third world countries. Some research suggests[citation needed] that the body, with less dirt and germs to fight off, turns on itself and attacks food proteins as if they were foreign invaders.

Antibiotics have also been implicated in Leaky Gut Syndrome which is another possible cause of food allergies

A lower incidence of food allergies in the developing world could also be due to differences in diet from the West and less exposure to food allergens.

Others have found that food allergies are due to widespread usage of baby skin care products that contain allergens, such as lotions based upon peanut’s oil. These skin care products are cheaper to manufacture than non-allergenic ones and using them sensitizes the baby, which later develops into a food allergy. This theory has yet to come with sufficient explanation as to why occurrence of allergies are on a steady rise in the last two decades.

Prevention:-
According to a report issued by the American Academy of Pediatrics, “There is evidence that breastfeeding for at least 4 months, compared with feeding infants formula made with intact cow milk protein, prevents or delays the occurrence of atopic dermatitis, cow milk allergy, and wheezing in early childhood.”[23]

Treatment:-
The mainstay of treatment for food allergy is avoidance of the foods that have been identified as allergens.

If the food is accidentally ingested and a systemic reaction occurs, then epinephrine (best delivered with an autoinjector of epinephrine such as an Epipen or Twinject) should be used. It is possible that a second dose of epinephrine may be required for severe reactions. The patient should also seek medical care immediately.

At this time, there is no cure for food allergies. There are no allergy desensitization or allergy “shots” available for food allergies. Some doctors feel they do not work in food allergies because even minute amounts of the food in question or even food extracts (as in the case of allergy shots) can cause an allergic response in many sufferers.

Ronald van Ree of Amsterdam University expects that vaccines can in theory be created using genetic engineering to cure allergies. If this can be done, food allergies could be eradicated in about ten years.
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Statistics:-
For reasons that are not entirely understood, the diagnosis of food allergies has apparently become more common in Western nations in recent times. In the United States food allergy affects as many as 5% of infants less than three years of age and 3% to 4% of adults. There is a similar prevalence in Canada.

The most common food allergens include peanuts, milk, eggs, tree nuts, fish, shellfish, soy, and wheat – these foods account for about 90% of all allergic reactions.

Differing views:-
Various medical practitioners have a differing views on food allergies. Irritable Bowel Syndrome (IBS) patients have been studied with regards to food allergies. Some studies have reported on the role of food allergy in IBS; only one epidemiological study on functional dyspepsia and food allergy has been published. However, since 2005 several studies have demonstrated strong correlation between IgG and/or IgE food allergy and IBS symptoms The mechanisms by which food activates mucosal immune system are incompletely understood, but food specific IgE and IgG4 appeared to mediate the hypersensitivity reaction in a subgroup of IBS patients. Specific chemicals and receptors have been demonstrated to be critical in food allergy development in murine models. Exclusion diets based on skin prick test, RAST for IgE or IgG4, hypoallergic diet and clinical trials with oral disodium cromoglycate have been conducted, and some success has been reported in a subset of IBS patients.

Studies comparing skin prick testing and ELISA blood testing have found that the results of skin prick testing correlate poorly with symptoms of irritable bowel syndrome that correlate with food allergies demonstrated through ELISA testing and dietary challenge.

Extensive clinical experience has demonstrated significant improvement of patients with IBS whose ELISA-based food allergy testing is positive and where treatment includes a careful exclusion diet.

In addition, many practitioners of alternative medicine ascribe symptoms to food allergy where other doctors do not. The causal relationships between some of these conditions and food allergies have not been studied extensively enough to provide sufficient evidence to become authoritative. The interaction of histamine with the nervous system receptors has been demonstrated, but more study is needed.[36] Other immune response effects are commonly known (swelling, irritation, etc.), but their relationships to some conditions has not been extensively studied. Examples are arthritis, fatigue, headaches, and hyperactivity. Nevertheless, hypoallergenic diets reportedly can be of benefit in these conditions, indicating that the current medical views on food allergy may be too narrow. Holford and Brady (2005) suggest three levels of response; classical immediate-onset allergy (IgE), delayed-onset allergy (giving a positive response on an ELISA IgG test but rarely on an IgE skin prick test), and food intolerance (non-allergic), and claim the last two to be more common. It is important to note that IgG is present in the body and is known to respond to foods. So some medical practitioners, especially allergists, claim that there is no predictive value to these types of tests, despite the studies cited above.

In children:-
Milk and soy allergies in children can often go undiagnosed for many months, causing much worry for parents and health risks for infants and children. Many infants with milk and soy allergies can show signs of colic, blood in the stool, mucous in the stool, reflux, rashes and other harmful medical conditions. These conditions are often misdiagnosed as viruses or colic.

Some children who are allergic to cow’s milk protein also show a cross sensitivity to soy-based products.[ There are infant formulas in which the milk and soy proteins are degraded so when taken by an infant, their immune system does not recognize the allergen and they can safely consume the product. Hypoallergenic infant formulas can be based on hydrolyzed proteins, which are proteins partially predigested in a less antigenic form. Other formulas, based on free amino acids, are the least antigenic and provide complete nutrition support in severe forms of milk allergy.

Seventy-fice percent of children who have allergies to milk protein are able to tolerate baked-in milk products, ie., muffins, cookies, cake.

About 50% of children with allergies to milk, egg, soy, and wheat will outgrow their allergy by the age of 6. Those that don’t, and those that are still allergic by the age of 12 or so, have less than an 8% chance of outgrowing the allergy.

Peanut and tree nut allergies are less likely to be outgrown, although evidence now shows[40] that about 20% of those with peanut allergies and 9% of those with tree nut allergies will outgrow their allergies. In such a case, they need to consume nuts in some regular fashion to maintain the non-allergic status.[citation needed] This should be discussed with a doctor.

Those with other food allergies may or may not outgrow their allergies.

Labeling laws
In response to the risk that certain foods pose to those with food allergies, countries have responded by instituting labeling laws that require food products to clearly inform consumers if their products contain major allergens or by-products of major allergens.

United States law
Under the Food Allergen Labeling and Consumer Protection Act of 2004 (Public Law 108-282), companies are required to disclose on the label whether the product contains a major food allergen in clear, plain language. The allergens have to clearly be called out in the ingredient statement. Most companies list allergens in a statement separate from the ingredient statement

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Lactose intolerance
Oral Allergy Syndrome
Medical emergency
Mast cell

IT IS ADVISED TO DO  YOGA & MEDITATION  (BREATHING EXERCISE) DAILY  TO GET RID OF ALLERGY 

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:

http://en.wikipedia.org/wiki/Food_allergy
http://www.mayoclinic.com/health/food-allergy/DS00082/DSECTION=symptoms

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Study to Nail Food Allergy Triggers

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CHICAGO: For 5-year-old Sean Batson, even a grandmother’s kiss is to be feared.
“My mother was wearing lipstick, and when she kissed Sean’s cheek, it broke out in hives,” said his mother, Jennifer Batson.

At his first birthday party, Sean had a severe allergic reaction — hives, swollen eyes, vomiting and wheezing — to his first nibble of cake. And when a toddler with an ice cream cone touched Sean’s arm with sticky hands during a play date, the arm erupted in hives.

The daily struggle of living with Sean’s allergies to nearly unavoidable foods and food products — soy, eggs and milk, traces of which can turn up even in nonfoods like lipstick — prompted Jennifer and her husband, Tim, to participate in a project that scientists are calling the most comprehensive food allergy study to date.

The international study, led by Xiaobin Wang and Jacqueline Pongracic of Children’s Memorial Hospital here, is searching for causes of food allergy by looking at hundreds of families in Boston, Chicago and Anhui Province in China.

Wang says the study’s multicenter design allows researchers to look at startling variations in the prevalence and types of food allergies across diverse populations and regions.

In China, for example, skin-prick testing found that large percentages of one rural population were sensitive to shellfish (16.7%) and peanuts (12.3%). Yet actual food allergies in that population, as diagnosed by physicians, were all but unheard of: less than 1%.

In the US, by contrast, 12 million people (4%of the population) suffer from food allergies, according to the Food Allergy and Anaphylaxis Network, a nonprofit information and advocacy group.

“We found something unexpected,” said Wang, director of the Smith Child Health Research Program at Children’s Memorial. “The apparent dissociation between high allergic sensitization and low allergic disease in this Chinese population is not seen in our two US study populations.

Although it is possible to be allergic to any food, eight foods account for 90% of all reactions — milk, eggs, peanuts, fish, shellfish, soy, wheat, and tree nuts like cashews and almonds. Up to 200 deaths each year are attributed to the most severe reaction, food-induced anaphylaxis.

Some experts suggest that children in a culture smitten with antibacterial detergents and hand sanitizers are exposed to fewer germs, depriving the immune system of its germ-fighting job and leading it to misidentify certain foods as foreign.

Sources: The Times Of India

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Anaphylaxis

Allergy skin testing
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Definition:

Anaphylaxis is a rapidly progressing, life-threatening allergic reaction.It is a type of allergic reaction, in which the immune system responds to otherwise harmless substances from the environment. Unlike other allergic reactions, however, anaphylaxis can kill. Reaction may begin within minutes or even seconds of exposure, and rapidly progress to cause airway constriction, skin and intestinal irritation, and altered heart rhythms. In severe cases, it can result in complete airway obstruction, shock, and death.

Anaphylaxis is an acute systemic (multi-system) and severe Type I Hypersensitivity allergic reaction in humans and other mammals. The term comes from the Greek words ana (against) and phylaxis (protection). Minute amounts of allergens may cause a life-threatening anaphylactic reaction. Anaphylaxis may occur after ingestion, skin contact, injection of an allergen or, in rare cases, inhalation….CLICK & SEE

Anaphylactic shock, the most severe type of anaphylaxis, occurs when an allergic response triggers a quick release from mast cells of large quantities of immunological mediators (histamines, prostaglandins, leukotrienes) leading to systemic vasodilation (associated with a sudden drop in blood pressure) and edema of bronchial mucosa (resulting in bronchoconstriction and difficulty breathing). Anaphylactic shock can lead to death in a matter of minutes if left untreated.

An estimated 1.24% to 16.8% of the population of the United States is considered “at risk” for having an anaphylactic reaction if they are exposed to one or more allergens, especially penicillin and insect stings. Most of these people successfully avoid their allergens and will never experience anaphylaxis. Of those people who actually experience anaphylaxis, up to 1% may die as a result. Anaphylaxis results in approximately 18 deaths per year in the U.S. (compared to 2.4 million deaths from all causes each year in the U.S.). The most common presentation includes sudden cardiovascular collapse (88% of reported cases of severe anaphylaxis).

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Researchers typically distinguish between “true anaphylaxis” and “pseudo-anaphylaxis or an “anaphylactoid reaction.” The symptoms, treatment, and risk of death are identical, but “true” anaphylaxis is always caused directly by degranulation of mast cells or basophils that is mediated by immunoglobulin E (IgE), and pseudo-anaphylaxis occurs due to all other causes. The distinction is primarily made by those studying mechanisms of allergic reactions.

Causes:-
Anaphylaxis is a severe, whole-body allergic reaction. After an initial exposure (“sensitizing dose”) to a substance like bee sting toxin, the person’s immune system becomes sensitized to that allergen. On a subsequent exposure (“shocking dose”), an allergic reaction occurs. This reaction is sudden, severe, and involves the whole body.

Hives and angioedema (hives on the lips, eyelids, throat, and/or tongue) often occur. Angioedema may be severe enough to block the airway. Prolonged anaphylaxis can cause heart arrhythmias.

Some drugs (polymyxin, morphine, x-ray dye, and others) may cause an “anaphylactoid” reaction (anaphylactic-like reaction) on the first exposure. This is usually due to a toxic reaction, rather than the immune system mechanism that occurs with “true” anaphylaxis. The symptoms, risk for complications without treatment, and treatment are the same, however, for both types of reactions. Some vaccinations are also known to cause “anaphylactoid” reactions. Antitoxins and antivenins may cause similar reactions.

Anaphylaxis can occur in response to any allergen. Common causes include insect bites/stings, food allergies (peanuts and tree nuts are the most common, though not the only), and drug allergies. Pollens and other inhaled allergens rarely cause anaphylaxis. In opthamology, the dye fluorescein used in some eye exams is a well known trigger. Some people have an anaphylactic reaction with no identifiable cause.
Symptoms:-
Symptoms of anaphylaxis are related to the action of Immunoglobulin E (IgE) and other anaphylatoxins, which act to release histamine and other mediator substances from mast cells (degranulation). In addition to other effects, histamine induces vasodilation of arterioles and constriction of bronchioles in the lungs, also known as bronchospasm (constriction of the airways).

Tissues in different parts of the body release histamine and other substances. This causes constriction of the airways, resulting in wheezing, difficulty breathing, and gastrointestinal symptoms such as abdominal pain, cramps, vomiting, and diarrhea. Histamine causes the blood vessels to dilate (which lowers blood pressure) and fluid to leak from the bloodstream into the tissues (which lowers the blood volume). These effects result in shock. Fluid can leak into the alveoli (air sacs) of the lungs, causing pulmonary edema.

Symptoms can include the following:

*polyuria
*respiratory distress
*hypotension (low blood pressure)
*encephalitis
*fainting
*unconsciousness
*urticaria (hives)
*flushed appearance
*angioedema (swelling of the lips, face, neck and throat): this can be life threatening
*tears (due to angioedema and stress)
*vomiting
*itching
*diarrhoea
*abdominal pain
*anxiety

The time between ingestion of the allergen and anaphylaxis symptoms can vary for some patients depending on the amount of allergen consumed and their reaction time. Symptoms can appear immediately, or can be delayed by half an hour to several hours after ingestion. However, symptoms of anaphylaxis usually appear very quickly once they do begin.

Diagnosis:-

Anaphylaxis is diagnosed based on the rapid development of symptoms in response to a suspect allergen. Identification of the culprit may be done with RAST testing, a blood test that identifies IgE reactions to specific allergens. Skin testing may be done for less severe anaphylactic reactions.

The time between ingestion of the allergen and anaphylaxis symptoms can vary for some patients depending on the amount of allergen consumed and their reaction time. Symptoms can appear immediately, or can be delayed by half an hour to several hours after ingestion. However, symptoms of anaphylaxis usually appear very quickly once they do begin.

Apart from its clinical features, blood tests for tryptase (released from mast cells) might be useful in diagnosing anaphylaxis.

In some cases, it is unclear from the patient interview what triggered the anaphylaxis. In this setting, skin allergy testing (with or without patch testing) or RAST blood tests can sometimes identify the cause.

You may click to see:->Anaphylaxis Flow Chart

Treatment:-

Emergency Treatment
Anaphylaxis is a life-threatening medical emergency because of rapid constriction of the airway, often within minutes of onset, which can lead to respiratory failure and respiratory arrest. Brain and organ damage rapidly occurs if the patient cannot breathe. Due to the severe nature of the emergency, patients experiencing or about to experience anaphylaxis require the help of advanced medical personnel. First aid measures for anaphylaxis include rescue breathing (part of CPR). Rescue breathing may be hindered by the constricted airways, but if the patient stops breathing on his or her own, it is the only way to get oxygen to him or her until professional help is available.

.A woman being treated in an emergency department after going into anaphylactic shock

.The primary treatment for anaphylaxis is administration of epinephrine (adrenaline). Epinephrine prevents worsening of the airway constriction, stimulates the heart to continue beating, and may be life-saving. Epinephrine acts on Beta-2 adrenergic receptors in the lung as a powerful bronchodilator (i.e. it opens the airways), relieving allergic or histamine-induced acute asthmatic attack or anaphylaxis. If the patient has previously been diagnosed with anaphylaxis, he or she may be carrying an EpiPen or Twinject for immediate administration of epinephrine. However, use of an EpiPen or similar device only provides temporary and limited relief of symptoms.

Tachycardia (rapid heartbeat) results from stimulation of Beta-1 adrenergic receptors of the heart increasing contractility (positive inotropic effect) and frequency (chronotropic effect) and thus cardiac output.[10] Repetitive administration of epinephrine can cause tachycardia and occasionally ventricular tachycardia with heart rates potentially reaching 240 beats per minute, which itself can be fatal. Extra doses of epinephrine can sometimes cause cardiac arrest. This is why some protocols advise intramuscular injection of only 0.3–0.5mL of a 1:1,000 dilution.

Some patients with severe allergies routinely carry preloaded syringes containing epinephrine, diphenhydramine (Benadryl), and dexamethasone (Decadron) whenever they go to an unknown or uncontrolled environment.

You may click to see:->First Aid for Anaphylaxis
Clinical care
Paramedic treatment in the field includes administration of epinephrine IM; antihistamines IM (such as chlorphenamine or diphenhydramine); steroids, such as hydrocortisone or dexamethasone; IV Fluid administration and in severe cases, pressor agents (which cause the heart to increase its contraction strength) such as dopamine for hypotension, administration of oxygen, and intubation during transport to advanced medical care.

In severe situations with profuse laryngeal edema (swelling of the airway), cricothyrotomy or tracheotomy may be required to maintain oxygenation. In these procedures, an incision is made through the anterior portion of the neck, over the cricoid membrane, and an endotracheal tube is inserted to allow mechanical ventilation of the patient.

The clinical treatment of anaphylaxis by a doctor and in the hospital setting aims to treat the cellular hypersensitivity reaction as well as the symptoms. Antihistamine drugs such as diphenhydramine or chlorphenamine (which inhibit the effects of histamine at histamine receptors) are continued but are usually not sufficient in anaphylaxis, and high doses of intravenous corticosteroids such as dexamethasone or hydrocortisone are often required. Hypotension is treated with intravenous fluids and sometimes vasopressor drugs. For bronchospasm, bronchodilator drugs (e.g. salbutamol, known as Albuterol in the United States) are used. In severe cases, immediate treatment with epinephrine can be lifesaving. Supportive care with mechanical ventilation may be required.

It is also possible to undergo a second reaction prior to medical attention or using an Epipen. It is suggested to seek one to two days of medical care.

The possibility of biphasic reactions (recurrence of anaphylaxis) requires that patients be monitored for four hours after being transported to medical care for anaphylaxis.

Many anaphylactic patients will be sent home or released after the initial reaction is declared over. Yet, rebound reactions are almost always bound to happen. Most people with anaphylaxis have a rebound a few hours after the initial reaction, yet there are cases where a rebound would occur after as much time as a week.
Planning for emergency treatment:-
The Asthma and Allergy Foundation of America advises patients prone to anaphylaxis to have an “allergy action plan” on file at school, home, or in their office to aid others in case of an anaphylactic emergency, and provides a free “plan” form. Action plans are considered essential to quality emergency care. Many authorities advocate immunotherapy to prevent future episodes of anaphylaxis.

Beta-blockers may aggravate anaphylactic reactions and interfere with treatment.

Prognosis:
The rapidity of symptom development is an indication of the likely severity of reaction: the faster symptoms develop, the more severe the ultimate reaction. Prompt emergency medical attention and close monitoring reduces the likelihood of death. Nonetheless, death is possible from severe anaphylaxis. For most people who receive rapid treatment, recovery is complete.

Prevention:-
Immunotherapy with Hymenoptera venoms is especially effective and widely used throughout the world and is accepted as an effective treatment for most patients with allergy to bees, wasps, hornets, yellow jackets, white faced hornets, and fire ants.

Avoidance of the allergic trigger is the only reliable method of preventing anaphylaxis. For insect allergies, this requires recognizing likely nest sites. Preventing food allergies requires knowledge of the prepared foods or dishes in which the allergen is likely to occur, and careful questioning about ingredients when dining out. Use of a Medic-Alert tag detailing drug allergies is vital to prevent inadvertent administration during a medical emergency.

People prone to anaphylaxis should carry an “Epipen” or “Ana-kit,” which contain an adrenaline dose ready for injection.

The greatest success with prevention of anaphylaxis has been the use of allergy injections to prevent recurrence of sting allergy. The risk to an individual from a particular species of insect depends on complex interactions between likelihood of human contact, insect aggression, efficiency of the venom delivery apparatus, and venom allergenicity. According to most authorities, venom immunotherapy has been demonstrated to reduce the risk of systemic reactions below 1% to 3%. One simple method of venom extraction has been electrical stimulation to obtain venom, instead of dissecting the venom sac. An allergist will then provide venom immunotherapy which is highly efficacious in preventing future episodes of anaphylaxis.

A vaccine has been in the works to prevent anaphylaxis from peanuts and tree nuts. Despite showing significant promise to prevent individuals with the allergy from developing anaphylaxis if eating a small amount of the food, the FDA has not yet approved the vaccine.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources :
http://en.wikipedia.org/wiki/Anaphylaxis
http://www.answers.com/topic/anaphylaxis
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Just Say No to Nuts During Pregnancy

Recent research has found that regular consumption of nut products during pregnancy raises the odds of your child having asthma symptoms by nearly 50 percent.

About 4 percent of American children have food allergies, and roughly 3 million people in the U.S. are allergic to peanuts or tree nuts. It’s already recommended that children under 3 not be given nuts or nut products, because their immune systems are still developing and may be more susceptible to allergens.

Daily consumption of nut products increases the odds that a child will have wheezing by 42 percent, shortness of breath by 58 percent, and steroid use to ease asthma symptoms by 62 percent.

Overall, the odds of developing asthma symptoms for a child whose mother ate nuts daily are 47 percent higher.

Sources:
U.S. News and World Report July 15, 2008

American Journal of Respiratory and Critical Care Medicine July 15, 2008; 178(2):113-4

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