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Food Allergy Advice
"Allergies Explained" From AllergyAdvice.com
Allergies affect millions of people worldwide and the problem is felt to be one of the most common chronic conditions people can develop. It is estimated that 10 to 30 percent of all people in the industrialized world are affected by allergies. The economic burden (cost of drugs and doctor visits, and missed days of work) of allergic disease is felt to exceed $3 billion dollars each year in the United States.
The problem appears to be on the rise though it is not fully understood why. This rise has been significant over the past two decades and does not appear to be slowing.
What is an allergy?
Being allergic to something involves an exaggerated response by the immune system against that something. The item can be plant pollen, animal dander, food, or some other substance. Sometimes a person cannot even see the thing they are allergic to such as dust mites or mold spores. These are too small to be seen by the naked eye. When allergies involve food it can be the tiny specks of a spice or the crunchy nuts that cause the problem.
An allergy producing substance is called an allergen. While one person may respond with an allergic response to an allergen, many people will not. This can become confusing.
What causes allergies?
The immune system is here to defend our body against harmful intruders, but sometimes it mistakes a non-harmful substance to be a harmful intruder and attacks it. So sometimes we want our body to mount an immune attack on a substance because it is harmful, but other times we wish it would just leave that pollen or dander alone because it really is not hurting us. A normal immune response to an invading bacteria is welcome and needed to keep us safe from infection.
The development of antibodies (Ig G, Ig M, and Ig A) helps our body to rid itself of the bacteria. It is the false alarms that the immune system sets off that we define as allergies.
The body’s immune system uses the release of histamine and the production of IgE antibodies as the two main responses against the false “intruder.” Our body will not make Ig E in response to bacteria and viruses. Usually there is a period of “sensitization” that can range from days to multiple years prior to a person having an allergic reaction. During this time the person was exposed at least once to the allergen. Sometimes it seems that the reaction occurs in response to the very first exposure, but this is not really possible.
There must have been prior contact with the allergen, or a substance that is very similar to the allergen. The person must have been exposed, even if they do not remember being exposed. It does not need to be a large exposure so it could be easy to forget about or ignore.
During the sensitization period the body is busy producing Ig E antibodies and attaching them to cells that store histamine. When the person is exposed to the allergen the body Ig E antibodies recognize this and set off the allergic response. Histamine is released which in turns causes the typical allergic symptoms. Localized swelling, itching and inflammation will occur. If it is a nasal allergy, extra mucus will be produced. Eyes may produce more tears. If the allergen is a food the person could vomit or develop diarrhea.
Who is most at risk for developing allergies?
Allergies can develop at any age from the very tiny to the very old. Curiously, some people “outgrow” their childhood allergies and are no longer reactive to the item as an adult. It seems that with environmental allergies a person grows into having the problem. The reason that even an older person can suddenly develop an allergy is changing exposures throughout a life time. An elderly person may move and suddenly be exposed to a new allergen.
The risk of developing allergies is related to family history. If a person’s parents or siblings have allergies they are at higher risk of having them as well. The environment can also have a strong role in their development. When someone is allergic to one thing then other triggers may cause a response also. It is rare for a person to have absolutely only one thing that they are allergic to.
You may wonder how can one person be allergic to a substance while most people are not. To be honest, medical science still does not understand fully how this happens. Since we know about family history playing a part it is assumed that genetics plays a large role in whether a person will be allergic to something. If a parent has a nut allergy a child has a higher risk of having the same problem. This would seem to be genetics carrying the risk forward from the parent to the child.
It is also known that certain exposures increase the risk of developing allergies. Exposure to tobacco smoke increases the risk so you can see how living in a household where someone smokes will increase a child’s risk for allergic reactions. It has also been found that children born by Cesarean section have a higher risk when compared to children born by the vaginal route, but we do not know the absolute difference that causes the increased risk.
Girls are less likely to have difficulties with allergies when compared with boys. Once again, the exact reason, the exact difference, which creates this increased risk is not known.
What are common allergy symptoms?
The parts of the body most prone to developing allergic symptoms are the eyes, nose, lungs, skin, and digestive tract. Even though the allergy symptoms can appear different, the cause is the same—histamine release and Ig E development. The body’s immune system has mistaken a friendly substance for a harmful substance and has attacked it.
Allergic rhinitis is the most common allergic disease. It refers to the nasal symptoms that can occur due to allergens. Usually the allergens are airborne and can include pollen, grass, dust mites, animal dander, or molds. It can be seasonal, only occurring when a certain flower is in bloom or it can be year round when it involves something like animal dander. Problems result from inflammation of the tissues in the nose with other areas such as eyes, ears, throat, and sinuses becoming involved as well. Common symptoms are a runny, stuffy nose, sneezing, itchy nose, eyes, and ears, and post nasal drip.
Asthma results from inflammation and hyper-reactivity of the airways leading to reversible narrowing of the airways. Many times it co-exists with allergic rhinitis. With asthma the person will have shortness of breath, wheezing, coughing, and chest tightness.
Allergies involving the eyes are also usually airborne. Inflammation of the tissue that covers the surface of the eyeball and the under-surface of the eyelid occurs due to exposure to the allergen. The person will notice redness of the eyelids and eye, itchy, watery eyes, and swelling of the tissues around the eyes.
Eczema is a common allergic skin condition. It is more often seen with other allergic conditions. It rarely is the result of direct allergen exposure of the skin. Usually it is a rash. The skin can be extremely dry and itchy. Main areas routinely involved include the face and behind the elbows and knees.
Hives is another allergic skin reaction. They appear as red, raised, itchy welts. Hives can occur on any part of the body. Many times they occur at the site of exposure, or close by. They disappear quickly over a matter of hours to at most a day. While they are itchy they are not painful. Many times the person also notices swelling in the area of the hives.
Anaphylaxis (Allergic Shock)
Anaphylaxis is the worst allergic reaction. It can be life-threatening, affecting multiple organs at the same time. Allergens that can lead to anaphylaxis include foods, medications, and venom (bee or wasp stings). Rarely would an airborne allergen cause such a significant response. Usually the allergic reaction starts like any other reaction with hives and nasal symptoms of congestion and itchiness. Quickly the person develops swelling of the tongue, mouth, and throat tissues with difficulty breathing. They may also notice abdominal discomforts including nausea, vomiting, and diarrhea.
If the reaction continues untreated the person will develop low blood pressure and finally shock. The low blood pressure is due to blood vessels enlarging significantly so as to decrease blood flow. This can cause low blood flow to important organs such as the brain.
Anaphylaxis is life threatening and requires medical attention. Even if the person carries an Epi-pen to use for their allergy if the anaphylactic reaction starts they should still be taken for medical care. This problem can take some time to fully resolve and the person may require more supportive care during that time.
Allergens are literally everywhere. They can be inhaled, swallowed, applied to the skin, or injected into the body. An airborne pollen will have little effect on the skin. Allergens that are swallowed or injected can travel to multiple parts of the body and invoke symptoms remote from their point of entry into the body. An example would be the person who is allergic to a specific food who develops hives.
Most airborne allergens cause nasal or eye allergy symptoms. Common airborne allergens include:
- Pollens from trees, flowers, plants, and grasses
- Dust mites
- Animal dander and other proteins they shed from their skin or in their urine
- Mold spores
- Insect parts, especially cockroaches
Common ingested allergens include foods and medications. Reactions usually start as localized tingling or itching of the mouth or a rash on the face near the mouth. Symptoms can develop further into swelling, nausea, vomiting, or diarrhea. If facial and airway swelling is bad enough the person may have difficulty breathing.
The most common food allergens are cow’s milk, eggs, peanuts and tree nuts, wheat, soy, shellfish and other fish. Children are most often bothered by allergies to milk, egg, wheat and soy. Many times they will outgrow their allergies over time. Adults are most often allergic to peanuts, tree nuts, and shellfish. When it comes to reactions to medications the most likely causes are antibiotics such as penicillin and anti-inflammatory agents such as aspirin or ibuprofen (Motrin).
Contact dermatitis is inflammation of the skin caused by a local exposure to an allergen. A great example is poison ivy or poison oak but dyes, cosmetics, laundry products, and nickel or other metals can cause an immune response. Most times the response is only local with no Ig E production.
The last type of allergen is that which is injected into our body. This does not mean that only medications can be involved. Any insect (or snake) venom is injected by the animal into our body. Vaccines and medications such as insulin can certainly cause an allergic reaction as well.
Allergy treatment always starts with avoiding the allergen whenever possible. This could mean that you should give your home or pet a thorough, regular cleaning. Getting rid of as much dust or dander that you can will help significantly. Keeping your home at a moderate temperature and humidity level will also help. HEPA filtration of air can help.
When you cannot avoid the allergen you want to be prepared with antihistamines to decrease your body’s response. Other common allergy medications include corticosteroids, decongestants, cromolyn sodium, and leukotriene modifiers. If you have a significant allergy your doctor may suggest that you carry an injectable epinephrine pen (Epi-pen) with you at all times.
Desensitization through immunotherapy can help at least some people cope better with their allergies. You may know of this treatment as “allergy shots” as a series of injections can be used to expose a person to slowly increasing amounts of purified allergen. Treatment may last for multiple years to reach full effectiveness. Even if you cannot stop your body’s reaction to the allergen completely many times you can decrease it to a lower and safer level.
Allergy causes and treatments are important research topics currently. More treatment options are sure to come and someday we will likely understand the true causes of our body’s response which we call allergies.
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