January 13, 2018


CASES of food allergies are on the rise. This is what I have noticed in my practice as well as when our department holds its monthly census of cases seen.

Cases that we have encountered may range from scattered pimple-like skin rashes to hives or what we call urticarial rash, and to life-threatening angioedema where there is difficulty of breathing.

So what is a food allergy, actually?

A food allergy is when your body’s immune system reacts to a food protein because it has mistaken it as a “threat.”

This food that you reacted to is called a “food allergen” while the response your body has to the food is known as “allergic reaction.”

When your body reacts to the allergen, it produces too much of an antibody called immunoglobulin E. This immunoglobulin E (Ig E) then fights the threatening food allergens by releasing histamine and other chemicals. This release of antihistamines and other chemicals are what causes the symptoms of an allergic reaction.

There is another condition though, known as “food intolerance” that is often confused with food allergy. They are actually different. Food intolerance happens when your body has trouble digesting the food that has been eaten.  It presents with symptoms like upset stomach or gassiness. It may cause discomfort but is not life-threatening. The most common example of food intolerance is that from lactose.

So what is the best way to avoid food allergies?

First of all, you have to identify what specific food you reacted to. Although we have a list of common food allergens, there are people with allergic reactions to not so common allergens, such as onions and even rice, as what two of my friends have.

So what are the common food allergens that have been identified?

In no particular order, these are: chicken, crustaceans, eggs, nuts, dried fish, bagoong, processed meat, and chocolates.

Since food allergic reactions could be serious, all persons with a known allergy or has a potential to develop allergies should always be cautious.  Below are common reminders to help allergic persons prevent a reaction:

  1. Always be aware of what you eat. If there is a label, read it every time. If you are eating in a restaurant, always ask the waiter to check with the cook all the ingredients included in a dish. Remember, you do not need to consume a significant amount for the reaction to occur. Some people I know react even to the smell.
  2. Be mindful of cross contact. Cross contact happens when a food that is an allergen comes into contact with a safe food and their proteins mix. As a result, each food contains small amounts of the other food, which might not even be seen but could still illicit a reaction. An example of a cross contact is using a common utensil to prepare or serve the food.
  3. Wear medical identification. This may not be common practice in our locality but this will prove life-saving if a patient suddenly collapses because he/she cannot breathe anymore due to anaphylaxis (severe allergy). Rescue or emergency staff would have an initial diagnosis as to the probable reason for the loss of consciousness or inability to breath. Medical management could be readily instituted. Bracelets or “dog-tags” with the name of the patient and the condition is engraved on it.
  4. Inform your family and people you often associate with of your allergies. At home, let them know where you keep your medicines, contact numbers of your physician and hospital. Alert them on what to do or of the need to bring you to a hospital should you develop significant allergic symptoms.
  5. Always carry your epinephrine auto-injector. Although this is not a common practice again in our country and this epinephrine auto-injector is not readily available here, it is the first line treatment for allergic emergencies and definitely this a life-saving management.
  6. Consult an allergologist who could conduct skin testing for you to determine all your food allergens and determine the severity of each allergen. He can also give you a management plan and drug prescription for your reactions.

What other important things do you need to know as a patient and as a patient’s folk?

  1. Seconds matter. Time is of utmost importance in recognizing and treating an allergic reaction.
  2. Know what a reaction would look like. Work with your allergologist to educate you what to look for. Remember, reactions are individualized and may vary depending on severity. Symptoms can appear between a few minutes to about two hours after exposure to a food allergen. But it can also begin later or what we call a delayed response.
  3. Symptoms can be localized and mild and maybe as simple as itchy nose or a few hives, or swelling of the skin around the eyes or swelling of your lips. But they can also be severe with generalized hives, trouble breathing, repetitive vomiting, loss of consciousness or a weak pulse.

Treatment would be antihistamines for mild attacks but when the symptoms are more severe, immediate hospitalization is necessary.

***

Jessica P. Segovia-Yap, M.D., FPAFP is a Diplomate and Fellow of the Philippine Academy of Family Physicians. She is a practicing Family Medicine Specialist and holds clinic at the Medical Arts Building of Iloilo Mission Hospital. For comments, questions and suggestions, you may email at drjec.is.in@ gmail.com./PN

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