 |
|||||
 |
Spring 2008 Respiratory Therapist in Alabama Asthma Clinic Helps Serve Unmet Needs of His Community Food Triggers for Asthma and Allergies |
|
|
 Food Triggers for Asthma and Allergies Recently, my wife was preparing dinner and, to her surprise, had a significant allergic reaction to a kiwi fruit concoction that she was preparing. As dinner went on, her symptoms grew progressively worse from an odd tingling sensation on her tongue to an inability to speak clearly and some associated minor respiratory distress. She found out the hard way that she was allergic to kiwi, which is not an uncommon thing. Everything turned out for the best, and the condition quickly reversed itself. She now knows that she cannot eat this forbidden fruit. This scenario is even more concerning for an asthma patient for whom an allergic reaction could lead to an asthma exacerbation requiring swift medical attention. What are the sources? Typical symptoms of a food allergy reaction are:2
The incidence of food allergy as a cause of anaphylaxis — a severe, whole-body allergic reaction — is rising. Death is usually caused by respiratory failure, and patients with asthma are at the greatest risk.3 Patients with asthma tend to experience more severe and life-threatening allergic food reactions; and when it is a reaction that is in the respiratory tract, there is always a more severe reaction.4 Unfortunately, most fatal anaphylactic reactions are unpredictable.5 Restaurants and fast food establishments may also pose a level of danger to the sensitive patient, especially someone who has peanut or tree nut allergies. Frequently this is seen in ice cream shops, bakeries, and restaurants that serve Asian food. The best defense for an allergic person is communication with the establishment in an attempt to understand what the ingredients of the meal may be and if there are any hidden ingredients that may reside in food served with the main courses (salad dressings, sauces, or egg rolls).6 Also, people with allergies should ask the restaurant chef how the food is prepared. If you are allergic to shrimp and it is cooked in the same skillet as the french fries, then eating the fries may trigger a reaction. A safe course would be to avoid eating at restaurants whenever possible. What treatments are available? It is vitally important that you know what foods you are allergic to and then avoid them at all costs. Generally, diagnostic testing that includes elimination diets, skin testing, and in vitro testing accomplishes this. Elimination diets must be done under the advice and direction of a physician. An elimination diet is essentially what it sounds like — the systematic removal of potential or suspected food allergens. They usually are taken over a period of 10 to 14 days. You can ask your health care provider for more information about this. Skin testing and in vitro testing are useful ways to determine whether you are allergic to a food. However, this may not be all-inclusive because some people who do present with a very strong positive history of food allergy may have a negative skin and in vitro test.8 Because of these variables, the American Academy of Allergy, Asthma and Immunology recommends that anyone being evaluated for possible allergies be referred to an allergy/immunology specialist. This is especially important for the patient who has had past reactions, severe or persistent disease, a hospital admission for exacerbation, coexisting asthma, allergic rhinitis, atopic dermatitis, or allergic conjunctivitis (may also be known as “pink eye”). As with asthma, you should work with your doctor and respiratory therapist to develop an action plan. The allergic components of asthma and the causative agents must be listed. The action plan should be made available to schools and day care centers as well as with any caregivers. The school nurse or nurse office should also have a copy of the action plan. The child should be told not to trade foods or sample anyone else’s food at school, as this may involve food that will cause a severe or life-threatening reaction. Rescue steps must also be detailed on the action plan. It is also important that the person with allergies/asthma and caregiver understand what rescue action must be taken to counteract a severe reaction. About the Author References 
|
|
