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Food Allergy Q&A
August 21, 2013
Do you have questions about food allergies and anaphylaxis? In every issue, Living Without’s medical experts answer your frequently asked questions, like these:
Can my doctor predict how bad my next allergic reaction will be?
Probably not. At present, tests cannot tell doctors how severe a person’s allergic reaction will be. It is also difficult to tell which patients are at risk for a severe reaction.
Even if your early symptoms seem mild, do not ignore them, especially if you have had a severe reaction in the past.
Can exercise bring on an asthma attack?
Yes. In susceptible people, asthma can be triggered by exercise. Asthma symptoms include cough, shortness of breath, wheezing and tightness of the chest. Other common asthma triggers are dust mites, pets, pollen, smoking, air pollution, viral infection, chemical fumes and cold weather.
What are the common symptoms of an allergic reaction?
An allergic reaction can involve any of the following symptoms, which may appear alone or in any combination. On the skin, there can be hives, swelling, itching, warmth and/or redness. With the respiratory system, there can be coughing, wheezing, shortness of breath, chest pain or tightness, throat tightness, trouble swallowing, hoarse voice, nasal congestion or hay fever-like symptoms (sneezing, runny or itchy nose, itchy or watery eyes). It can impact the gastrointestinal system with nausea, stomach pain or cramps, vomiting, diarrhea. It can strike the cardiovascular system with dizziness, a weak pulse, a change in skin color (to pale or blue), fainting, shock, loss of consciousness.
An allergic reaction can prompt brain-related symptoms, such as anxiety, headaches and feelings of “impending doom” (the feeling that something really bad is about to happen). In women, it can even bring on uterine cramps.
Is epinephrine dangerous? Are there side effects?
Epinephrine is safe to use in normally healthy individuals. It rarely causes harm, even if given when not needed. Possible side effects can include rapid heart rate, paleness, dizziness, weakness, tremors and headache. These side effects are generally mild and go away within a few minutes.
I’m worried about confusing asthma symptoms with anaphylaxis. What if I give my child the wrong medication?
Many parents worry they might mistake anaphylaxis symptoms for an asthma attack or the other way around. Epinephrine can be used to treat both asthma and severe allergic reaction. Before modern asthma medications were available, epinephrine was used to treat asthma attacks.
If you suspect your child is having an anaphylactic reaction, give the epinephrine auto-injector immediately. Keep in mind that antihistamines are slow to act and have not been proven to stop anaphylaxis.Give other medications, such as asthma drugs and antihistamines, after administering epinephrine.
I have a severe food allergy. Should I be wearing a medical bracelet?
Yes. If you are alone or become unconscious due to an allergic reaction, your identification jewelry can provide others with critical information about your allergy so that you can receive proper medical attention. Medical ID’s are also very important for children who are too young to adequately describe their allergy.
My daughter was just diagnosed with severe allergies. I want to explain this to her in a positive way. Can you help?
Your child learns from you, especially from your attitude and what you do. When your language, behavior and overall attitude show that you are confident, your child will feel the same. The lessons you teach your child when she is young will help her successfully self-manage her allergies as she grows older.
Do not use terrifying words to describe her medical condition, such as “deadly food allergies,” or “this food can kill you.” Remember that your youngster is listening to conversations that you have with others, too, so be mindful of this when speaking about her allergies to others, especially to caregivers like her teachers or babysitters.
Talk about the fact that food allergies can be managed. For young children, phrases like “eggs can make you sick” or “peanuts are not safe for your body” may work. As children grow older, they’re more able to understand the role of the immune system. For example, “the immune system, the part of the body that usually fights germs, mistakes the food for something harmful. When the immune system fights back, that causes the allergic reaction.”
How fast can a food reaction occur?
Most allergic reactions happen within minutes but some can occur a few hours after exposure.
Is it okay to give a second dose of epinephrine?
If allergic symptoms come back after the first dose or if they worsen, a second dose of epinephrine can be given as early as 5 to 15 minutes after the first dose. A second wave of anaphylaxis, called a biphasic reaction, can happen after the initial symptoms are resolved. This can occur after the first reaction, even several hours afterwards.
Epinephrine can wear off and the person may need more, as well as other treatment. This is why it’s important that anyone having anaphylaxis be quickly taken to the emergency department to be seen by a doctor.
This information, published in Living Without’s Aug/Sept 2013 issue, was excerpted with permission from Living Confidently with Food Allergy (©2013 Anaphylaxis Canada), a handbook written by Michael Pistiner, MD, MMSc, Jennifer LeBovidge, PhD, and Anaphylaxis Canada (Laura Bantock, director, western region; Lauren James, development coordinator; Laurie Harada, executive director). Living Confidently with Food Allergy is a North American collaborative effort led by Anaphylaxis Canada. This free, easy-to-read handbook uses evidence-based information in a practical way to give parents the tools to keep their children safe, as well as address their emotional needs. For specific references, see Living Confidently with Food Allergy, which can be found at AllergyHome.org and Anaphylaxis.ca. This information is not a replacement for professional medical advice. All matters regarding your health should be supervised by a licensed health-care professional.