Alleviating allergies
WellBeing|Issue 194
Are allergies making you miserable? Soothe your sniffles, itches and tears with natural approaches that encompass lifestyle change, diet, herbs and your mind.
CAROLINE ROBERTSON

Decades ago, food allergies were relatively rare. Today allergies are among the fastest-growing conditions in Australia, according to the Australasian Society of Clinical Immunology and Allergy (ASCIA). Approximately 20 per cent of Australians have an allergic disease with 10 per cent of infants experiencing immediate food allergies. Food allergies and eczema are more common in children. Insect allergy, drug allergy, asthma and allergic rhinitis (or hay fever) are more prevalent in older people.

Allergens are substances that provoke allergies. Potential allergens are everywhere — in the air, animals, food, drink, cleaning agents, personal care products, insect stings, medicines, plants, metals, latex and agricultural products. Studies show that while we can outgrow allergies to cow’s milk, egg, soy or wheat, approximately 75 per cent of children have persistent allergies to nuts, sesame and seafood. The mechanism of allergies is clear but their cause and cure remains hazy.

Allergies explained

There are two types of allergies, IgE-mediated and non-IgE-mediated.

An IgE-mediated response is when the body reacts to a usually harmless substance by releasing immunoglobulin E antibodies. These attach to mast cells that then release granules and chemicals such as histamine, cytokines, leukotrienes, heparin and proteases. Many mediators cause characteristic allergy symptoms such as rashes, hives, itching, streaming eyes, congested or runny nose, asthmatic breathing, tingly mouth or lips, swelling and anaphylaxis in severe cases.

An IgE-mediated food allergy generally shows symptoms within hours, whereas a non-IgE-mediated food hypersensitivity can take from hours to weeks to manifest. According to the Royal Children’s Hospital Melbourne, “Non-IgE-mediated food allergies are caused by a reaction involving other components of the immune system apart from IgE antibodies. The reactions do not appear immediately after the ingestion of the food and usually relate to reactions in the gastrointestinal tract such as vomiting, bloating and diarrhoea.”

Non-IgE-mediated food allergy usually has gastrointestinal symptoms such as cramps, bloat, vomiting and bowel issues. This is commonly caused by foods such as cow’s milk, egg, peanut, tree nuts, wheat, soy, sesame, fish and shellfish. Rates of non-IgE-mediated food allergies such as eosinophilic esophagitis are escalating in Australia. Non-IgE-mediated food allergies include intestinal coeliac disease, eosinophilic esophagitis (affecting the oesophagus), FPIES (impacting the small intestine) and proctocolitis (seated in the large intestine).

The mainstay of management for these conditions involves allergen avoidance with subsequent food challenge testing according to each individual. Some may outgrow an allergy or observe lifelong allergen abstinence. Therapeutic support such as allergen immunotherapy, medication, nutrition, supplements, herbs and mind–body healing can offer great relief for both IgE and non-IgE-related allergies. Anaphylactic reactions require immediate medication with subsequent preventive measures.

Intolerance, allergy or anaphylaxis?

Many confuse food allergy with food intolerance. According to the American Academy of Allergy, Asthma and Immunology (AAAAI), “A food intolerance response takes place in the digestive system. A food allergic reaction involves the immune system. Unlike an intolerance to food, a food allergy can cause a serious or even life-threatening reaction by eating a microscopic amount, touching or inhaling the food.”

Hence food intolerance symptoms are considered less serious, and maybe managed by improving digestion, taking limited quantities of the food or preventing a reaction with a substance like lactase if intolerant to lactose. Food intolerances can have many causes, including lack of enzymes, irritable bowel syndrome, sensitivity to additives, stress, gut dysbiosis, increased intestinal permeability (leaky gut) or coeliac disease.

Anaphylaxis is a life-threatening emergency involving more than one body system. It is caused by an IgE-related allergy rather than a non-IgE issue. Anaphylaxis may be evident by any one of the following symptoms:

• difficult/noisy breathing

• swelling of the tongue

• swelling/tightness in throat

• difficulty talking and/or hoarse voice

• wheeze or sudden persistent cough

• persistent dizziness or collapse

• pale and floppy (of young children)

• abdominal pain and vomiting (for insectsting or injected drug allergy).

Avoiding exposure to the anaphylactic agent is ideal, but if anaphylaxis occurs, swift, sure action can be lifesaving. It is essential to keep an anaphylactic casualty still, either lying down or sitting, administer an adrenalin autoinjector and call 000 followed by emergency contacts. The adrenalin autoinjector is a single-use device which may be used by non-medical people. It can reduce airway swelling, induce bronchodilation, induce vasoconstriction and increase strength of cardiac contraction. If uncertain whether the symptoms are due to anaphylaxis or asthma, then give the adrenalin autoinjector followed by the asthma inhaler. If symptoms do not subside within five minutes another adrenalin autoinjector may be administered. The casualty must then stay still for four hours under medical observation as there can be a second surge of anaphylactic reaction.

Curious how casualties feel after an adrenalin shot? Pounding heartbeat, nervousness, sweating, nausea, vomiting, difficult breathing, headache, dizziness, anxiety, shakiness or pale skin are common reactions. If it is the first time experiencing anaphylaxis it is vital to identify the trigger and carry an adrenalin autoinjector at all times if old enough to self-administer it. ASCIA advises that high school and upper primary school students should usually carry at least one device on their person.

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