What are Food allergy and Food intolerance

Many people assign their variety of symptoms to food, and many such victims are seen and started on exclusion diets. The scientific proof that food does damage in most instances is feeble, although unfavorable reactions to food definitely exist. These can be classified into those that involve immune mechanisms as “food allergy” and those that do not involve immune mechanism as “food intolerance”.


Food allergy

Food allergy affect up to about 5% of young children and about 1-2% of adults. This form of allergy may be IgE mediated or non-IgE mediated (T-cell mediated). The IgE mediated reactions occurs within minutes or hour after the ingestion of the food . Adults are more likely to be allergic to fish, shellfish and peanuts, while young children are mostly allergic to cow's milk, egg white, wheat, and soy. Peanuts are very allergenic and when it is there it persists throughout life. The following conditions can result from food allergy


Acute hypersensitivity: After ingestion of nuts, strawberries or shellfish the patient suffers from urticaria , vomiting and diarrhea. These normally don’t pose much problem as the patients are aware and learn to avoid the suspected food. Unintentional eating of the incriminating foodstuff can sometimes occur, leading to angioneurotic oedema, a life threatening condition.

Eczema and asthma: Mostly IgE mediated and affect the children.

Rhinitis and asthma: In the atopic individuals these are mostly produced by milk and chocolates.

Chronic urticaria: Exclusion of particular food releive the problem in most patients

Food-sensitive enteropathy: Coeliac disease (gluten (wheat) sensitive enteropathy), and cow's milk enteropathy (in infants) are the example of this reaction.


Food intolerance

Migraine: Intake of foods like chocolate, cheese and alcohol Some patients suffer from migraine. These foods are rich in certain amines, such as tyramine, which are responsible for such attacks. Those on monoamine oxidase inhibitors, which are involved in the metabolism of these amines, are particularly susceptible.

Irritable bowel syndrome: Though mechanism not clearly understood, certain food precipitates the attack of IBS following ingestion of certain food items, such as wheat.

Chinese restaurant syndrome: dizziness, faintness, nausea, sweating and chest pains may follow after ingestion of Chinese food in some. The responsible agent is Monosodium glutamate, a flavoring agent used in cooking Chinese food.

Lactose intolerance: Abdominal bloating and diarrhea following intake of milk is probably the commonest form of food intolerance all over the world. Lactose present in the milk is the causative factor. This may be genetic in origin

Phenylketonuria: This is also a type of food intolerance, and is due to missing phenylalanine hydroxylase, which is essential for the metabolism of phenylalanine in the protein of the diet

There are other genetic errors of metabolism, which can be regarded as forms of food intolerance.

Food intolerance can occur:

To any constituent of food like the histamine in mackerel or canned food, or the tyramine in cheese.

Or,

Chemical mediators released by food stuff like histamine may be released by tomatoes or strawberries.

Or,

Toxic chemicals present in food like the food additive tartrazine.

Though sometimes thought, there are no evidence to prove that conditions such as arthritis, behavior and affective disorders and Crohn's disease are because of certain type of food ingestion. Multiple vague symptoms such as tiredness or malaise as sometimes blamed are not due to food allergy. Mostly, these patients are victim of some form of psychiatric disorder.


Treatment of food allergies and intolerance:

A careful history may help to outline the contributory mediator, particularly when the effects are instant.

Skin-prick testing with allergen, measurement of antigen or antibodies in the do not correlate with the symptoms and results are usually misleading. 'Fringe' techniques like hair analysis, has negligible value, though advised widely.

Diagnostic exclusion diets are useful but very time-consuming. They can sporadically be of value in recognizing a particular food causing allergy or intolerance.

Dietary challenge is a method where food and the test being given sublingually or by inhalation in an attempt to reproduce the symptoms. Again this may be helpful in small number of cases.

Most people who have acute allergies to food identify it and stop taking the food, and do not usually require medical treatment. In rest of the patients, a small number seem to be helped by modifying their diet, but there is no good scientific substantiation to prove these exclusion diets.

Asthma And Your Child

If your child is suffering from asthma, here is good news for you. By regular treatment from the guidance of your physician, he can live an absolute normal life. It is very common for them to get depressed at times and it is your responsibility to boost them up through your positive attitude like:

• Encourage your child to participate in normal day to day activities.
  
• Encourage him to do what he enjoys most.
  
• Encourage him to be independent.
  
• Teach him the facts about asthma, when he will be mature enough to understand.
  
• He should be made responsible for taking his medicines regularly.
  
• He should be able to contact emergency in need.
  
• Inform school authority regarding his asthma.
  

Childhood Asthma - Frequently Asked Questions (FAQ)

Q1. Can my child outgrow asthma?

Answer: Some child outgrows asthma as they grow older. In some it stops for some time and then recurs and in the rest it persists.

Q2. W ill my other children also be affected with asthma?

Answer: Asthma is not a contagious disease and not transmitted from person to person. Since this tends to run in the families, chance of them of being affected cannot be ruled out but not necessarily that does not mean that they will be affected as a rule!

Q3. Can my child exercise?

Answer: It is very important to do exercises. Swimming, Yoga and breathing exercises help to relieve asthma in a great way. In case he cannot, consult with your physician, he will titrate the doses and prescribe graded exercise till he reaches the normal level.

Q4. Should my child have special diet?

Answer: Not much known about the role of diet in asthma. Any trigger factor known to be present in diet must be completely avoided. Breastfeeding in infants increases immunity and helps the child to fight asthma better.

Q5. What to do when he starts going to school?

Answer: Don't hide his asthma from his teacher and the school authority. They should be properly informed regarding his treatment schedule. He must carry his medicines along in the school.

Q6. Can I send him to school trips?

Answer: If the asthma is properly controlled, yes you can. The accompanying teacher must be well informed about your child's asthma and its management protocol. He should carry all the medicines, including the emergency medicines along with him.

Frequently Asked Questions (FAQ) about Asthma:

Here are few frequently asked questions by the asthma sufferers with their answers:

Q1. Can I lead normal life?

Answer: Never expect anything less than that. Stick to the regime prescribed by your doctor. Trust him and please don't listen to them, around you, who know everything about anything! It is sure that you will lead a perfect normal healthy life in all respect.

Q2. When preventer medicines are needed?

Answer: Though it is your doctor can judge and tell you the best; here are few thumb rules:

• When cough, wheeze and difficulty in breathing is hampering your normal activities 2 – 3 times a week.
  
• Your sleep is getting disturbed for few nights a week.
  
• You are requiring the reliever drugs for 2 – 3 times a week.
  

Q3. The preventers, which I know are steroids, are safe to use for long term?

Answer: Yes they are safe as long as you are taking them in proper doses as prescribed by your doctor and taking them regularly. Don't forget to wash your mouth after taking the puff to wash away the remnant medicines from your oral cavity.

Q4. I have heard that the medicines have side effects.

Answer: Taking in proper doses regularly as advised by your physician has negligible, if any, side effects relative to your suffering in asthma.

Q5. Are the asthma drugs addictive?

Answer: No way they are addictive. Of course you have to take them regularly for prolonged periods to keep yourself symptom free, but that does not mean that they are addictive. In that way water should also be called addictive!

Q6. Can I exercise?

Answer: Exercising help asthmatics. Swimming, Yoga and breathing exercises are particularly helpful. Limit you exercise up to your tolerance level and raise the level gradually towards expected level. In case you found it is difficult consult your physician, he will regulate the doses for you.

Q7. I am asthmatic. Can I smoke a little?

Answer: Just don't. Even passive smoking must be avoided. Smoke will irritate your airway, thereby narrowing it will aggravate your asthma.

Q8. I am on asthma medication. Can I be pregnant or breast feed my baby?

Answer: It is very important to continue your asthma medication throughout your pregnancy. If not, it will hamper mother's health as well as growth and development of the baby. The only way to control asthma is regular inhaler therapy as prescribed. Breast feeding has no problem with asthma medication.

Q9. Is it safe to travel for the asthmatics?

Answer: If in control, asthmatics can travel by any mode of transport. Do carry your medicines, which are required and the medicines you may require in case of sever attack. Consult your doctor before starting your journey.

Understanding The Treatment Of Asthma

Main aim of treatment of asthma is to ensure:

1. The person symptom free or, minimal symptoms.
   
2. Sound sleep at night without any symptoms.
   
3. He should not miss any normal activities like work and studies, and other physical activities due to asthma.
   
4. To stop visiting hospital emergencies and admitting now and then.
   
5. Nil or, minimal side effects from the medicines.
   

Treatment of asthma has to be designer and it varies from person to person. Your doctor will tailor made the regime, which suits you most.

There are two types of medications for asthmatics.

• Quick relief or, in other words relievers
  
• Preventive measures or, preventers.
  

Relievers:

These should act immediately to relieve your symptoms by widening your airways. Their action lasts for 4 – 6 hours and help to relieve your breathing problem and cough, associated with the acute attack.

Preventers:

They are the key medicines for managing asthma and not meant for giving you immediate relief. Regular use of them keeps your airway protected from acute attacks.

Different ways of taking asthma medicines:

There are three routes, by which medicines reach lungs to relieve asthma

1. You puff
   
2. You swallow
   
3. Take injections
   

Puff or Inhaler:

Being the treatment of first choice, the most commonly used form of treatment today are inhalers. Though there are many myths and misconceptions regarding the inhalers, which I will elaborate later in this article, for the time being, I want to stress upon, this is the only way by which you can lead a normal life.

Here the medicines are directly going to your lungs. Like you are using the eye drops for your eye sore and ear drops for your ear problems. A minute quantity of medicine is required to bring upon a desired effect, relative to the oral medications and thus the side effects are eventually nil or negligible.

There are many types of inhalers found in the market. The major types commonly used are:

• Powder inhaler or, Rota haler
  
• Spray inhaler or, metered dose inhaler
  
• Nebulizers – Mostly used in hospital to control an acute severe attack. Here medicines are in a form of a mist and breathed by the patient by normal respiration.
  

Swallow or, oral medicines:

Tablets and syrups were used in rampant few years back. They work by reaching the blood stream from your stomach and then to the lung to produce the results. Much larger doses are necessary to achieve the desired effect thus results in higher side effects.

Injections:

They are required to control severe intractable attack of asthma, not controlled by inhaler or nebulizers.

Myths and Misconception regarding inhalers:

Myth I: Inhalers are the last resort for treatment of asthma

Truth: They are the first choice even in mildest cases.

Myth II: Inhalers are addictive:

Truth: This is the only way you can control asthma. No question of addiction is there but you have to take those regularly to prevent the attack.

Myth III: The inhalers are very expensive.

Truth: They actually save your life as well as money by increasing your efficiency, preventing hospitalization and expensive treatments. The best part is they protect your lung from acute life threatening attacks.

Know the factors, which aggravate or, precipitate asthma

Asthma triggers are the substances, which precipitates the asthma attack in a person. There is a list of very common triggers and there may be a particular trigger for a particular person. The affected person learns quickly their triggers and they should avoid those triggers as far as practicable.

Let us know some of the common triggers:

• Virus and cold: 80% asthmatics are sensitive.
  
• Smoky place and cigarette smoke: 70% asthmatics are sensitive.
  
• Cool Breeze: 60% asthmatics are sensitive.
  
• Household dust: 70% asthmatics are sensitive.
  
• Air Pollution: 40% asthmatics are sensitive.
  
• Pollen grain: 50 % asthmatics are sensitive.
  
• Physical exercise and strain: 80% asthmatics are sensitive.
  
• Feather and furs of pets: 80% asthmatics are sensitive.
  

The other triggers commonly found are paint fumes, flour dust, wood dust, grains and even emotional strains can precipitate or aggravate the asthma attacks.

Steps one should take to avoid triggers:

• Keep the pets outside your bed room. Give them bath once a week, if possible by some other person than the affected one.
  
• Avoid flowering plants in the home
  
• Don't do dusting of furniture with dry cloth. Better take a wet cloth and wipe the dust.
  
• Avoid using carpet. Carpet attracts dust and will aggravate the sufferings.
  
• Wash bed cover, pillow cover, soft toys etc at least once a week with warm water.
  
• Clean the A/C and air cooler filter frequently.
  
• While painting your home cover your nose and mouth with clean handkerchief.
  
• Don't smoke and don't allow other to smoke beside you.
  
• Keep your kitchen and bathroom airy. This will prevent mould and fungus, a known trigger.
  
• Use scarf to cover your head and neck in cold.
  
• Know if any medicine, you are sensitive to. Tell your doctor before hand. Pain killers, some antibiotics and some medicines for hypertension ( beta blocker) are better to avoid.
  
• While exercising take your preventive inhaler before hand. Properly warm up and cool down before and after exercise.
  
• Excessive emotion, laughing, crying are known to precipitate attacks. Try to avoid as far as practicable.
  

Know whether you have asthma?

Shortness of breath, a tight feeling in the chest, cough and wheeze while breathing are the main symptoms of asthma. The wheezing sound is sometimes so prominent and so specific of asthma; people easily recognize it as asthma.

The symptoms differ from person to person and even in the same person at different times. Some people may have all the symptoms together while some present only with one e.g. tightness in chest or cough.

The other symptoms are:

• Disturbance in sleep:

If somebody wakes up at night suddenly by vigorous cough, the most likely cause is asthma. Asthma tend to worsen at night and early morning.

• Breathing problem on physical strain :

When asthma patient exercises, they are prone to develop breathlessness early. They quit exercising because of sudden onset of cough and wheezing.

• Cough and cold:

For all people, during the change of season it is fairly common to catch cough and cold; but with asthmatics this cough does not clear up easily with other symptoms. It is common to think it is a chest infection, which is not actually the case. In fact the most common cause of long standing cough is asthma.

You Need To Know Asthma

Nowadays Asthma is neither a stigma and nor a terrifying disease. Since last two decades major advances are made in understanding the disease, its prevention and management. By the recent diagnostic methods and the treatments, both preventive and curative, one can enjoy life like a normal person, provided he sticks to the treatment offered by the doctor, without listening to so many wise persons, who know everything of anything, around him.

Through the following few articles, you will be able to understand asthma better. You will know why asthma occurs, how to prevent and treat asthma and so on.

Let us start with – What is asthma?

Asthma is primarily a disease of the lungs. Sufferers tend to have difficulty in normal breathing and they usually cough vigorously. This happens because, the airways, which is used for breathing become narrower than usual. The muscles around that pipe become tighter, the inner lining of the tube, which is known as mucus membrane swells up, which in medical term we say oedema, they produce sticky secretion (mucus). These altogether set up a condition, when air is blocked while they go in or come out of the lungs.

Asthma is very common condition and it affects people irrespective of age, sex, race, ethnicity, country. Asthma tends to run in families too. Sometimes it may skip few generations to affect a person in a same family!

But the best news is asthma is treatable. It should be diagnosed properly. Forget all the myths, which I will tell you in my next few articles, one can live absolutely normal life, and expect nothing less than that.

Just to boost your morale here are the names of few celebrities who are the victims of asthma and won it.

• Saurav Ganguly – Former captain of Team India Cricket
  
• Ian Botham – Former captain of England Cricket Team
  
• Jackey Joyner Kersey – Athlete
  
• Dr. Rajendra Prasad – First President of India
  
• Indira Gandhi – Former Prime Minister of India
  
• John Kennedy – Former President of America
  
• Amitav Bachhan – Actor
  
• Sharon stone – Actress
  
• Kenny G – Musician
  
• Charles Dickens - Novelist