Tips on How to Treat a Food Allergy Reaction

Most of us know whether we have an allergy to certain foods. There are exceptions, though. Children often don’t know for sure if they have a food allergy.

Key takeaways:
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    Food allergy diagnosis and treatment may be challenging.
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    Food allergy reactions may occur inadvertently from accidental ingestion or contact, cross-contamination, or hidden allergies.
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    Treatment of food allergies should start with avoidance and a clear diet elimination plan.
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    Treatment of food allergies includes mainly antihistamines and injectable epinephrine with other adjunctive therapies.

Sometimes there are hidden ingredients to foods, unknown foods used in food preparation, which we're not aware, such as nuts, or cross-contamination of foods like at a buffet.

What are food allergies?

Food allergies are immune responses that cause adverse effects from certain foods. In theory, any food protein can trigger an immune response. Hundreds, if not thousands, of food allergies have been described.

Signs and symptoms of food allergies can range from mild gastrointestinal symptoms like nausea or vomiting to more severe, even life-threatening symptoms like trouble breathing or swallowing, or angioedema which is severe throat swelling and obstruction.

If a food allergy reaction is suspected, it is important to obtain a complete list of the foods which may be the culprits, how the foods were prepared or cooked, or any personal or family history of food allergies. Other intangible factors like whether the person was exercising, taking anti-inflammatory medications, or drinking alcohol can cause an ordinary mild food allergy to become serious.

Other important information to gather is the route of the exposure and how much. Some food allergic reactions can be caused by skin contact or inhalation in addition to ingestion. The timing of the onset of symptoms and duration are important too.

Determining a food allergy diagnosis may be challenging. Therefore, the diagnosis is important, but it does not change the immediate management of someone who is suffering from an allergic reaction to food.

Later, once the allergic reaction to food is treated successfully, then the person can undergo laboratory studies, skin testing, or diet-related diagnostic measures such as a diet diary, elimination diet, or a food challenge.

What is the only proven treatment for food allergy?

The only proven treatment is prevention. That means strict dietary elimination of the offending food allergen. But that is not always possible and there can be inadvertent exposures to foods that can cause known or hidden allergic reactions.

An elimination diet must be managed and planned to include:

  • Education of parents and families.
  • Avoidance of cross-contamination (eg, through shared plates, utensils, or cooking surfaces).
  • Elimination of only those foods that are confirmed to provoke allergic reactions.
  • Pre-emptive anticipation of potential food allergy candidates such as avoiding all nuts not just peanuts.
  • Avoidance of high-risk situations such as picnics or buffets.

Best ways to treat someone with a food allergy reaction

Accidental or inadvertent ingestions or contact with food allergens can occur, particularly with children. There is no benefit to anyone to begin scolding or lecturing the child if something happens. Making the person upset may worsen the symptoms and even cause more significant airway compromise.

It may seem obvious that further exposure to the food allergen by either ingestion or otherwise should be halted. But in some cases, this may be a concern, however. The person should be warned to stop eating or having contact with an offending agent before matters worsen. A good example may be a child continuing to eat something that they shouldn’t.

Strategies for dealing with potential food allergies are vital. There should be a concise, written emergency plan which is personalized for the person who has known food allergies. This plan should be clear to family, friends, and any potential caretakers such as at school, daycare, work, counselors, and clergy if the person spends time at church.

Most people with known food allergies should have medical identification jewelry. This is usually either a bracelet or necklace with clear information about what the person is allergic to, how severe the reaction may be, and what to do in case of an emergency.

Emergency contact numbers should be readily available. In cases involving children, it may be a good idea to have anticipatory guidance measures such as warning the child to avoid all nuts if they are allergic to peanuts.

Symptoms may include panic

If the person is exposed to a food allergy, the symptoms may manifest initially with a rash, but then progress to more serious symptoms such as mouth and tongue swelling, hives, difficulty swallowing or breathing, and a feeling of impending doom.

While panic may seem like a natural response, it is never a helpful reaction on either the patient’s side or those witnessing the allergic food reaction. Staying calm, measuring the need for an appropriate response, and methodical planning is vital to the success of any food allergy situation.

How to treat a food allergy

Antihistamines are a good first step. They can be either in the drowsy or non-drowsy form and usually, the non-drowsy version is best. Antihistamines will strategically block the histamine release and prevent much of the severity of the food allergy reaction in most cases.

H-2 blockers can be added. These are medications usually used for the treatment of gastroesophageal reflux or heartburn, but they can add to the histamine blockage.

If the food allergy reaction worsens, it is important to manage the person’s breathing or swallowing whenever possible. This means clearing the person’s airway and making sure they have the best chance of taking slow, deliberate breaths. It is not a good idea to have the person continue to eat or drink because there may be an increased risk of choking or aspiration (having liquids flow down into the lungs instead of the esophagus).

The drug of choice for a food-induced anaphylactic reaction (severe) is injectable epinephrine. Anyone who has a known risk of anaphylactic reactions. Injectable epinephrine should be self-injectable and readily available to the person. All individuals who have injectable epinephrine should be properly trained in its use.

Other adjunctive measures include bronchodilators, corticosteroids, and glucagon, but these should never be substituted for injectable epinephrine and are usually given by healthcare professionals. In severe cases of hypotension (low blood pressure), intravenous fluids are given.

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