Food Allergy ,, Growing Public Health Burden

Written by: Dr. Magdy Badran

CAIRO, Nov. 9 (SEE) - Food allergy is an immune system reaction that occurs soon after eating a certain food. It is increasingly recognized as a growing public health burden, it has been referred to as the “second wave” of the allergy epidemic, following asthma and has been increasing in prevalence in the last few decades.

It affects an estimated 6 to 8 percent of children under age 3 and up to 3 percent of adults, 3% of infants and toddlers have the milk allergy and 3% of school-age children have the peanut allergy.

Food allergens are the substances of food which can stimulate an allergic reaction. About 90% of all reactions result from the consumption of eight foods: cow's milk, shrimp, eggs, fish, peanuts, soybeans, nuts, and wheat.

Even a tiny amount of allergy-causing food can trigger symptoms such as digestive problems, hives or swollen airways. Mild symptoms include rash, itching, and swelling of the lips and tongue.

More severe symptoms can include trouble breathing, wheezing, throat swelling, and nausea, vomiting or diarrhea. Cutaneous manifestations are the most common manifestations, followed by oral allergy, diarrhea, infant colic, asthma, and rhino-conjunctivitis. A very severe allergic reaction is called anaphylaxis, which can be life-threatening and requires immediate medical attention.

Allergic eosinophilic gastroenteritis is a special type of food allergy which may cause nausea, vomiting, abdominal pain, diarrhea, malabsorption, gastrointestinal bleeding, intestinal obstruction, and ascites.

Food allergy may be a risk factor for anxiety, depression and severe psychological distress. Living with food allergies constitutes a unique stressor: daily meals and snacks can trigger a rapidly-progressing, life-threatening allergic reaction.

Exclusive breastfeeding has a preventive effect on the early development of allergic diseases; asthma, allergic dermatitis, and allergic rhinitis, up to 2 years of age.

In infants and children, it is important to eliminate as few foods as possible and for as short a period of time as possible. Cautious re-introduction of a "prohibited" food should be attempted after 6-12 months. The natural history of food allergy in many children is of gradual improvement of symptoms.

The earlier a child is exposed to allergens, the more likely they are to cause an allergic reaction. Where there is a family history of allergy, solids should not be introduced before 6 months, start with the least allergenic food first, such as baby rice, pears, and yellow vegetables. Introducing 1 new food per week.

All foods even fruits should be cooked. At the age of 9 months, green vegetables & meat may be started. Do not introduce wheat and soy until 12 months, cow's milk until 12 months, eggs until 18-24 months and peanuts, nuts, fish, and shellfish until 36 months.

Current guidelines for food allergy management include education, strict and careful food avoidance, nutritional monitoring, appropriate treatment of anaphylaxis and regular medical follow-up. Patients are encouraged to read ingredient labels and avoid cross-contamination.

Patients who have experienced a life-threatening reaction to any food should wear Medic-Alert discs. Future therapy of Food Allergy focuses on rice protein, friendly bacteria, and Immunotherapy.