What is wheat allergy called
An oral challenge test can cause a severe allergic reaction. That’s why this test is only given under shut supervision by an allergist.
You may get an allergic reaction during an elimination diet. You should talk to your allergist about how to manage potential reactions.
A skin prick test can annoy the skin. If your skin is itchy or irritated after the test, your allergist may prescribe medicine to relieve the symptoms. In rare cases, a skin test can cause a severe reaction. So this test must also be done under shut supervision by an allergist.
There is extremely little risk to having a blood test.
You may own slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.
Why do I need food allergy testing?
You or your kid may need food allergy testing if you own certain risk factors and/or symptoms.
Risk factors for food allergies include having:
- A family history of food allergies
- Other types of allergies, such as hay fever or eczema
- Other food allergies
Symptoms of food allergies generally affect one or more of the following parts of the body:
- Skin. Skin symptoms include hives, tingling, itching, and redness.
In babies with food allergies, the first symptom is often a rash.
- Digestive system. Symptoms include abdominal pain, metallic taste in the mouth, and swelling and/or itching of the tongue.
- Respiratory system (includes your lungs, nose, and throat). Symptoms include coughing, wheezing, nasal congestion, trouble breathing, and tightness in the chest.
Anaphylactic shock is a severe allergic reaction that affects the entire body.
Symptoms may include those listed above, as well as:
- Tightening of the airways and trouble breathing
- Pale skin
- Rapid swelling of the tongue, lips, and/or throat
- Fast pulse
- Feeling faint
Symptoms can happen just seconds after someone is exposed to the allergic substance. Without quick medical treatment, anaphylactic shock can be fatal. If anaphylactic shock is suspected, you should call 911 immediately.
If you or your kid is at risk for anaphylactic shock, your allergist may prescribe a little device you can use in an emergency. The device, which is called an auto-injector, delivers a dose of epinephrine, a medicine that slows below the allergic reaction.
You will still need to get medical assist after using the device.
So, You’ve Been Diagnosed with Hives!
by Richard S. Roberts, M.D.
Do you really own the Hives?
Don’t despair. You’re not alone. Approximately 20% of the population will own hives (urticaria) at one time or another during their lifetime. First off, are you certain that they’re really hives? True hives are red, itchy, generally raised lesions that look very much love mosquito bites. They are often circular or oval but can be irregularly shaped.
Their size may vary from ¼ inch to several inches in diameter. They may blend together. Each spot lasts anywhere from 4-36 hours and is surrounded by normal looking skin. As they resolve the skin looks normal, not flaky or rough. While the hives are present one spot will be resolving while another nearby is developing. In about 40% of cases localized swelling (angioedema) of the lips, eyelids, hands, feet or tongue also occurs.
So, if these are really hives they must be from an allergy, right? Well, unfortunately it’s not that simple and modern science doesn’t own every of the answers.
The history of how they first appeared and what’s happened to them since can provide significant clues as to what category of hives you own. But first, what actually is a hive?
Everyone’s skin is made up of numerous types of cells. One of these cells is called a mast cell. Everyone’s mast cells make and store histamine. They also routinely make leukotrienes and other substances that can cause localized inflammation. Mast cells don’t generally release much of these substances into the surrounding skin but if they do, these substances, especially histamine produce localized redness, itch and swelling we recognize as a hive or if it’s slightly deeper, angioedema.
So, if acute hives don’t seem to own an allergic cause what else could be going on? One of the more common presumed causes, especially in children is post-infectious hives.
During or within a week of viral, strep or other infections hives may happen through poorly understood mechanisms. This often leads to confusion when antibiotics own been given for the infection. Were the hives from the antibiotic or from the underlying illness? Post-infectious hives can recur for up to 6 weeks. At times, even without infection or any obvious trigger a few hours to a few days of hives happen. These are called acute idiopathic hives. We assume that the immune system is inappropriately activating the skin mast cells but we don’t know why. We don’t ponder that stress is a common cause.
So, your hives own gone on for more than 6 weeks, so they drop into the chronic urticaria category.
Now what? Once again you’re not alone. Approximately 3 million Americans of every ages own the same problem. There are some significant things that you should know. The first is that, unlike acute urticaria, less than 5% of the cases are due to some external cause. Also, unlike acute urticaria, the hives and /or swelling are rarely dangerous. In this form of hive problem various quirks and idiosyncrasies of the immune system, as they relate to mast cells, are the primary cause.
Our understanding of the problem is improving but there are numerous unanswered questions. The best understood of these idiosyncrasies is called chronic autoimmune urticaria.
Approximately 45% of every chronic hives are of this type. In this condition the immune system makes a detectable antibody (for which we own a test) that mistakenly thinks that parts of the mast cell surface are the enemy. This antibody attacks the skin mast cells which leads to the release of histamine, etc. It’s been known for a endless time that if our body makes one autoantibody type of error it’s easier for it to make other autoantibody mistakes. Therefore, it’s not terribly surprising that in chronic autoimmune urticaria approximately 20% of patients, especially women, will also own autoantibodies that target the thyroid gland.
This may lead to Hashimoto’s thyroiditis and periodically blood tests for thyroid function should be checked. Unfortunately, treating this thyroid condition probably does not benefit the hives.
The next most common type of chronic urticaria is chronic idiopathic urticaria.
This condition is almost certainly due to the immune system’s interaction with mast cells but the details are unknown. Both chronic autoimmune and chronic idiopathic urticaria may worsen during febrile illnesses, with the use of aspirin family medicines, prior to the monthly menstrual period or with sustained pressure to or rubbing of the skin.
Individual hives that sting more than itch, leave bruises and final 3 or more days may indicate hives due to vasculitis (inflammation of the blood vessels).
Other forms of chronic hives own to do with the immune system’s reaction to physical triggers. Hives produced by stroking of the skin is called dermographism. Some people’s hives are triggered just by freezing, heat, skin pressure, vibration, exercise, sun or even water. These conditions are fairly rare. Some exercise induced patients can either react just to exercise while others react only if their exercise follows the consumption of a food to which they are mildly allergic, most commonly wheat, celery and shellfish.
These exercise reactions can produce anaphylaxis and may be dangerous. Another dangerous condition, this one involving angioedema and never hives, is called hereditary angioedema. In these patients swelling of the upper airway can be fatal. Such patients also generally own pronounced abdominal pain from swelling of their intestines. Treatment is available.
So, now that you’ve put your hives into a category how are they treated? For acute hives and rare cases of chronic hives avoidance of triggers is the key.
If the acute hives are already present antihistamines and if severe, a short course of oral steroid is used. For chronic hives daily preventative antihistamines are essential. Doses higher than those used for nasal allergy treatment are often needed. If maximum antihistamine dosing has been reached without control, addition of an H2 blocker (e.g. Tagamet) and/or a leukotriene blocker (e.g. Singulair) may be tried. Maximizing the above therapy should minimize the need for oral steroid. Relying on recurrent courses of oral steroids (prednisone) especially without full antihistamine, H2 blocker and anti-leukotriene support is to be discouraged. In rare cases cyclosporin or other immunomodulatory medicines may be added.
Once control has been achieved medicines should be continued for several weeks or longer past the final symptoms. Slow tapering can then be attempted.
So, why are my mast cells releasing histamine and other things when they shouldn’t? The first question that needs to be asked is for how endless own you had hives? Hives that own been present intermittently or daily for less than 6 weeks are called acute hives, and if longer, chronic hives. Amongst the numerous possible causes of acute hives those due to allergic reactions get the most attention.
In allergic patients the mast cells are coated with an allergy antibody, called IgE, that recognizes a extremely specific target (peanut, penicillin, yellow jacket, etc.). When that substance, such as peanut, becomes attached to that allergy antibody a chain reaction occurs that activates the mast cell which results in the release of histamine and other inflammatory substances. A hive is born! For food allergy reactions, there are 3 useful rules to consider:
- First, the reaction begins quickly, within 5-30 minutes of eating the food; on rare occasions up to an hour but almost never longer.
- Second, it goes away within a few hours or at the most within a day or two.
Therefore, you never get hives for a week from one serving of peanut butter.
- Third, the reaction is reproducible, meaning that if hives were caused by eating 4 peanuts on a Monday, eating 4 peanuts the following week will almost always cause the same problem.
Despite favorite belief, artificial food colorings and food additives almost NEVER cause hives.
Hives from antibiotics is a diverse situation. The hive reaction can start anywhere from a few minutes after the first dose to 10 days after finishing the course. Antibiotic related hives can persist for up to approximately 2 weeks.
Allergic hives from stinging insects are generally obvious but occasionally they can be sneaky by occurring while you’re asleep or distracted. They start quickly after the sting and resolve in a few hours to a few days. In the U.S. spiders, flies and mosquitoes almost never cause hives although rare cases own been reported.
Almost any medicine or herbal product can potentially cause hives but one of the most common medicines implicated is the aspirin family (aspirin, ibuprofen, naproxen, etc.).
Isolated swelling without hives is a unique side effect of the ACE inhibitor blood pressure medicines. Soaps, detergents, fabric softeners almost never cause hives but if they do, the hives happen only where the skin is touched. Airborne allergy to pollen, dust, etc. almost never causes hives unless the person is in the midst of a massive hay fever attack. In an allergic person, direct skin contact with a potent allergic substance love animal saliva or latex can cause hives at the site. Every categories of allergic hives are potentially dangerous while chronic hives are generally not.
So, what’s my prognosis Doc?
As noted above:
- Acute hives resolve spontaneously.
- Less than 30% of idiopathic acute hives will go on to be chronic.
- If you own chronic hives that aren’t of the “physical” type at least 50% will resolve in less than a year and another 20% will resolve over the next several years.
The “physical” hives tend to be more endless lasting.
Research is ongoing in every of these areas. So hold your chin up, take your antihistamine, and get the necessary attention to the type of hives that you have.
What is food allergy testing?
A food allergy is a condition that causes your immune system to treat a normally harmless type of food as if was a dangerous virus, bacteria, or other infectious agent.
The immune system response to a food allergy ranges from mild rashes to abdominal pain to a life-threatening complication called anaphylactic shock.
Food allergies are more common in children than adults, affecting about 5 percent of children in the United States. Numerous children outgrow their allergies as they get older. Almost 90 percent of every food allergies are caused by the following foods:
- Tree nuts (including almonds, walnuts, pecans, and cashews)
For some people, even the tiniest quantity of the allergy-causing food can trigger life-threatening symptoms.
Of the foods listed above, peanuts, tree nuts, shellfish, and fish generally cause the most serious allergic reactions.
Food allergy testing can discover out whether you or your kid has a food allergy. If a food allergy is suspected, your primary care provider or your child’s provider will probably refer you to an allergist. An allergist is a doctor who specializes in diagnosing and treating allergies and asthma.
Other names: IgE test, oral challenge test
Will I need to do anything to prepare for the test?
You don’t need any special preparations for a food allergy test.
What happens during food allergy testing?
The testing may start with your allergist performing a physical exam and asking about your symptoms.
After that, he or she will act out one or more of the following tests:
- Oral challenge test. During this test, your allergist will give you or your kid little amounts of the food suspected of causing the allergy. The food may be given in a capsule or with an injection. You’ll be closely watched to see if there is an allergic reaction. Your allergist will provide immediate treatment if there is a reaction.
- Skin prick test. During this test, your allergist or other provider will put a little quantity of the suspected food on the skin of your forearm or back.
He or she will then prick the skin with a needle to permit a tiny quantity of the food to get beneath the skin. If you get a red, itchy bump at the injection site, it generally means you are allergic to the food.
- Elimination diet. This is used to discover which specific food or foods is causing the allergy. You’ll start by eliminating every suspected foods from your child’s or your diet. You will then add the foods back to the diet one at a time, looking for an allergic reaction. An elimination diet can’t show whether your reaction is due to a food allergy or a food sensitivity.
An elimination diet is not recommended for anyone at risk for a severe allergic reaction.
- Blood test. This test checks for substances called IgE antibodies in the blood. IgE antibodies are made in the immune system when you are exposed to an allergy-causing substance. During a blood test, a health care professional will take a blood sample from a vein in your arm, using a little needle. After the needle is inserted, a little quantity of blood will be collected into a test tube or vial.
You may feel a little sting when the needle goes in or out. This generally takes less than five minutes.
What is it used for?
Food allergy testing is used to discover out if you or your kid has an allergy to a specific food. It may also be used to discover out whether you own a true allergy or, instead, a sensitivity to a food.
Food sensitivity, also called food intolerance, is often confused with a food allergy.
The two conditions can own similar symptoms, but complications can be extremely different.
A food allergy is an immune system reaction that can affect organs throughout the body. It can cause dangerous health conditions. Food sensitivity is generally much less serious. If you own a food sensitivity, your body can’t properly digest a certain food, or a food bothers your digestive system. Symptoms of food sensitivity are mostly limited to digestive problems such as abdominal pain, nausea, gas, and diarrhea.
Common food sensitivities include:
- Lactose, a type of sugar found in dairy products.
It may be confused with a milk allergy.
- MSG, an additive found in numerous foods
- Gluten, a protein found in wheat, barley, and other grains. It is sometimes confused with a wheat allergy. Gluten sensitivity and wheat allergies are also diverse from celiac disease.
In celiac disease, your immune system damages your little intestine when you eat gluten. Some of the digestive symptoms can be similar, but celiac disease is not a food sensitivity or a food allergy.