Food Allergy Treatment

Food Allergy Treatment

Also called: Emergency Treatment, Food Elimination, Dietary Restriction

Summary

The only reliable treatment for a food allergy is the complete elimination of food allergens from the diet. Food allergies can result in a fatal reaction if not properly treated through avoidance. Avoiding problem foods, though often difficult, allows a person to completely avoid food allergy symptoms. 

Individuals with a food allergy will need to modify their diets to avoid problem food allergens. However, diligently working to avoid allergens is well worth the effort. An individual should work with a physician or dietitian to learn how to:

  • Properly check food labels for problem ingredients
  • Find hidden sources of food allergens
  • Check to make sure a restaurant or dining facility is safe
  • Avoid places where accidental allergen exposure might occur

If accidental exposure to a food allergen does occur, it is possible for the allergic individual to very rapidly go into life-threatening anaphylactic shock. For this reason, people should always use the drug epinephrine at the first sign of a strong food allergy reaction, or if they have knowingly ingested an allergen. Epinephrine quickly opens up the airways to restore normal breathing. People who have strong allergic reactions to food are advised to carry epinephrine injections and self-administer the medication as needed. These individuals are also advised to carry a medical alert bracelet or necklace to inform healthcare workers of their condition. After using epinephrine, a patient should always call for an ambulance.

There are also several medications that can help relieve the symptoms of an allergic reaction if exposure to an allergen does occur. These medications are capable of reducing allergy symptoms, and some can provide emergency treatment in the case of a severe reaction. The types of medications used to treat allergy symptoms include:

  • Antihistamines (interfere with the allergic reaction itself)
  • Bronchodilators (open the airways and loosen mucus in the lungs)
  • Corticosteroids (reduce or prevent inflammation)

People may be tempted to try alternative allergy treatments for relief from food allergies. Most of these types of treatment are untested, and most physicians are skeptical of their use. Patients should involve their physicians in any treatments that they are considering for the relief from or prevention of allergy symptoms.

About food allergy treatment

The only way to effectively treat a food allergy is to avoid contact with any problem foods. However, even very careful individuals can occasionally come into contact with food allergens.

Eight types of food are responsible for over 90 percent of food allergies:

  • Cow’s milk
  • Eggs
  • Peanuts
  • Wheat
  • Soybeans
  • Fish
  • Shellfish
  • Tree nuts

People with one or more food allergies will need to modify their diets to avoid problem food allergens. This is not as simple as it sounds, since components of foods can appear in products even when the whole food is not obviously present. For instance, lecithin (a food ingredient often made from soy) can be found in baked foods, canned tuna and sauces.

Food allergy treatments are designed to disrupt or prevent the allergic cascade that is triggered when an individual consumes a food allergen. During an allergic reaction the immune system mistakes food protein for a harmful substance and produces immunoglobulin E (IgE) antibodies to defend against the “invader.” 

The most severe kind of food allergy reaction is the potentially life-threatening condition known as anaphylactic shock. This condition involves multiple organ systems, including constriction of the airways and difficulty breathing, and requires a specific type of treatment known as an epinephrine injection. This form of adrenaline can quickly counteract an anaphylactic reaction and restore normal respiration during an attack.

Physicians recommend that anyone who suffers from severe food allergy reactions carry an epinephrine injection (allergy kit) with them at all times and know how to use it. An individual should use epinephrine at the first sign of a food reaction, or immediately if a food allergen has been knowingly ingested. People who are frequently around the patient (e.g., family members, coworkers, school or daycare staff) should also know how to administer the drug. Countering a food allergy reaction early greatly reduces the chance of having a more powerful, harmful reaction. However, a person should also always call for an ambulance after using an epinephrine injection, even if symptoms subside. Additional medical attention is necessary because the drug may fail to adequately control the reaction.

When being treated for a strong food allergy reaction, it is important to inform the physician or healthcare worker if any corticosteroids, ACE inhibitors or beta blockers have been taken, as these may interfere with treatment.

Besides medication, there are several general tips that are good to follow in the event a food allergy reaction does occur:

  • For reactions that involve hives or skin irritations, take cool showers and wear light clothing that is not uncomfortable to the skin.

  • Try to keep activity levels low. An elevated pulse can circulate allergens through the body faster.

  • If feeling light-headed or faint, try to lie down and elevate the legs. This makes it easier for blood to flow to the head, reducing the chance of unconsciousness.

  • If symptoms continue to worsen, or a severe reaction is expected, immediately call an ambulance.

  • For stronger reactions, try to stay calm. Becoming excited could make a reaction worse. Immediately take epinephrine if it is available, and call for an ambulance.

People struggling to control allergy symptoms are often tempted to try alternative allergy treatments. These nontraditional allergy therapies are sometimes referred to as complementary and alternative medicine (CAM). Few alternative allergy treatments have been clinically studied. For this reason, most physicians advise against their use for this condition.

Medications used in food allergy treatment

When an allergic reaction to a food allergen does occur, the most common way to treat the reaction is with medication. Allergy medication is not a cure or antidote for an allergic reaction. Only avoidance of problem foods can successfully treat a food allergy. Instead, medications are used to relieve specific symptoms after a reaction has occurred. The medications that may be used in the treatment of food allergies include:

  • Epinephrine injection. A synthetic form of adrenaline that, when injected, is a powerful bronchodilator, opening breathing tubes and restoring normal respiration quickly. It also constricts the blood vessels, prevents fluid leakage and raises blood pressure.

    Epinephrine should be used at the first sign of a food allergy reaction since food allergies commonly involve life-threatening anaphylactic shock. Most physicians recommend that individuals who are susceptible to severe reactions carry an injection of epinephrine with them at all times and understand how to self-administer the drug. People who spend a lot of time with the patient should also know how to use the injectable device. After using epinephrine, a person should always call for an ambulance in case additional treatment is necessary. Individuals who carry epinephrine should also carry a medical alert bracelet or necklace to inform healthcare workers of their food allergy condition.

  • Antihistamines. Medications that provide relief for more common food allergy symptoms such as hives, sneezing, runny nose and gastrointestinal symptoms. Antihistamines directly counteract the effects of the histamines, which are responsible for most allergy symptoms. Antihistamines come in a variety of forms (e.g., pills, liquids, nasal sprays, topical creams, eye drops). Oral antihistamines are commonly used to control mild food allergy reactions. For more severe allergic reactions, a physician may recommend an injected form of antihistamine.
  • Bronchodilators. Medications that open the airways, relieving symptoms such as shortness of breath or wheezing. They also help loosen mucus in the lungs, making it easier to cough up and out of the body. They may be recommended for people whose food allergies trigger asthma attacks or asthma-like symptoms. They are usually breathed directly into the lungs using an inhaler, though they can also be administered through pills, liquids or an injection.

  • Corticosteroids. While there are several types of corticosteroids, all work on the same principle – reducing or preventing inflammation. Corticosteroids are used to treat food allergies and reduce or prevent inflammation in the respiratory tract to relieve or avoid airway blockages. Corticosteroids are considered the most effective medication currently available for the treatment of inflammation in the bronchial tubes. Some corticosteroids are associated with a wide range of side effects.

    This type of drug is administered through nasal sprays, topical creams and injections. Different forms are used for different reasons:

    • Corticosteroids by mouth (e.g., pills, liquids) and injection can be used to get control over a strong food allergy reaction. The onset of action is usually after several hours but is essential to prevent a recurrence or “late phase” reaction.

    • Some oral corticosteroids are designed to be used for several days to control the recurrence of allergy or asthma episodes. These would not generally be used to treat food allergies.

    • Topical corticosteroids may be recommended for skin-related symptoms, such as skin rashes.

Though not medications, allergy shots (immunotherapy) are a form of allergy treatment in which increasing, controlled doses of an allergen are injected into a patient over a period of time. The goal is to increase the patient’s tolerance to the allergen while reducing symptoms brought on by an allergic reaction.

Although immunotherapy is an effective form of treatment for some forms of allergies, it is not typically recommended for food allergies.  

Lifestyle considerations

People susceptible to the severe and potentially life-threatening type of food allergy reaction known as anaphylactic shock should carry an epinephrine injection (allergy kit) with them at all times. These individuals should know how to properly administer the drug in the case of a severe reaction. Family members, coworkers, teachers, daycare workers and other people commonly around the patient should also know when and how to administer epinephrine. Because of the quick onset associated with food allergy symptoms, a person should take epinephrine at the first sign of a food allergy reaction, or after knowingly ingesting an allergen. 

After identifying a reaction and taking epinephrine, a person should immediately call for an ambulance for further treatment and evaluation. Further doses of epinephrine or other drugs may be necessary. Patients should inform anyone providing treatment if they have recently taken any corticosteroids, ACE inhibitors or beta blockers. These medications can interfere with the treatment of a food allergy reaction.

Highly sensitive individuals should also carry a medical alert bracelet or necklace to inform healthcare workers of their condition.

People with food allergies need to make significant lifestyle changes to effectively remove the problem food from their diet. This often involves altering their diet and social habits, because people must be constantly vigilant against accidental contact with a problem food. Reading food labels for problem foods and learning any alternate names a dangerous food may be listed under are crucial. Allergic individuals must also be very careful when eating away from home, and should always inquire about cooking techniques and ingredients when eating out. 

Food allergies are manageable. With diligence and the proper knowledge of what foods and ingredients to avoid most people can completely avoid, allergy symptoms. People who suffer from food allergies are encouraged to work closely with their physicians to better understand how to manage their condition with a minimum of disruption.

Questions for your doctor

Preparing questions in advance can help patients to have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions related to food allergy treatment:

  1. What are my treatment options?
  2. What side effects are associated with my allergy medications?
  3. Am I a candidate for allergy shots?
  4. Should I carry an allergy kit with me at all times?
  5. What foods should I try to avoid?
  6. What terms should I look for when reading an ingredient label?
  7. What is the first thing I should do if I accidentally eat a problem food?
  8. When does an allergic reaction require a visit to the hospital?
  9. Should I still go to the hospital if I feel better after a dose of epinephrine?
  10. Would I benefit from any alternative allergy treatments?
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