MALADY OF AN ALLERGY

Did the god who gave us flowers and trees, also provide the allergies?

- Yip Harburg

I don’t know why I thought of doing an article on allergies.  I don’t have them nor does anyone close to me, my brother did have one when we were young, a proposed allergy of lead I suppose because he would start scratching his nose every time our mom made us study. (It was more of an allergy to studying I guess).  Allergies, are very interesting and intriguing, that’s what lured me. Allergies are an immune response, an exaggerated one, towards a harmless substance. It’s just a misunderstanding, or immune system misjudges and reacts without any rhyme or reason.

There are many types of allergies, in different forms and to different things, can be environmental, dietary, to medications (some people are allergic to antibiotics and can be treated using one if ever there be a need).  Most commons is food allergy. Our immune system reacts to a harmless food protein, this allergic reaction is known as anaphylaxis and is mediated by immunoglobulin E (IgE) specifically. The “Wrongly” presumed harmful food protein is termed as allergen.

Allergies in their potent form can be fatal. IgE , an antibody, on encountering “harmful” substance, releases chemicals like histamine, prostaglandins, leukotrienes and kinins, which are responsible for the wide array of symptoms- abdominal pain, nausea, vomiting, cyanosis, drop in blood pressure angioedema(swollen lips),  chest pain, urticara (rash), diarrhea and stroke, in extreme conditions, leading to death. 

Common food allergens largely affecting people are cow's milk, soy, eggs, wheat, peanuts, tree nuts, fish, and shellfish. People allergic to tree nuts may be allergic to one or all nuts like walnuts, pistachio, pecans, pine nuts and even seeds like poppy or sesame. Allergies are genetic in nature, meaning it runs in the family. Allergic parents are likely to have allergic kids however it may not be same kind of allergies.

An unusual kind of allergic reaction is observed in few cases where in an allergic reaction to a particular food normally tolerated well occurs after a rigorous exercise regime. This reaction is seen to manifest within an hour or two after the exercise. It is an isolated incidence and may or may not happen again, so it is not actually an allergy. It is known as food dependent exercise induced anaphylaxis (FEIAn).

Diagnosing the presence of an allergy is no simple task. First step involves identifying the particular food item that causes allergy. This can be done by elimination of suspected foods one at a time or by keeping a food-symptom diary, wherein a complete detail of food consumed is recorded by the person himself along with the symptoms, if they occur. Elimination of the suspected food products should be complete, avoiding its raw forms, cooked and even isolated proteins.

Followed by identification is immunological test, to determine the presence of an immune response towards that food product. A test called the pharmacia (CAPFEIA) (fluroscein enzyme immunoassay is a specific test with 96%accuracy in indentifying children with egg, milk, fish and peanut allergies. The efficiency of this test is limited to assessing allergies pertaining six foods- egg, peanut, milk, wheat, soy and fish. Another diagnostic tool is a skin test, also known as prick test.  They are economical and less time consuming, providing results within minutes. This test is useful in assessing eight food allergies which include- milk, egg, peanuts, soy, wheat, cod fish, cat fish and cashew.

There is no cure for allergies, in some cases they are outgrown with time, in others they are not. Medicines are prescribed to minimize immune reactions like steroids and epinephrine to counteract symptoms that occur on exposure to allergens. Total elimination of the allergy producing food is the only proven treatment. The main concern arising here is the compromise on the nutritional aspect of that particular food. Families and individual with allergies should seek professional help and seek guidelines on how to avoid allergic foods in the meal planning and how to replace foods with nutritionally balanced alternatives.

Careful selection and meal planning of food is important. Lists of all foods and products “not to be” purchased should be kept handy.  Caretakers and school personnel’s taking care of the child should be clearly informed about the allergies to prevent accidental exposures. Reading food labels and properly identifying ingredients before buying products is of great significance. Allergic foods may at times not be clearly listed or be hidden in an unfamiliar ingredient. For example mayonnaise is listed as an ingredient but not egg which is an ingredient of mayonnaise.

In Children till the age of two, hypersensitive to certain foods is commonly seen and these hypersensitivities are outgrown with age so careful observation is necessary.  Cow’s milk protein (CMP) is a most common allergen for infants. In such cases proper infant formulas should be selected through professional help which doesn’t jeopardize infant’s growth and development.  Introducing weaning foods at early stages replacing breast milk has shown to increase the chances of developing an allergy.  Therefore, Infants should be breast feed exclusively for six months. Foods known for their propensity to produce allergy like peanuts, eggs, tree nuts, milk and fish should be not introduced to the child till the age of 2-3 years.

Environmental allergens like pollens and latex expose themselves through certain fruits and vegetables. Latex allergy in some people can occur through fruits and vegetables handled by workers wearing latex gloves. Largely affected fruits are bananas, avocado, kiwi and chestnuts.

Many researches and experiments are being undertaken to discover ways to deal with allergies. A food immunotherapy vaccine is a possible future treatment. The main aim of this vaccine is to prevent allergic reaction (anaphylactic) or reduce the intensity of the reaction and prevent death when accidental exposed to an allergen.  It is still in experimental stage.

Probiotics, the healthy micro organism, found in curds and yoghurts and fermented products maintain the population and promote the growth of healthy and useful microorganism in the intestines. These probiotics when added  to the diet of an expectant mother or given to  infants after six months of birth strengthens their immune system and may prevent development of food allergy. Breast feeding infants so far is the best form of nutrition for the child and protection against allergies but it doesn’t eliminate the possibility of developing an allergy.

Another plausible theory suggests that children less exposed to microbes have a greater risk of developing allergies. Children should be encouraged to cuddle and play with pets to prevent development of allergies and asthma during the first year of life.  The whole idea is to expose children to the microbes residing in the furs of pets which will strengthen and help children’s immune system to differentiate between harmful and harmless substances.

Allergy may not have a sure shot remedy but it can always be managed with tact and utmost care. The key is to be alert in all situations. It is not an illness or infirmity just a problem we all can deal with.

“There may be no remedy

Oh!  It’s just a malady,

Allergy is a nature’s dare,

All you do is take care.”

To healthy living!!