Patch Testing Allergy Diagnosis

Patch Testing Allergy Diagnosis 

This video explains and demonstrates Patch Testing. Patch testing is the recognised test used to identify and confirm contact allergic dermatitis.

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What is Allergy

This video explains what allergy actually is. What the different types of allergy are and what the body is up to. Presented by John Collard.

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Office: Allergies & U

Office: Allergies & U

Part 1 of 2: Educational video from Advanced allergy relief of arizona on allergies and how they can effect you. Learn the many ins and outs that Dr. Dylan Foster, DC has learned over the years in this 2 part series. The more you can learn, the more you can help yourself!

Part 2 of 2: Educational video from Advanced allergy relief of arizona on allergies and how they can effect you. Learn the many ins and outs that Dr. Dylan Foster, DC has learned over the years in this 2 part series. The more you can learn, the more you can help yourself!

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Allergies in the Office

Allergies in the Office

Reviewed By: Jennifer Robinson, MD, December 2014
SOURCES: Medical University of South Carolina
© 2012 WebMD, LLC. All rights reserved.

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Casein Allergy Overview

If a glass of milk or a slice of pizza causes swollen lips, hives, or other significant symptoms, you may have an allergy to casein, a protein in milk. Another milk protein associated with food allergies is whey. Some people are allergic to both casein and whey.

Most people with an allergy to milk have symptoms which appear when they are infants and outgrow them as they get older. However, some people do not outgrow these symptoms and continue to be allergic as adults. It is unusual to develop an allergy to milk proteins later in life. Lactose intolerance can appear later in life with symptoms including bloating, pain, gas, diarrhea or gastroesophageal reflux. Lactose intolerance is not an allergy but an intolerance, where individuals are unable to digest the sugar lactose in milk. But that inability does not result in potentially life threatening reactions. It is important to learn how to recognize and avoid potential allergens.

Milk or Casein Allergy: Cause and Symptoms

A casein allergy occurs when your body's immune system mistakenly thinks the protein is harmful and inappropriately produces allergic (IgE) antibodies for protection. The interaction between these antibodies and the specific protein triggers the release of body chemicals such as histamine that cause symptoms which may include:

• Swelling of the lips, mouth, tongue, face, or throat
• Skin reactions such as hives, a rash, or red, itchy skin
• Nasal congestion, sneezing, runny nose, itchy eyes, coughing, or wheezing

The most serious reaction to milk allergy is called anaphylaxis. This is a potentially life threatening reaction that can occur rapidly. Allergy to foods (including casein in milk) is believed to be the leading cause of anaphylaxis outside the hospital setting. People who have asthma in addition to a serious food allergy to an item, such as casein, are at greater risk for worse outcomes if they suffer an exposure and develop an anaphylactic reaction.

Symptoms such as swelling inside your mouth, chest pain, hives or difficulty breathing within minutes of consuming a milk product may mean you are experiencing an anaphylactic reaction and need emergency medical attention.

Milk or Casein Allergy Treatment

If you are diagnosed with a food, or specifically milk or casein, allergy, your doctor may advise you carry injectable of epinephrine with you in case you accidentally eat a food containing casein and have a reaction. Your doctor or pharmacist can show you how to give the epinephrine. You may also want to keep an over-the-counter antihistamine on hand to help alleviate allergy symptoms. In the case of a severe or serious reaction, the antihistamine will not act as rapidly or as effectively as epinephrine. Epinephrine is the same as adrenaline, the chemical your body produces at times of excitement or stress.

If you experience a severe allergic reaction with symptoms of anaphylaxis, give yourself the epinephrine to counteract the reaction until help arrives, then call 911 for emergency help. Because up to one-third of anaphylactic reactions can have a second wave of symptoms several hours following the initial attack, you may need to be observed in a clinic or hospital for four to eight hours after the initial reaction.

Milk or Casein Allergy Prevention

The best treatment for milk/casein allergy is prevention or avoidance. To prevent an allergic reaction to casein, you must follow a casein-free diet, avoiding all foods that contain milk or milk products.

Avoiding milk products involves more than just leaving the cheese off your sandwich. It may also mean leaving off the deli meat if it was cut with the same equipment used to slice the cheese. Even miniscule amounts of casein may be enough to trigger a reaction. In people who are allergic, the level of sensitivity varies from person to person. Some individuals might be able to tolerate small amounts of milk, especially if the milk is baked or cooked in items. However, for most individuals, strict avoidance is best since the amount of milk many not be consistent between products from different manufacturers or even between batches from the same manufacturer.

Giving up milk doesn't have to mean giving up calcium. Because even people who drink milk often don't get enough calcium in their diets, many other foods -- including juices, cereals, and rice and soy drinks -- are now enriched with calcium. Vegetables including kale, spinach, and broccoli are good sources of calcium as well.

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Allergies and Anaphylaxis

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Anaphylaxis is a serious, potentially life-threatening allergic responsethat is marked by swelling, hives, lowered blood pressure, and dilatedblood vessels. In severe cases, a person will go into shock. If anaphylactic shock isn't treated immediately, it can be fatal.

This condition occurs when the immune system develops a specific allergen fighting antibody (called immunoglobulin E or IgE) that drives an inappropriate or exaggerated reaction toward a substance that is normally harmless, such as food. Your body may not react upon initial exposure but may produce antibodies with later exposures. When you are exposed to the substance later, the binding of the allergen to antibodies can lead to the presence of a large amount of a protein called histamine, which can then lead to the symptoms described above.

What Are the Symptoms of Anaphylaxis?

Anaphylaxis may begin with severe itching of the eyes or face and, within minutes, progress to more serious symptoms. These symptoms include swallowing and breathing difficulties, abdominal pain, cramps,vomiting, diarrhea, hives, and angioedema (swelling similar to hives, but the swelling is beneath the skin instead of on the surface).

If you have anaphylaxis, seek emergency medical attention immediately. The condition can quickly result in an increased heart rate, sudden weakness, a drop in blood pressure, shock, and ultimately unconsciousness and death.

What Are the Common Triggers of Anaphylaxis?

Food is generally the most common cause of anaphylaxis. Common food triggers include nuts, shellfish (shrimp, lobster), dairy products, egg whites, and sesame seeds. Wasp or bee stings are also common causes of anaphylaxis.

Additionally, exercise can trigger anaphylaxis if the activity occurs after eating allergy-provoking food.

Medications are also a common cause of anaphylaxis.

Pollens and other inhaled allergens (allergy-causing substances) rarely cause anaphylaxis.

Some substances can cause reactions -- called anaphylactoid reactions -- that are similar to and just as serious as anaphylaxis, but do not involve immunoglobulin E antibodies. Common causes are fish and some medications, such as intravenous radiological contrast dye.

How Is Anaphylaxis Diagnosed?

Anaphylaxis is diagnosed based on its symptoms. People with a history of allergic reactions may be at greater risk for developing a severe reaction in the future.

Skin testing may help confirm the substances that cause severe allergic reactions. However, this type of test may not be recommended if you have reason to suspect that you will have an anaphylactic reaction to the substance.

What Is the Treatment for Anaphylaxis?

There is only one rapidly effective treatment for anaphylaxis --epinephrine by injection. Epinephrine is adrenaline and it rapidly reverses anaphylactic symptoms. It is typically given through an automatic injection device. The most common and most effective injection site is the thigh. 

If you are near someone who is going into anaphylactic shock, call for professional medical help immediately. CPR and other lifesaving measures may be required.

In addition to epinephrine, treatment for shock includes intravenous fluids and medicines that support the actions of the heart and circulatory system. After a person in shock is stabilized, antihistamines and steriods may be given to further reduce symptoms.

How Can I Be Prepared for Anaphylaxis?

If you are allergic to bee stings or any other substances that cause anaphylaxis, you should always be prepared. Ask your doctor to prescribe an epinephrine injection kit and carry two with you at all times. It is also important to note that avoidance is the foundation and first step to preventing allergic reactions. Be sure to educate yourself on how to recognize and avoid potential triggers.

Also, it's important that you inform your health care provider of any drug allergies before undergoing any type of medical treatment, including dental care.

It is also a good idea to wear a medical alert bracelet or pendant, or carry a card that identifies your allergy. In cases of emergency, it could save your life.

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Irritable Bowel Syndrome – IBS

Irritable Bowel Syndrome (IBS) is a common disorder of the gastrointestinal tract (the gut).  The cause is unknown although many patients with IBS suspect that their diet plays a key role in causing their symptoms. Not all IBS sufferers will have food related problems.

It is useful to consider the symptoms that you are getting, do you suffer from spasmodic tummy pain, alternating bouts of constipation and diarrhoea, and bloating or excessive wind?  Although this may indicate IBS, symptoms like these or any changes in bowel habits should be investigated by your GP, as there are other bowel conditions that should be ruled out first before you focus on a diagnosis of IBS.

The symptoms of IBS can often be eased with treatments such as anti-spasmodic medications, bulking agents, stool softeners or laxatives. If foods are the trigger, these can be easily investigated by studying your diet carefully. Keeping a detailed food and symptom diary can be used to identify dietary triggers. Because IBS is unlikely to be IgE mediated, there are no reliable tests that can be used to identify these foods, so this makes accurate diary-keeping an essential diagnostic tool. 

Lifestyle can also contribute to IBS so the following tips may help:

Do you go for a long time without eating and drinking?

A regular meal pattern could mean a regular bowel pattern. Skipping breakfast could mean that your bowels are missing the important reflex triggered by the first meal of the day. Fluids, especially water, mean that the contents of your bowel stay soft - passing hard stools is difficult and painful.  Aim for 8 - 10 glasses a day, more if are exercising or in a hot environment, or if you eat a high fibre diet.

Aim for five portions of fruit or vegetables every day.  The type of fibre in fruit, vegetables and peas/beans/pulses (lentils, chick peas, kidney beans etc) can help regulate the bowel and stool consistency.

Do you suffer from diarrhoea?

Look at your lifestyle. Are you the type of person who is always rushing around, missing meals and then fitting in a large dinner late at night?

Taking time out for food and drink away from the stresses of the day and eating regularly is very likely to help.

Excessive amounts of caffeine or acidic drinks may also be responsible.  Tea, coffee, cola drinks, fruit juice and alcohol may bring on bouts of diarrhoea.

Foods containing sorbitol such as diabetic products and some sweets can cause diarrhoea in a sensitive individual.

Diarrhoea symptoms with IBS may indicate food intolerance.  Symptoms can take from a few hours to 48 hours after eating to appear, making it very difficult to pinpoint the culprit.  The best thing to do is to keep a food and symptom diary for at least two weeks to see if a pattern emerges. Once the food has been identified, then you need to think whether it affects the balance of your diet.  If for example you find that chocolate triggers symptoms, then avoiding chocolate is not going to have a major impact on your diet.  If, however, you find that it  a major food group such as milk or wheat is not tolerated and needs to be excluded, then you may need to have your diet supervised by a dietitian. If you cannot identify the trigger foods from the food diary, the dietitian may suggest you follow an EXCLUSION DIET, which needs careful interpretation and monitoring. A suitable vitamin or mineral supplement may be required whilst these investigations are ongoing.

Bloating may be a main symptom on its own or it may occur alongside constipation and/ or diarrhoea.  Certain foods can cause excessive bloating and wind. 

Common foods include onions, artichokes, baked beans, lentils, cabbage, brussel sprouts, under-ripe bananas, and food that has been cooked, cooled and reheated, fizzy drinks may also make the problem worse for some people.

Eating too fast or talking whilst eating and so gulping down excessive air and drinking fizzy drinks with a meals can be a cause of bloating. 

Peppermints or peppermint tea can be helpful in alleviating some of the symptoms of IBS.

FODMAPS

Fructo oligosaccarhides, disaccharides, monosaccharides, and polyols (FODMAPS) are compounds found in certain foods and there is some good evidence to say that cutting down on these can help the symptoms of IBS.  For further information on FODMAPS and whether this could be a suitable dietary trial for you see www.fodmap.com

If you have IBS, helpful advice and information can be obtained from the IBS Network.

In summary, there are many dietary treatments for IBS and with expert advice it is possible to improve or resolve symptoms.

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