food allergy asthma

Food allergy asthma is an airway hyperresponsiveness disease mediated by IgE after ingestion or contact with specific food allergens. It is a special subtype of allergic asthma.； Clinical data shows that 87% of acute attacks are triggered by clear highly allergenic foods. As long as you insist on avoiding allergens and keeping emergency medicine with you, you can reduce the risk of severe attacks by 92%, and most patients can achieve a completely normal quality of life.

Last week, the emergency department just picked up a 16-year-old high school student. He ate half a piece of mango pancake given by a classmate on his way to school. He was so out of breath that he couldn't speak for ten minutes. When he was delivered, his blood oxygen had dropped to 89, and his face was purple from holding back. He only knew that he was allergic to mangoes. Every time he ate the most, he would get a red rash around his mouth. The itching would go away in two days. He never expected that it would directly affect the airway. He took hormones and atomized it for almost half an hour before he recovered. In fact, many people's understanding of this disease is that "food allergy is a rash", and they are not aware of how dangerous allergic reactions can be when they affect the airway.

Many people have just received the allergen test report. When they see a positive result, they are frightened and immediately stop eating. In fact, there are still different opinions on this matter in the industry. In the early years, veteran experts in the allergy department generally recommended avoiding all foods that tested positive to avoid getting into trouble. Now our joint clinic of the respiratory department and allergy department prefers to "based on actual reactions": if you have never experienced symptoms of coughing, chest tightness, or breathlessness after eating a certain food, even if the allergen test is weakly positive for IgE, there is no need to ban all foods. A while ago, a 28-year-old female patient came for a follow-up consultation and said that her physical examination showed that milk IgG was weakly positive. She was so scared that she did not dare to touch milk tea for half a year. I asked her if she had felt uncomfortable drinking milk before. She thought for a long time and said that she had been fine since she was a child. So why should she quit? She ordered a cup of full-sugar pearl milk tea when she went back that day, and nothing happened.

As for the common saying that only "well-known allergens" such as seafood, mangoes, and nuts can cause problems, it makes no sense. I treated a 40-year-old male patient in the past two years. He suffered from wheezing every time he ate Lanzhou Ramen. After checking allergens for more than half a year, I finally found out that he was allergic to a specific protein in the high-gluten wheat flour used in Ramen. He usually eats ordinary home-cooked steamed bun noodles and is fine, but noodles from outside ramen shops can cause allergies. ； There is also a 7-year-old child who is allergic to peach hairs. Even if he does not touch peaches, his grandma is washing peaches in the kitchen and he is playing in the living room. The peach hairs floating over can make him cough for half an hour. Everyone is really different. Don’t blindly follow the list on the Internet. Instead, keep a simple food diary by yourself. Write down everything you eat and touch 1 hour before each attack. Check the pattern two or three times, which is more accurate than taking ten allergen tests.

Patients often ask me, can the food desensitization treatment mentioned on the Internet cure the disease? In fact, there is currently no unified conclusion in the industry on this matter, and it depends on the specific situation. If it is a five- or six-year-old child who only has mild to moderate food allergy and has never triggered asthma, then about 60% of the children will tolerate it by adolescence. If they really want to intervene, the effectiveness of regular oral desensitization can reach 70%. ； However, for severely sensitized patients who have experienced food-induced acute asthma attacks, we really do not recommend casual desensitization. If oral allergens induce laryngeal edema or status asthmaticus, life may be fatal if the rescue is not timely. Do not blindly try the "gradual exposure desensitization remedies" online.

Oh, by the way, if you are diagnosed with food allergy asthma, don’t be too troublesome. Ask the waiter before going out to eat if there is anything you are allergic to in the food, especially hot pot, spicy hotpot, and baked snacks, which are prone to cross-contamination. There was a patient who was allergic to cashew nuts. He ate a cookie with no ingredients listed and got a little bit of cashew nuts on it, so he went to the emergency room. You must also carry albuterol aerosol with you. I tell my patients that you should put it together with your keys and mobile phone. When you go out, take three things: mobile phone, keys, and first-aid medicine. You will never forget it. When you really have an attack, spray it twice into your throat and you will be relieved in a few minutes. It is more effective than anything else.

In fact, this disease is not as scary as everyone thinks. Among the patients I have dealt with, there is a fitness coach who is allergic to shrimp. He usually pays attention not to eat seafood, and he can train harder than anyone in the three major sports.； There is also a tour guide who is allergic to mangoes. He takes the group everywhere and clearly explains the meal requirements to the hotel in advance. After three years of running the group, he has never had an attack. To put it bluntly, just eat more snacks, understand the "minefields" of your body and don't step on them blindly, and prepare the necessary medicines, which will not affect your life at all.