cold food allergy

There is currently no independent diagnostic item for "cold food allergy" in clinical practice. What we often refer to as "allergic-like" reactions such as swollen lips, wheals on the skin, abdominal pain, diarrhea, and tight throat after eating iced drinks, iced fruits, and iced seafood are essentially a mixed manifestation of "a special type of allergic reaction induced by cold physical stimulation" + "mucosal stress caused by insufficient tolerance of the spleen and stomach." The incidence of related discomforts is close to 40% among people who are greedy for cold drinks all year round. This is not pretentious, but a real physiological reaction.

A while ago, I accompanied a friend to the allergy department to get a report. I met a 16-year-old girl, holding a half-cup of half-dissolved poplar nectar smoothie. Her lips were swollen like small buns. She kept rubbing her arms and said that she was "allergic" when eating ice cream. She sometimes had stomachaches and diarrhea. She had checked dozens of common allergens and all results were negative. She was not even allergic to mango or milk. The doctor took an ice pack wrapped in plastic wrap and attached it to her inner forearm. Within ten minutes, the area where it was applied turned red, and three small wheals formed. He concluded on the spot that this was not an allergy to food, but an allergy to "cold". It was a type of cold urticaria, but the mucous membrane of the digestive tract was more sensitive than the skin, and people who ate ice were the first to suffer the attack.

Interestingly, for this situation, the explanation logic of Chinese and Western medicine is completely different, but the final intervention direction is the same. Western medicine generally believes that there is no need to single out the term "cold food allergy". There are essentially two types of problems: either the cold urticaria just mentioned, which is a branch of physical urticaria. It is caused by the abnormal release of histamine from the mast cells of the skin and mucous membranes after being stimulated by low temperature. In severe cases, it may even occur when exposed to cold water or cold wind. It has nothing to do with the food itself. If you don't believe me, steam the ice watermelon and eat it hot, and you will be fine. ； Either the gastrointestinal mucosa itself is in a sub-healthy state, such as people who like to stay up late, have irregular meals, or have irritable bowel syndrome. Once ice enters the gastrointestinal tract, the mucosa will be stimulated and directly spasm, resulting in abdominal pain and diarrhea. This is a normal stress, not even an allergy.

But many Chinese doctors who are deeply involved in clinical practice do not think so. They think that people who only have attacks when eating cold food and have negative cold stimulation tests should be classified separately: many people put ice packs on their arms and are fine, but they feel uncomfortable when they eat ice. The essence is insufficient Zhongyang, deficiency of the spleen and stomach, and cold food directly Various discomforts will occur when the internal organs are unable to transport and transform. This situation is completely different from systemic cold allergy. After two weeks of conditioning with some prescriptions that warm the yang and strengthen the spleen, most people can eat a small amount of ice normally. There is no need to be careful when touching cold water in winter like patients with cold urticaria.

My cousin who has been a nurse in the gastroenterology department for almost 10 years said that there are currently a lot of patients like this in their outpatient clinic. Most of them are young people in their twenties. In the summer, they can't leave their hands with iced coffee and iced milk tea. In the winter, they dare to nibble on popsicles. It's fine at the beginning, but after two or three years, they start to feel uncomfortable when eating ice. She usually advises people to do a cold challenge test first. If cold urticaria is diagnosed, they should be treated according to the allergy procedure. In severe cases, anti-allergic drugs should be prepared. ； If the test is negative, we would first advise the person to stop drinking cold drinks for a month, soak their feet more often, and drink a cup of warm ginger water in the morning. Most people will be fine without taking medicine.

To be honest, I have stepped into this pit before. Last summer, I drank two bottles of iced Coke every day for a week. Then one time I had a stomachache that made me break out in a cold sweat after just two sips. I had to have a bowel movement twice before I recovered. During that time, even eating watermelon at room temperature made my stomach feel heavy. Later, I went to Zusanli twice for treatment with a traditional Chinese medicine friend. I drank ginger and jujube tea two or three times a week for more than two months. Now I can eat ice cream occasionally, and I don’t have to completely avoid it. I just don’t dare to show off like before.

There is currently an interesting debate in the academic community, which is whether to list this "anaphylaxis-like reaction induced by only eating cold foods" as a separate diagnostic item. Supporters believe that many people now have this problem, but the allergens cannot be found by checking. Different departments give different opinions, which makes it easy to take detours. Listing them separately can unify the diagnosis and treatment standards. ； Opponents feel that it is completely unnecessary. The current classification can fully cover related symptoms. Listing it separately will easily confuse people and think that they are allergic to all "cold foods". They dare not even eat crabs, pears, and dragon fruits at room temperature. Many dietary taboos have been added for no reason.

In fact, for us ordinary people, there is no need to worry about whether this diagnostic name exists or not. The physical feelings are the most real, right? If you feel uncomfortable after eating ice, then eat less. If you have frequent attacks, go to the hospital for a checkup. If you want to treat it, both Chinese and Western medicine have appropriate plans. Don’t let yourself suffer unnecessarily in pursuit of that cool mouthful of ice.