food reactions
TRANSCRIPT
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Food Reactions
A diverse spectrum
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Food reactions Immunological –
IgE &
Non-IgE – T cells, macrophages Non-immunological
Pharmacological- drug-like –dose dependent
Enzyme deficiencies
Food poisoning- Toxic
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Immunological Reactions
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Non-Immunological Reactions
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Prevalence of food allergy IgE mediated allergy1-2.5% of adults6-8% of childrenThe incidence of other types of food
reactions is not known
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Systems affectedGastrointestinalRespiratorySkinCardiovascularGeneral-Anaphylaxis
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Respiratory reactions Throat tightness Wheezing, asthma Shortness of breath Repetitive coughing Cyanosis- turning blue Nasal congestion Runny nose Cough
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Gastrointestinal symptoms Itching, tingling, swelling lips, mouth Tongue & Throat swelling Angio-oedema (swelling, puffiness) Nausea Vomiting Diarrhoea Abdominal pain, cramps Colic , reflux
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Skin reactionsPruritus – itchingFlushingUrticaria – rashAngio-oedema- tissue swelling Eczema/dermatitis
Itchy eyes and ears
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CardiovascularHypotension – low blood pressureShockSyncope- faintingArrhythmia – irregular heartbeatChest pain
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Most common allergenic foods Milk Wheat Egg Soy Peanut Tree nuts Fish & shellfish Any foods can theoretically trigger allergies
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Cross-reactions may occur Wheat and other grains Soy and other legumes Cow’s milk & horse, sheep, goat’s milk Different tree nuts Nuts and peanuts Pollen & some fruit Latex and avocado, kiwi, chestnut, banana
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Anaphylaxis –food inducedFoods most commonly implicated
EggsWheatMilk PeanutsFish
Shellfish
Nuts
Celery
Seeds
Legumes
Guar gum
Rice
Many others
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Exercise induced AnaphylaxisAnaphylaxis occurring after exercise,
when certain foods are eaten prior or after exercising
Common culprits: Wheat,cereals, celery, fruit,vegetables, shellfish
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Anaphylaxis – be prepared Carry Epinephrine and learn how to use it Always treat first, then review, never wait and see Know how to find help fast Have an emergency action plan Follow your doctor’s instructions Only eat “safe” foods Let others know about your condition Be prepared, anxiety can cause similar symptoms
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Watch out for: “may contain”
“may contain” implies careless manufacturing & preparation practices
“may contain” only reduces the manufacturer’s legal risks
Avoid foods “manufactured on shared equipment”
Don’t assume restaurants are able to prevent cross-contamination
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Peanuts – a case to consider If you react to peanutsDon’t ever trust “nuts” they could be de-
and re-flavoured peanutsPeanuts are widely used in the food
industry It only takes a minute grain to reactAsk others to be considerate
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Immunological reactions- IgE IgE mediated reactions Onset: minutes to several hoursMast cells, basophilsHistamine, prostaglandins, leukotrinesVasodilation, mucous secretion, smooth
muscle contraction, influx of inflammatory cells
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Immunological reactions- non-IgE
Non-IgE mediated reactionsT-cellsMacrophages Cytokines
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Food Intolerances Enzyme deficiencies Food poisoning Intestinal fermentation Food aversions
Pharmacological reactions- reactions to chemicals in foods or additives. Reactions are dose dependent and can be cumulative.
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DiagnosisSkin prick test for IgE reactionsRAST- blood test for IgE to foodsElimination diet and food challengesChallenges should not be done where
there is a risk of anaphylaxisChallenges require backup emergency
treatment facilities
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Hidden allergen avoidanceStudy the pages on different foods to
familiarize yourself with all the possible sources of hidden food allergens
Always read food labelsEat less processed foodsChoose fresh, simple foods
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Do the right thing Don’t just restrict your freedom of eating a
wide variety of foods Do seek professional help to investigate the
symptoms you have. The cause may not always be what you think! Remember- it can take up to 36-48 hours for
some reactions to develop – even longer in some conditions