WHELEHANS HEALTH BLOG


Whelehans Health Blog

Friday 25 September 2015

Understanding signs and treatment of serious allergies can save lives

Emma Sloan, 14, was out for a family meal in December 2013 when she ate a sauce containing peanuts and suffered a severe allergic reaction known as anaphylaxis. She died on O’Connell St in Dublin because she did not receive a life-saving injection of adrenaline in time. Few people ever experience a reaction as severe as Emma did, but more awareness of food allergies will save lives. In an Irish Examiner article on May 2nd 2015, Jonathan Hourihane, professor of paediatrics and child health in University College Cork and a specialist in allergic disorders in children indicated that the rate of food allergies in children in Ireland is about 4% and between 1990 and 2010, allergy rates trebled in the US which is likely to be similar in Ireland.

Pharmacist Eamonn Brady of Whelehans Pharmacy Mullingar explains “we should all learn to spot symptoms of allergic reactions and to identify and avoid the triggers that cause them. We should know what to do if we see someone suffering from anaphylaxis, the most severe allergic reaction of all; none of us can predict when it could happen to someone we know”. Eamonn says that anyone “working within schools or organisations should know to use an adrenaline pen; especially if someone within that school/organisation has a history of allergies. Administering an adrenaline pen is simple and you can ask your local pharmacist to demonstrate how to use it. This is why I am offering a free service where I visit schools/businesses and demonstrate to staff how to administer adrenaline pens. More people knowing how to administer adrenaline pens will means more lives are saved”

Anaphylaxis can kill if not treated quickly
A few foods account for approximately 90% of all food allergies and include milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. Reactions to these foods can vary from mild (red rash and clears up in a matter of hours) to moderate (skin erupts in hives, eyes, hands, feet, lips, mouth, and throat swell) right up to life threatening anaphylaxis. Anaphylaxis begins in the mouth and throat within minutes of eating a food. It often starts with swelling of the lips and throat; within minutes the person can stop breathing if not treated. Anyone diagnosed with a severe allergy should carry an auto-injector of adrenaline. If this emergency shot is not administered within a short time of eating the food, the reaction can be fatal

Free Adrenaline Pen Administration training by a pharmacist
Do you work in a school or organisation where a pupil or colleague is prescribed an adrenaline pen due to their history of severe allergies? Anaphylaxis can include severe reactions to the likes of nuts, insect stings, eggs and shellfish. People prescribed adrenaline pens (eg. Epipen®, Anapen®, Jext®) are trained how to use them; however there are occasions when a teacher/colleague may have to administer the adrenaline pen (eg. Person becomes unconscious). Pharmacist Eamonn Brady MPSI can call to your premises and give teachers / staff a demonstration on how to administer safely. This is a free service and takes less than half an hour. Don’t risk waiting for a major event; be prepared today and call Whelehans Pharmacy at 04493 34591 or e-mail info@whelehans.ie to arrange for a pharmacist to call out to demonstrate safe administration of adrenaline pens.

References:
1.       “We need to understand allergies”, Sharon Ni ChonchĂșir, Irish Examiner, May 2nd 2015

For comprehensive and free health advice and information call in to Whelehans, dial 04493 34591 or log on to www.whelehans.ie. You can also e-mail queries to info@whelehans.ie. Find us on Facebook

Monday 7 September 2015

Food allergies V Food intolerance

Food allergies and food intolerances are different but they are often confused. About 2 of a 100 people have a food allergy but many more have food intolerances.

Food allergy or intolerance?

Food intolerance is an adverse reaction to a particular food or ingredient, which occurs every time the food is eaten. It's often confused with a food allergy, but it's very different because the immune system isn't activated. A food allergy is an allergic reaction to the food.

An allergy produces specific symptoms, such as swelling of the lips, which usually develops within minutes of eating the food, while intolerance produces more general symptoms, such as indigestion and bloating, which can develop several hours after eating.

Only a tiny particle of food is needed to trigger a food allergy, whereas you would usually need to eat a larger amount of food to trigger intolerance.

The symptoms of a food allergy can be life threatening, whereas the symptoms of a food intolerance are unpleasant but are never immediately life threatening

Food intolerance occur when the body is unable to deal with a certain foodstuff, usually because it doesn't produce enough of the chemical or enzyme needed to properly digest that particular food.

One of the most common intolerances is to cow's milk, which contains a certain type of sugar called lactose. If you have a shortage of the enzyme lactase, you can't break down milk sugar into simpler forms that can be absorbed into the bloodstream. When intolerant to lactose the sufferer may experience symptoms such as bloating, abdominal pain and diarrhoea when they eat or drink dairy products,

Food allergies

Since 1990, there has been a 500 per cent increase in hospital admissions for food allergies among the young. The most frequent food allergies in children are to milk, eggs, soya, wheat, fish, nuts, citrus fruit and tomatoes. Food allergies are more common in children than adults. According to a study done by the Food Safety Agency in the UK in 2008, it was estimated that 5 to 8% of children and 1 to 2% of adults suffered from a food allergy.

In general terms, there are two types of food allergy; an immediate type of allergy and a delayed type of allergy. With immediate type allergies, you notice a reaction very quickly after you eat the offending food, usually within a few minutes. Symptoms include hives, itchiness and swelling and in extreme cases, a potentially life-threatening allergic reaction called anaphylaxis. Anaphylaxis is an extremely rare but potentially life threatening allergic reaction which if left untreated may lead to death. Symptoms vary but can include anxiety, shortness of breathe, palpitations, swelling of lips, tongue or throat and loss of consciousness. An adrenaline injection is normally the treatment of choice. The adrenaline device used in children is called an Anapen® Junior device and must be prescribed by the child’s GP. It will only be prescribed in cases of children known to suffer from anaphylactic attacks. It should be carried everywhere by the child. The child’s parent must be trained to recognise the symptoms of anaphylaxis and shown how to use the Anapen® Junior device. The GP, practice nurse or pharmacist can demonstrate how to use the device. 

Delayed-type allergies are more subtle and more difficult to detect. This is because it is the chronic build-up of a particular food that causes the allergic reaction. In young children, the most common delayed type of food allergy is to milk protein, which causes chronic symptoms such as eczema, colic, reflux and diarrhoea. This should not to be confused with lactose intolerance, which does not involve the immune system. Delayed-type allergies are difficult for doctors to diagnose because there's no obvious relationship between eating the food and the onset of symptoms. Because of the fact that these symptoms are also common in children without allergies makes a diagnosis even more difficult.

Most children outgrow food allergies such as milk, eggs, soya and wheat by the time that they start school. Peanut allergies are usually more persistent in children. An estimated 80% of children with peanut allergies remain allergic to peanuts for the rest of their life.

There is currently no cure for food allergies. Treatment involves identifying the specific food that triggers the allergic reaction and then avoiding it. If the child inadvertently eats the food that causes the allergy, an antihistamine such as Zirtek® liquid can be given to the child to reduce symptoms such an itch and hives. Zirtek® liquid is available in pharmacies without prescription and is non drowsy so won’t affect school work. 

Food intolerance

Food intolerance is more common than food allergies. It can occur in adults and children. It occurs when the body is unable to deal with a certain food. This is generally because the affected person lacks enough of the particular chemical or enzyme that is needed for digestion of that food.

One of the most common types is intolerance of cow's milk, which contains a type of sugar called lactose. Many people have a shortage of the enzyme lactase, which is normally made by cells lining the small intestine. Without this enzyme, the lactose intolerant person can not break down milk sugar into simpler forms that can be absorbed into the bloodstream. Symptoms of lactose intolerance include indigestion, bloating, flatulence, diarrhoea and nausea. Babies are usually born with higher levels of lactase, so lactose intolerance usually only begins after the age of about two, as the body begins to produce less of the enzyme. But many people don't experience symptoms until they're much older. A temporary lactase deficiency may follow gastroenteritis, especially in children. Lactose intolerance in children and adults is sometimes misdiagnosed as irritable bowel syndrome (IBS) as many of the symptoms are similar.  

Lactose intolerance is less common among people of northern and western European origin than people of Mediterranean, African, Native American and Asian origin. The reason lactose intolerance is less common in northern and western Europe is evolutionary as dairy consumption has long been a part of the diet in these areas so lactase production has developed as part of evolution over time in people from these areas. About 10 to 15% of the population in northern/western Europe suffer from lactose intolerance. In non-dairy consuming societies such a Thailand, lactose intolerance can be as high as 98% of the population as dairy is not a major part of diet so lactase is not required.

Colic is the name given to the sharp, intermittent abdominal pains suffered by 20-25% of babies. The exact cause of colic is not fully understood, but a recent study in Guy’s Hospital in London found that over half of babies suffering from colic had lactose intolerance. When the enzyme lactase was added to the milk of the babies in the study, the symptoms either disappeared or were significantly reduced. Lactase Enzyme drops are available in Whelehan’s Pharmacy. Ask our pharmacist for advice and information and treatment options if you feel your baby or child may be lactose intolerant.

Some people have adverse reactions to chemical preservatives and additives in food and drinks, such as sulphites, benzoates, salicylates, monosodium glutamate, caffeine, aspartame and tartrazine. These can be hard to diagnose by eliminating foods so a food intolerance test with a health professional may help.

The lack of a specific enzyme in the body may lead to the build up of toxic by-products and histamine, which then mimic the symptoms of an allergy. The symptoms of food intolerance can be similar to an allergic reaction. This is why many tests for food intolerance, including the one performed by Whelehan’s Pharmacy, check for IgG antibodies which if present can detect certain food intolerance.

I will discuss more about Food Intolerance in my next Health Blog

Food intolerance test
Whelehans Food Intolerance Testing Service checks for food intolerance to 59 of the most common causes of food intolerance. If a patient tests positive, to certain foods, the simple act of eliminating the food could have a massive positive impact on overall wellbeing. Our food intolerance test costs €100; it only takes a few minutes and you can have results later that day. We will advise on the best next steps depending on your results. Call us at 04493 34591 to find out more or to book an appointment.

Disclaimer: Food intolerance tests are not meant as a substitute for full medical check-up from your GP 

For comprehensive and free health advice and information call in to Whelehans, dial 04493 34591 or log on to www.whelehans.ie. You can also e-mail queries to info@whelehans.ie. Find us on Facebook