Treatments for Peanut Allergy
Treatment List for Peanut Allergy
The list of treatments mentioned in various sources
for Peanut Allergy
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Adrenalin injection if anaphylaxis
- Antihistamine preparations to reduce symptoms
- Complete avoidance of peanuts
- Dietary challenge - small amounts of food given in controlled environment to help build tolerance
- Treatment of peanut allergy is dependant upon the type of allergic symptom, the body system affected, and the severity of the reaction. Treatments for peanut allergies include:
- Allergen avoidance - avoidance of peanuts and education of children and carers
- Antihistamines - may help in mild reactions
- Asthma medications such as inhaled beta agonists and inhaled corticosteroids - used to treat asthma which may have allergy as a contributing factor
- Oral steroids - used in short courses for moderate allergic reactions especially with asthma symptoms or skin conditions
- Topical steroids - used to treat skin manifestations such as eczema which may result from peanut allergy
- Desensitisation - evidence is mixed, and efficacy dependant or the type of allergy and specific type of reaction
- EpiPen - used as first line treatment prior to hospital care for those who have proven anaphylaxis to peanuts
- Anaphylaxis is a severe life threatening allergic response and may occur in individuals with peanut allergies. Treatment includes:
- Hospitalisation
- IM adrenaline
- High flow oxygen
- Intravenous fluids
- Intravenous and oral steroids
- Nebulised bronchodilators
- Nebulised adrenaline for upper airways obstruction
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Discussion of treatments for Peanut Allergy:
Food allergy is treated
by dietary avoidance. Once a patient and the patient's doctor have
identified the food to which the patient is sensitive, the food must
be removed from the patient's diet. To do this, patients must read
lengthy, detailed ingredient lists on each food they are considering
eating. Many allergy-producing foods such as peanuts, eggs, and
milk, appear in foods one normally would not associate them with.
Peanuts, for example, are often used as a protein source and eggs
are used in some salad dressings. The FDA requires ingredients in a
food to appear on its label. People can avoid most of the things to
which they are sensitive if they read food labels carefully and
avoid restaurant-prepared foods that might have ingredients to which
they are allergic.
In highly allergic people even minuscule
amounts of a food allergen (for example, 1/44,000 of a peanut
kernel) can prompt an allergic reaction. Other less sensitive people
may be able to tolerate small amounts of a food to which they are
allergic.
Patients with severe food allergies must be
prepared to treat an inadvertent exposure. Even people who know a
lot about what they are sensitive to occasionally make a mistake. To
protect themselves, people who have had anaphylactic reactions to a
food should wear medical alert bracelets or necklaces stating that
they have a food allergy and that they are subject to severe
reactions. Such people should always carry a syringe of adrenaline
(epinephrine), obtained by prescription from their doctors, and be
prepared to self-administer it if they think they are getting a food
allergic reaction. They should then immediately seek medical help by
either calling the rescue squad or by having themselves transported
to an emergency room. Anaphylactic allergic reactions can be fatal
even when they start off with mild symptoms such as a tingling in
the mouth and throat or gastrointestinal discomfort.
Special
precautions are warranted with children. Parents and caregivers must
know how to protect children from foods to which the children are
allergic and how to manage the children if they consume a food to
which they are allergic, including the administration of
epinephrine. Schools must have plans in place to address any
emergency.
There are several medications that a patient can
take to relieve food allergy symptoms that are not part of an
anaphylactic reaction. These include antihistamines to relieve
gastrointestinal symptoms, hives, or sneezing and a runny nose.
Bronchodilators can relieve asthma symptoms. These medications are
taken after people have inadvertently ingested a food to which they
are allergic but are not effective in preventing an allergic
reaction when taken prior to eating the food. No medication in any
form can be taken before eating a certain food that will reliably
prevent an allergic reaction to that food.
There are a few
non-approved treatments for food allergies. One involves injections
containing small quantities of the food extracts to which the
patient is allergic. These shots are given on a regular basis for a
long period of time with the aim of "desensitizing" the patient to
the food allergen. Researchers have not yet proven that allergy
shots relieve food allergies.
Infants and Children
Milk and soy allergies are particularly common in
infants and young children. These allergies sometimes do not involve
hives and asthma, but rather lead to colic, and perhaps blood in the
stool or poor growth. Infants and children are thought to be
particularly susceptible to this allergic syndrome because of the
immaturity of their immune and digestive systems. Milk or soy
allergies in infants can develop within days to months of birth.
Sometimes there is a family history of allergies or feeding
problems. The clinical picture is one of a very unhappy colicky
child who may not sleep well at night. The doctor diagnoses food
allergy partly by changing the child's diet. Rarely, food challenge
is used.
If the baby is on cow's milk, the doctor may
suggest a change to soy formula or exclusive breast milk, if
possible. If soy formula causes an allergic reaction, the baby may
be placed on an elemental formula. These formulas are processed
proteins (basically sugars and amino acids). There are few if any
allergens within these materials. The doctor will sometimes
prescribe corticosteroids to treat infants with severe food
allergies. Fortunately, time usually heals this particular
gastrointestinal disease. It tends to resolve within the first few
years of life.
Exclusive breast feeding (excluding all other
foods) of infants for the first 6 to 12 months of life is often
suggested to avoid milk or soy allergies from developing within that
time frame. Such breast feeding often allows parents to avoid
infant-feeding problems, especially if the parents are allergic (and
the infant therefore is likely to be allergic). There are some
children who are so sensitive to a certain food, however, that if
the food is eaten by the mother, sufficient quantities enter the
breast milk to cause a food reaction in the child. Mothers sometimes
must themselves avoid eating those foods to which the baby is
allergic.
There is no conclusive evidence that breast
feeding prevents the development of allergies later in life. It
does, however, delay the onset of food allergies by delaying the
infant's exposure to those foods that can prompt allergies, and it
may avoid altogether those feeding problems seen in infants. By
delaying the introduction of solid foods until the infant is 6
months old or older, parents can also prolong the child's
allergy-free period.
Controversial Issues There are
several disorders thought by some to be caused by food allergies,
but the evidence is currently insufficient or contrary to such
claims. It is controversial, for example, whether migraine headaches
can be caused by food allergies. There are studies showing that
people who are prone to migraines can have their headaches brought
on by histamines and other substances in foods. The more difficult
issue is whether food allergies actually cause migraines in such
people. There is virtually no evidence that most rheumatoid
arthritis or osteoarthritis can be made worse by foods, despite
claims to the contrary. There is also no evidence that food
allergies can cause a disorder called the allergic tension fatigue
syndrome, in which people are tired, nervous, and may have problems
concentrating, or have headaches.
Cerebral allergy is a term
that has been applied to people who have trouble concentrating and
have headaches as well as other complaints. This is sometimes
attributed to mast cells degranulating in the brain but no other
place in the body. There is no evidence that such a scenario can
happen, and most doctors do not currently recognize cerebral allergy
as a disorder.
Another controversial topic is environmental
illness. In a seemingly pristine environment, some people have many
non-specific complaints such as problems concentrating or
depression. Sometimes this is attributed to small amounts of
allergens or toxins in the environment. There is no evidence that
such problems are due to food allergies.
Some people believe
hyperactivity in children is caused by food allergies. But
researchers have found that this behavioral disorder in children is
only occasionally associated with food additives, and then only when
such additives are consumed in large amounts. There is no evidence
that a true food allergy can affect a child's activity except for
the proviso that if a child itches and sneezes and wheezes a lot,
the child may be miserable and therefore more difficult to guide.
Also, children who are on anti-allergy medicines that can cause
drowsiness may get sleepy in school or at home.
Controversial
Diagnostic Techniques One controversial
diagnostic technique is cytotoxicity testing, in which a food
allergen is added to a patient's blood sample. A technician then
examines the sample under the microscope to see if white cells in
the blood "die." Scientists have evaluated this technique in several
studies and have not been found it to effectively diagnose food
allergy.
Another controversial approach is called sublingual
or, if it is injected under the skin, subcutaneous provocative
challenge. In this procedure, dilute food allergen is administered
under the tongue of the person who may feel that his or her
arthritis, for instance, is due to foods. The technician then asks
the patient if the food allergen has aggravated the arthritis
symptoms. In clinical studies, researchers have not shown that this
procedure can effectively diagnose food allergies.
An immune
complex assay is sometimes done on patients suspected of having food
allergies to see if there are complexes of certain antibodies bound
to the food allergen in the bloodstream. It is said that these
immune complexes correlate with food allergies. But the formation of
such immune complexes is a normal offshoot of food digestion, and
everyone, if tested with a sensitive enough measurement, has them.
To date, no one has conclusively shown that this test correlates
with allergies to foods.
Another test is the IgG subclass
assay, which looks specifically for certain kinds of IgG antibody.
Again, there is no evidence that this diagnoses food allergy.
Controversial
Treatments Controversial treatments
include putting a dilute solution of a particular food under the
tongue about a half hour before the patient eats that food. This is
an attempt to "neutralize" the subsequent exposure to the food that
the patient believes is harmful. As the results of a carefully
conducted clinical study show, this procedure is not effective in
preventing an allergic reaction.
Summary Food
allergies are caused by immunologic reactions to foods. There
actually are several discrete diseases under this category, and a
number of foods that can cause these problems.
After one
suspects a food allergy, a medical evaluation is the key to proper
management. Treatment is basically avoiding the food(s) after it is
identified. People with food allergies should become knowledgeable
about allergies and how they are treated, and should work with their
physicians.
Resources
HOTLINE:National Jewish
Medical and Research Center in Denver.
Nurses available to
answer questions
1/800/222-LUNG
http://www.njc.org/ALLERGY
REFERRALS:American Academy of Allergy, Asthma and
Immunology
611 East Wells Street
Milwaukee, WI
53202
1/800/822-2762.
http://www.aaaai.org/scripts/find-a-doc/main.aspEXTRACTS
FOR ALLERGY TESTING:U.S. Food and Drug
Administration
Center for Biologics Evaluation and
Research
1/800/835-4709
http://www.fda.gov/cber/index.htmlECZEMA:National
Arthritis, Musculoskeletal and Skin Diseases Information
Clearinghouse
One AMS Circle
Bethesda, MD
20892-3675
301/495-4484
http://www.nih.gov/niams/American
Academy of Dermatology
930 N. Meacham Rd.
Schaumburg, IL
60173
1/888/462-DERM
http://www.aad.org/Eczema
Association
1221 S.W. Yamhill, Suite 303
Portland, OR
97205
503/228-4430
LACTOSE INTOLERANCE
and
CELIAC SPRUE:National Digestive Diseases
Information Clearinghouse
Box NDDIC
Bethesda, MD
20892
301/654-3810
http://www.niddk.nih.gov/health/digest/pubs/lactose/lactose.htmhttp://www.niddk.nih.gov/health/digest/pubs/celiac/index.htmFOOD
CONTENTS: U.S. Department of Agriculture
Food and
Nutrition Information Center
301/436-7725
http://www.nalusda.gov/fnic/index.htmlRECIPES:
American Dietetic Association
216 W. Jackson
Boulevard
Chicago, IL 60606-6995
1/800/877-1600
http://www.eatright.org/RESOURCES:Food
Allergy and Anaphylaxis Network
10400 Eaton Place, Suite
107
Fairfax, VA 22030
1/800/929-4040
http://www.foodallergy.org/American
College of Allergy, Asthma and Immunology
85 W. Algonquin Road,
Suite 550
Arlington Heights, IL 60005
1/800/842-7777
http://allergy.mcg.edu/Asthma
and Allergy Foundation of America
1125 15
th Street,
N.W., Suite 502
Washington, DC 20036
1/800/7-ASTHMA
http://www.aafa.org/ (Source: excerpt from
Food Allergy and Intolerances, NIAID Fact Sheet: NIAID)
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