Food Allergies: All about anaphylaxis

As a food blogger (among other topics), especially a "specialty" food blogger, the most disappointing and potentially limiting thing to have is a food allergy. Tree nuts are typically a huge part of any vegetarian diet, but I'm one of those lucky people who gets an anaphylactic reaction to tree nuts -- pecans, cashews, walnuts, almonds, and so forth are all out of the question. It actually kinda sucks.

I've written about food allergies before (When Soy Annoys and Honeymoon Stories), but I haven't really discussed what anaphylaxis itself is and how serious a condition it can become.

Why this topic now? Because, although it's been a while, I had a pretty severe anaphylactic reaction today to a dish at lunch with a friend of mine. We're talking, throat swelling closed, nausea, stomach pains, the works. It was pretty miserable, and while I would never recommend that anyone simply take Benadryl and sleep it off, that's exactly what I did. Please please please do as I say here, not as I do. :P

Anyway, below is some information on what anaphylaxis is, the symptoms, treatment options, and ways to avoid a reaction. Hope y'all find it handy!

What is anaphylaxis?

Anaphylaxis (or anaphylactic shock) is a severe whole-body allergic reaction to an allergen, such as a bee sting or food. The reaction happens quickly after exposure, is incredibly severe, and involves the whole body as tissues in different parts of the body quickly release histamine and other substances.

"True" anaphylaxis and an "anaphylactoid reaction" are different -- the latter is often a result of exposure to a certain drug, such as morphine, x-ray dye, and aspirin. The reactions are not the same as with "true" anaphylaxis, but can exhibit the same symptoms, have the same complication risks, and are treated the same way.

Pollen and other inhaled allergens, by the way, rarely cause anaphylaxis, though it can happen. Some people also have anaphylactic reactions with no known cause.

Anaphylaxis is life-threatening!

What are the signs and symptoms of anaphylaxis?

Symptoms can develop within minutes or even seconds from exposure to an allergen, and may include the following:

• Abdominal pain or cramping


• Abnormal (high-pitched) breathing sounds


• Anxiety


• Confusion


• Cough


• Diarrhea


• Difficulty breathing


• Difficulty swallowing


• Fainting, light-headedness, dizziness


• Hives, itchiness


• Nasal congestion


• Nausea, vomiting


• Palpitations


• Skin redness


• Slurred speech


• Wheezing

(For what it's worth, I had every symptom above today save only for the hives and itchiness. That one's reserved for mangoes. :P)

How is anaphylaxis treated?

Remember, anaphylaxis is life-threatening and requires immediate professional medical attention! Call 911 immediately if you suspect anaphylaxis -- one warning sign is a hoarse or whispered voice due to the airway closing.

1. Go down the ABC's of Basic Life Support checklist ("A"irway, "B"reathing, "C"irculation) and begin rescue breathing and CPR if necessary.


2. Call 911 immediately.


3. Calm and reassure the person, who is likely going into shock.


4. For a bee sting: Scrape the stinger off the skin with something firm, like a fingernail or plastic credit card. Do not use tweezers or otherwise squeeze the stinger, as this will release more venom.


5. If the person has emergency allergy medication, such as an EpiPen, help the person administer the treatment. Avoid oral medication if breathing is difficult.


6. Take steps to prevent shock: Have the person lie flat with feet raised about 12" off the ground, and cover the person with a coat or blanket. Do not place the person in this position if a head, neck, or leg injury is suspected or if it causes discomfort.

DO NOT...

... assume that any allergy shots the person has already received will provide complete protection. Call 911!

... place a pillow under the person's head if the person is having trouble breathing, as this can block the airways.

... give anything, even medication, by mouth if the person is having trouble breathing.

A paramedic or physician may open the airways with a tube through the nose or mouth (endotracheal intubation) or perform a tracheostomy to place a tube directly into the trachea. Antihistamines and corticosteroids may also be administered to further reduce symptoms after lifesaving measures and epinephrine are given.

What are some complications of anaphylaxis?

Some complications of anaphylaxis include but are not limited to:

• Airway blockage


• Cardiac arrest


• Respiratory arrest


• Shock

So yes, immediate treatment is critical.

How can anaphylaxis be prevented?

Obviously, avoidance is the best prevention.Triggers such as foods and medication that have caused even a mild allergic reaction in the past can go rogue and cause anaphylaxis in the future. Carefully examine ingredient labels... and especially after an experience like this, get clarification on ingredients when eating away from home and any potential contact with allergens.

If you have a child who is allergic to certain foods, introduce one new food at a time in small amounts so an allergic reaction can be recognized. (We'll have to do this with our kids, between my tree nut and mango allergy and Matt's shellfish allergy. Fun!)

A medical ID tag is a great idea if you tend to get severe allergic reactions. This can help alert someone who is trying to help you. Carrying emergency medications, such as a chewable form of diphenhydramine and injectable epinephrine ("EpiPen") or bee sting kit, is always prudent, too. And of course, never share your medications.

PubMed Health - Anaphylaxis