As soon as anaphylactic symptoms begin, a shot of epinephrine or adrenaline, referred to pharmaceutically as an “epi-pen,” should be intramuscularly injected into the patient as quickly as possible.
Individuals who live with ongoing risk of anaphylactic shock keep epi-pens on their person at all times. Many rabbanim permit such a person to carry an epipen on Shabbat in areas without an eruv.
In addition to an epipen, patients might require resuscitation measures such as airway opening, supplemental oxygen and large volumes of IV fluids. Some cases even need a second shot of epinephrine five to 15 minutes after the first if the initial dose has not been effective.
Five to 20 percent of patients may experience a recurrence of anaphylaxis 8-12 hours after the initial incident. Therefore, once brought to the hospital, these patients are monitored for several hours. Steroids are administered to reduce the risk of a secondary episode of anaphylaxis. Furthermore, anaphylaxis may result in respiratory failure, shock, multiorgan system failure, and prolonged symptoms can last up to 32 hours despite treatment. Once the patient is released from the hospital, the swelling and rashes may persist for days or weeks until the body recovers.
Allergy Vs. Sensitivity/ Intolerance
Food allergies can be triggered by even a small amount of the food and occur every time the food is consumed. People with food allergies are advised to avoid the offending foods completely. On the other hand, food intolerances often are dose related. Someone with lactose intolerance may be able to have some milk in their coffee with no reaction, but not be able to handle an entire glass of milk.
Many factors contribute to food intolerance. In some cases, as with lactose intolerance, the person lacks the enzymes necessary to properly digest certain proteins found in food. Also common are intolerances to some chemical ingredients added to food to provide color, enhance taste, and protect against the growth of bacteria. These ingredients include various dyes and monosodium glutamate (MSG), a flavor enhancer.
Substances called sulfites are also a source of intolerance for some people. They may occur naturally, as in red wines or may be added to prevent the growth of mold.
Salicylates are a group of plant chemicals found naturally in many fruits, vegetables, nuts, coffee, juices, beer, and wine. Aspirin also is a compound of the salicylate family. Foods containing salicylates may trigger allergy symptoms in people who are sensitive to aspirin. Of course, any food consumed in excessive quantities can cause digestive symptoms.
Intolerance to wheat has been a growing issue. In addition to celiac disease, which requires a gluten and thereby wheat free diet, non – celiacs have found incredible intolerance to wheat. Many speculate that new intolerance to wheat and other genetically modified foods is due to tampering with the agricultural model which makes our food. Today’s wheat is not the wheat that was eaten 50 years ago. Mark Hyman, MD describes how today’s wheat is becoming a really popular allergen because It contains a “Super Starch,” amylopectin A, that is allows fat to form in the body. Today’s “gmo” (genetically modified) wheat contains a form of “super gluten” that is highly inflammatory. Finally, “gmo” wheat is designed to be extremely addictive, making us crave and eat more of it.
Symptoms of food intolerance include:
Gas, cramps, or bloating
Irritability or nervousness
Identifying a Food Sensitivity
Identifying a food sensitivity is very important. Symptoms caused by food sensitivities can be more debilitating than environmental allergies and include migraine, joint pain, and GI distress.
Allergies and sensitivities can be tested for by use of skin tests and blood tests. These tests are not always accurate, however. Patients are urged to keep a food diary and make a daily accounting of what they ate (or perhaps what they came in contact with chemically) and to note any symptoms on that day. This would theoretically narrow down the offending trigger.
Another way to identify problem foods is to go on an elimination diet. This involves completely eliminating any suspect foods from the diet until symptoms completely go away. Then, the patient would begin to reintroduce the foods, one at a time. This helps pinpoint, which foods cause symptoms. For ideas of what these offending foods may be, try adhering to a diet based on your blood type.
Treatment of Food Sensitivities
Avoidance and elimination of the offending food as much as possible is the best treatment for food sensitivities.