Title: Am I intolerant or just irritated Third QPEM Conference 11-13 th of January 2019 Name: Dr Jimmy abraham FRCPCH MSc PG Dip
DISCLOSURE I do not have any relevant financial relationship with commercial interest to disclose.
Learning Objectives At the end of the presentation, the attendee will be able to: Being able to recognise allergies in children 1 Overview of the management pathway 2 Managing parental expectation 3
What can We do for YOU • Listen to your concerns as Parents • Point you in the right direction • Help you make informed choices • Lets do this together and give your child the best on offer
Food Intolerance • Food intolerance is not so clear cut and is a more controversial area • Food intolerance reactions do not involve IgE and the mechanisms are unclear however it is known that reactions are more likely to be delayed with the reaction occurring several hours and sometimes up to several days after eating the offending food.
The Allergic March
Is Allergy increasing • The latest surveys show that the rates of allergy are increasing throughout the world, affecting around 30-40% of people at some stage in their lives.
Why • Changes in the foods we eat • Changes in how we are exposed to food allergens • Environmental factors • The Hygiene Hypothesis • Genetics
Common Food Allergens • Milk • Eggs • Peanuts • Soy • Wheat • Tree nuts (such as walnuts and cashews) • Fish • Shellfish (such as shrimp)
Allergy Reactions • Skin: itchy red bumps (hives); eczema; redness and swelling of the face or extremities; itching and swelling of the lips, tongue, or mouth (skin reactions are the most common type of reaction) • Gastrointestinal tract: abdominal pain, nausea, vomiting, or diarrhea • Respiratory tract: runny or stuffy nose, sneezing, coughing, wheezing, shortness of breath • Cardiovascular system: lightheadedness or fainting
Anaphylaxis • This sudden, potentially life-threatening allergic reaction involves two or more of the body areas listed above. • In addition, there also can be swelling of the airway, serious difficulty with breathing, a drop in blood pressure, loss of consciousness, and in some cases, even death.
Anaphylaxis This sudden, potentially life-threatening allergic reaction involves two or more of the body areas listed above. In addition, there also can be swelling of the airway, serious difficulty with breathing, a drop in blood pressure, loss of consciousness, and in some cases, even death.
Allergy’s can trigger • Asthma • Eczema • Irritable bowel syndrome • But all the above can occur without allergies • We can determine if this is allergy related or not
Investigations • Allergy Skin Test • Blood test for allergy • The Oral Challenge Test
Treatment
Treatments • If it irritates avoid it • Nasal Steroid sprays and Anti Histamines • Immunotherapy • Have a management Plan • Adrenaline Auto Injectors
Questions that you may be asked as health professionals • How do you know my child has nasal allergies? How can you confirm the diagnosis? • Does my child need further allergy testing or other allergy treatment? Are allergy injections (immunotherapy) available? Is there anything else I should be doing to help control the allergies, such as dusting the • house more often or taking other environmental measures? • If my child develops a cough, especially at night, could that be related to nasal allergies? • How can I tell the difference between my child having allergy symptoms and having a cold • We have pets. Do they make treating allergies more difficult? • Should my child carry an adrenaline injector pen or wear a medical alert bracelet • Which allergy symptoms are serious enough to make an appointment to see the doctor? • At what point should my child be referred to a hospital specialist for allergy treatment?
Questions
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