Lecture 13-food allergy practical Flashcards
Food Allergy
Adverse food reaction
breaks into 2 categories
1)Food allergy (immune medicated)
2)Food intolerance (non immune mediated e.glactose intolerance)
Food allergy (immune mediated) breaks into three categories
-IgE mediated
-Mixed IgE/ Non-IgE-mediated
-Non-IgE-mediated
IgE-mediated
Immediate onset (<60min)
- Allergy
-Anaphylaxis
Mixed IgE/ Non-IgE-mediated
-Atopic dermatitis
-Eosinophilic Oesophagitis
Non-IgE-mediated
-Food protein-induced allergic proctocolitis
-Food Protein-induced Enteropathy
-Food Protein-Induced Enterocolitis syndrome
-Other enteropathy:coeliac disease
Food allergy can occur in ……% of under 1yr olds
10%
Food allergy can occur in ……% of under 5yr olds
4-8%
When is the reponse to immune mediated food allergy
Quick response 1 hrs of ingestion of food
IgE mediated Food allergy can occur in
Childhood and adulthood
symptoms of IgE mediated Food allergy
Hives, swelling, breathing difficults, vomiting, floppy/pale
what is IgE mediated Food allergy associated with
anaphylaxis
What are common foods that cause IgE mediated Food allergy
Peanut, treenuts, milk, eggs, wheat, soy, fish, seafood, sesame, but can be other foods
Diagnosis IgE mediated Food allergy
Diagnosis with clinical symptoms and positive SPT or serum IgE antibody tests
They will number what food allergues they are testing and in what part of the body for adults and children
They will number what food allergies they are testing
The will test it on the forearm for adults and they will do it on the babies back
what will the specialist measure after the prick
The specialist will measure how big the wheel and the raise is of the affected area
when do non-IgE mediated food allergy usually occur
These usually occur within the first year of life and usually resolve in early childhood
what does non-IgE mediated food allergy involve
The immune system
when does non-IgE mediated food allergy react
Delayed reaction 2hrs-24hrs
what does the non-IgE mediated food allergy usually involve
Gastrointestinal system, such as blood/mucus in stools, reflux, diarrhoea/constipation,excessive crying/abdominal pain
diagnosis of non-IgE mediated food allergy
Diagnosis with clinical symptoms and will have negative SPT/serum IgE testing
non-IgE mediated food allergy : Food protein induced allergic protocololitis
Occurs in first year of life. Causes blood/mucus in stools and unsettledness. Infant often thriving. Most common cause are cows milk, and soy
non-IgE mediated food allergy: Food protein-Induced Enteropathy
Inflammation of the small intestine in early infancy. Causes reflux, loose stools, can be mucus/blood in stools, sometimes poor weight gain, unsettledness, possibly bloating and malabsorption. Most common cause is cows milk and soy.
non-IgE mediated food allergy: Food protein-Induced Enterocolitis syndrome
Profuse vomiting around 2-4 hrs after ingestion of food, may go pale/floppy, fatigue and usually starts in early infancy. Most common food triggers are rice, cows milk, soy, oats and beed
Prevention of food Allergy
from 6 months and before 12 months of age, introduce all allergen foods into the infants diet, offer regulary once introduced
Food Intolerance is more common in
Older children and adults
Food Intolerance reaction time
Delayed reaction after ingestion of a large amount of the food
Food Intolerance is most common in
Lactose and fructose intolerance, other FODMAP foods
Food Intolerance cause
Cause abdominal pain, diarrhoea/constipation, bloating, gas
Food Intolerance can be related to reduction
In digestive enzymes e.g lactase
A dietitian role in food allergy/intolerance
-Education on what it is
-Help identify the food allergy
-Give advice avoidance
-Food alternatives
-Read food labels
-Growth monitoring
-Altering family meals advice
-Ensure nutritional requirements are met
-Infant formula prescription
-Other supplements
-Support to reintroduce food allergen if ready
Infant Milks for IgE and Non-IgE cows milk Protein allergy:
-Lactose free formula is not suitable as a baby is reacting to the protein in the milk
-Many infants that react to cows milk will react to soy
-Infants under 6 months should not be given soy formula, but can be given after 6 months of age
Extensively hydrolysed formula
Not suitable for infants with severe cows milk protein allergy or anaphylaxis
What are the three infant milk for IgE and non-IgE cows milk protein allergy
-Extensively hydrolysed formula
-Rice Formula
-Amino Acid Formula
Advice for family given
Continue breastfeeding and mum was following a low dairy diet
-inform of food substitutes
-Read food labels
-Encourage and explain intro of allergens
-Ezzema manangement
-Growth closely monitored
Advice in the toddler years
-Continue breastfeeding until around 2 years
-Continue on Neocate Syneo (infant formula)
-Advice on managing daycare and anaphylaxis plan from specialist
-Advice on family meals
-Growth monitored
Alternative Milks and Yoghurts
Check milk gives at least…..
120mg calcium per 100mls
Alternative milks
-Soy milk - best choice good protein, fat, energy
-Oat milk- Good energy levels and some protein
-Rice milk-Good energy levels, maximum 300mls per day
-Almond/coconut/cashew milk-low energy protein, fat-last resort
Yogurt alternatives
-Can make your own using Vegan starter
-Soy yogurt- Alpro soy
-Coconut yogurt- not many clacium except the collective dairy free pouch
-Cashew yogurt-Little Island has calcium
alternative cheeses
-Angel foods
-Zenzo
-Sheese
Egg replacer
Orgran egg replacer
You can get gluten free products especially in
Pasta and bread
