pre reading online week 1 nutrition and skin - haven't finished Flashcards
define food allergy
when symptoms are caused by an immune reaction, usually IgE mediated, but sometimes non-IgE (thought to be T-cell mediated but not well understood).
define food intolerance
a non-immune reaction, e.g. lactose intolerance where there is lactase enzyme deficiency leading to poor breakdown of lactose in the gastro-intestinal tract and the excess unabsorbed lactose results in symptoms.
list some causes of food intolerance (3)
enzyme deficiencies,
pharmacological agents and naturally occurring substances.
list IgE mediated food allergy skin signs and symptoms (4)
Pruritus Erythema Acute urticaria – localised or generalised Acute angioedema – most commonly of the lips, face and around the eyes
list non IgE mediated food allergy skin signs and symptoms (3)
pruritus
erythema
atopic eczema
list IgE mediated food allergy GI signs and symptoms
Angioedema of the lips, tongue and palate Oral pruritus Nausea Colicky abdominal pain Vomiting Diarrhoea
list the non-IgE mediated food allergy GI signs and symptoms
Gastro-oesophageal reflux disease Loose or frequent stools Blood and/or mucus in stools Abdominal pain Infantile colic Food refusal or aversion Constipation Perianal redness Pallor and tiredness Faltering growth in conjunction with at least one or more gastrointestinal symptoms above (with or without significant atopic eczema)
resp system signs and symptoms for food allergy
Upper respiratory tract symptoms (nasal itching, sneezing, rhinorrhoea or congestion [with or without conjunctivitis]) Lower respiratory tract symptoms (cough, chest tightness, wheezing or shortness of breath)
what should an allergy-focused clinical history tailored
to the presenting symptoms and age of the child or young person include…
any personal history of atopic disease (asthma, eczema or
allergic rhinitis)
any individual and family history of atopic disease (such as
asthma, eczema or allergic rhinitis) or food allergy in parents or
siblings
details of any foods that are avoided and the reasons why
an assessment of presenting symptoms and other symptoms
that may be associated with food allergy (see recommendation
1.1.1), including questions about:
the age of the child or young person when symptoms first
started
speed of onset of symptoms following food contact
duration of symptoms
severity of reaction
frequency of occurrence
setting of reaction (for example, at school or home)
reproducibility of symptoms on repeated exposure
what food and how much exposure to it causes a reaction
cultural and religious factors that affect the foods they eat
who has raised the concern and suspects the food allergy
what the suspected allergen is
the child or young person’s feeding history, including the age at
which they were weaned and whether they were breastfed or
formula-fed – if the child is currently being breastfed, consider
the mother’s diet
details of any previous treatment, including medication, for the
presenting symptoms and the response to this
any response to the elimination and reintroduction of foods
in a allergen focused physical examination pay particular attention to
growth and physical signs of malnutrition
signs indicating allergy-related comorbidities (atopic eczema,
asthma and allergic rhinitis).
what investigations would you do if you suspect a child has IgE mediated allergy
offer the child or young person a
skin prick test and/or blood tests for specific IgE antibodies to the
suspected foods and likely co-allergens
what must you do before carrying out allergy testing
carry out an allergy focused history
what should you do if non IgE mediated allergy is suspected after focused history ?
trial elimination of the suspected allergen (normally for between 2–6 weeks) and reintroduce after the trial. Seek advice from a dietitian with appropriate competencies, about nutritional adequacies, timings of elimination and reintroduction, and follow-up.
