Jaffe Food Allergy Institute Overview FAQ

• What are the symptoms of anaphylaxis?
• What is the purpose of The Jaffe Food Allergy Institute?
• What should I expect during my initial visit?
• What is food allergy?
• Can I prevent food allergy?
• What is anaphylaxis?
• What is atopic dermatitis?
• What foods cause allergies?

What are the symptoms of anaphylaxis?
Symptoms almost always start within minutes after an exposure, although a delay of up to an hour or more is possible. Symptoms can affect the skin (swelling, hives/welts, itchiness, redness), gut (itchy mouth, stomach ache, nausea, vomiting, diarrhea), throat and breathing (hoarseness, difficulty swallowing, throat closing, trouble breathing, wheezing, repetitive coughing), and circulation (paleness, dizziness, passing out, low blood pressure, loss of pulse). A "feeling of impending doom" is often described. Women may experience uterine contractions. Mild symptoms without increasing parts of the body being affected are usually not thought of as life-threatening anaphylaxis (skin symptoms alone, itchy mouth alone, stomach aches alone). Sometimes a reaction will subside and then start up again 1 to 3 hours later.

What is the purpose of The Jaffe Food Allergy Institute?
We care for all types of allergic problems including asthma, allergic rhinitis (hayfever), atopic dermatitis (eczema), food allergy, drug allergy, hives, insect sting allergy, severe allergic reactions (anaphylaxis), immune system problems, and many other allergic and immunologic disorders.

We also offer specialized care focused upon all types of food allergic disorders of all degrees of severity. In this regard, we are a preeminent center for clinical care and research on food allergic disorders. We have numerous ongoing studies concerning the diagnosis and treatment of food allergy and you/your family may inquire about these at the time of your visit.

What should I expect during my initial visit?
During your initial visit, expect to meet with the physician and his/her associates to discuss your medical history and to have a physical examination. Based on the history and physical examination findings, we may determine that allergy tests are needed. Any tests will be explained in detail before they are performed. Once the problem is diagnosed, treatment options can be discussed. Sometimes an evaluation may need to be continued on another visit in order to complete the diagnostic evaluation and/or to provide medications and detailed information about treatment.

We offer comprehensive care that includes an emphasis on education about the treatments for each illness that we treat. You may meet with physicians and support staff, review written and videotaped instructions, and be referred for additional services that are appropriate to your care, if necessary.

What is food allergy?
A true food allergy happens when the immune system "attacks" harmless proteins in our food. The immune system is the part of the body that usually fights infections, but in this case the responses are misdirected. Here, let's consider what is not a food allergy. For example, typical food poisoning is not a food allergy, but some types of food poisoning are tricky and can look like a food allergy because a spoiled food may cause vomiting and diarrhea. Natural constituents of our foods can also cause adverse reactions, like when one gets jittery from caffeine; these are also not allergies. One of the adverse reactions to food that is most often confused with allergy is "intolerance." Intolerance is just a way of saying that an individual develops symptoms from a food (usually a component of the food) based on the individual's inability to digest or process the food, but there is no immune response involved (not an allergy). The classic example of intolerance is "lactose intolerance." Lactose is a type of sugar found in milk. Individuals with lactose intolerance may appear "allergic" because they get diarrhea and gas from ingestion of products that contain lactose (milk, cheese, etc.), but they do not have life-threatening reactions, and their immune system is not reacting to the food. They are missing a digestive enzyme that is needed to break down the milk-sugar.

Can I prevent food allergy?
Probably the most important point to make here is not to feel guilty about anything you did or did not do in terms of a child with food allergy. We see children with peanut allergy who, as far as anyone knows, never were exposed to any peanut and still showed up with a strong positive blood test. Based upon the available but limited literature, most authorities suggest that breast feeding is important (for many reasons) and also seems to have some allergy-preventative properties (but even this finding is controversial). The only other fairly solid suggestion is to try to delay the introduction of solids for infants to age 6 months. Eliminating some common allergenic foods over the first several years may prevent the expression of an allergy that would have been outgrown whether the food was or was not initially given, but much more research on this theory is still needed. Physicians only have available what is already known and have to make some judgments for recommendations with many limitations.

A panel from the American Academy of Pediatrics made a set of recommendations aimed at newborns at "high risk" for allergy. If you read these recommendations, please understand that the use of terms such as "could," "may," "seem reasonable," etc. indicates that these recommendations are not set in stone. Before undertaking any diet, please discuss these issues with your pediatrician, allergist, and obstetrician, because nutritional deficiencies could result. If you choose to undertake a diet strictly, a dietitian may be needed to evaluate it.

What is anaphylaxis?
Technically, it is when an allergic reaction (caused by the body's immune system) comes on suddenly and affects several parts of the body, sometimes in a severe and progressive way.

What is atopic dermatitis?
Atopic dermatitis, or eczema, is a chronic skin disease estimated to occur in 10% of children. While the exact cause is not known, eczema is frequently associated with allergies and may be aggravated by foods, dust, pollens, or animals. The skin is dry with an itchy, red rash. Weeping, oozing, and crusting of skin may occur as well as thickening (lichenification) of continually affected areas. The scratching itself is felt to play a major role in the development of these skin changes. Bacterial skin infection is common and causes more itching and redness. The skin also has an increased susceptibility to viral infections such as warts or herpes (cold sores, shingles).

Skin of patients with atopic dermatitis does not regulate body temperature normally. There may be abnormal sweating and abnormal blood vessel responses, such as the opening and closing of these vessels in the skin. Your child may not react as you expect with changes in room temperature. He may sweat very little. Since intact skin is also important in holding body fluid, your child may lose extra fluid (simply by evaporation) when he is severely affected. You might note increased drinking of fluids. These problems are not dangerous for your child if appropriate therapy is used to clear up the skin lesions.

What foods cause allergies?
Although a person could be allergic to virtually any food , most people with food allergies are allergic to fewer than 4 foods. In children, the most common foods causing significant reactions are egg, milk, peanut, soy, wheat, tree nuts, and fish and shellfish. In adults the most common foods are peanut, tree nuts, and fish and shellfish. Many people mention strawberries, citrus, corn, and chocolate as common allergy-causing foods, but they are actually quite uncommon. It seems that we are seeing some increase in allergies to seeds like sesame, poppy, and maybe even mustard and more (mild) reactions to various fruits and vegetables.