Allergies 101

What is an allergy?

An allergy is a condition where the body overreacts following  “contact” with an allergen (dust, molds, pollen, flower, dander, fur, animal protein from hair, perfume, cosmetics, medications—applied to skin or swallowed—food or drink, etc.).  Symptoms could be as trivial as sneezing or as serious as sudden inability to breathe, shock and death.

What is the incidence of allergies?

About 10 percent of people have some form of allergies or another.  So, almost 10 million Filipinos suffer from this malady. Luckily, most of the allergies people have are mild. If repeated exposures to the same allergen, at the same high dose, are allowed to occur, the symptoms could become more severe.

What triggers the symptoms?

Allergic reaction is triggered, and symptoms develop, when the body’s immune system detects the presence of an allergen. This automatic protective response is aimed at warding off any adverse effects of the “culprit substance” on the body by producing antibodies and mobilizing the “immune soldiers into the battlefield to fight the invading foreign” substance. This is a natural part of the defense mechanism of our body.

What are the symptoms of allergies?

From the mild symptoms to the life-threatening ones, they could be one or a combination of the following: sneezing, nasal congestion, runny nose, red, itchy watery eyes, skin rashes or hives, stomach cramps, nausea, vomiting, tachycardia (fast heart beat), dyspnea (difficulty breathing), wheezing, hypotension (drop in blood pressure), cardiac arrest (stoppage of heart beat), and death. While the last 3 situations are not common, they are nonetheless very significant and still far too many, especially because these are preventable disasters.

Have there been deaths from exposure to animal hair?

Yes, and two such sad and tragic deaths happened to my godson and, in a separate incident, to a friend’s daughter (both in their twenties), who died within an hour after exposure to horses in a barn.

How about fatal allergy to MSG?

A classmate of mine, a chest surgeon from California, was attending a meeting in Nice, France, a few years ago, when he and his wife decided to eat oriental food, after a week of French cuisine. Inspite of their instruction to the waiter to make sure the chef did not add MSG (Mono Sodium Glutamate, a flavor enhancer) to the food they ordered because he was allergic to it, somehow MSG was used anyway.  After ingesting a mouthful, my friend became very short of breath, collapsed, and died a couple of hours later from anaphylactic shock.

What is Chinese Food Syndrome?

Monosodium Glutamate has been used for years as a food enhancer in many recipes in restaurant or at home. People who are sensitive to MSG (whose food has a lot of MSG) may experience mild and transient warmth and flushing in the face and the rest of the body, some with mild chest tightness that goes away in a few minutes. Since many Chinese recipes call for the use of MSG, this reaction has been termed “Chinese Food Syndrome.” This is actually not an allergy, but there are some people to are really allergic to MSG.

What is anaphylactic shock?

This is a violent allergic reaction, which results in massive swelling and rapid closure of the air passages, precipitous drop in blood pressure, and death by suffocation.  In some cases, bee stings have caused anaphylactic shock.

How common is food allergy?

Medical reports have shown that about 2% (two out of a hundred) of adults and about 8% of children have true food allergies. Food allergy is not the same as food intolerance (like stomach aches following ingestion of milk for those with deficiency of lactase, the enzyme that digests lactose–milk and milk products). Food intolerance is due to body metabolism and does not involve the immune system. Some people are allergic to shellfish, peanuts, a few to chicken.  Cow’s milk, soy, wheat and eggs are common cause of allergies in children. In some cases, children outgrow their allergies, but early peanut allergy can be for life, although new strategy using desensitization is now being used to treat them.

What are the signs of an allergic reaction?

Sneezing, skin rashes or hives, runny nose, swelling of the lips or tongue, stomach cramps, vomiting and diarrhea, difficulty in breathing, wheezing, and in more severe cases, anaphylactic shock as described above.

How about allergies to food additives?

Adverse allergic reactions to some food additives have been reported. Among some of them are aspartame (as in Equal, a sweetener), MSG, FD&C Yellow No. 5 (a food color also known as tartrazine), and sulfites (sulfur-based preservatives). Following controlled studies in aspartame, the FDA determined it is not an allergen, and that aspartame is safe. Pregnant women with high level of phenylalanine in the blood, some people with a genetic disease called PKU (phenylketonuria), and those with advance liver disease have a problem with aspartame because these people do not metabolize the amino acid called phenylalanine, which is a component of aspartame. High levels of phenylalanine in the body can cause brain damage.

Are sulfite preservatives allergens?

Yes, sulfites, which are antioxidants used to prevent or reduce discoloration of light colored fruits and vegetables and also to inhibit the growth of bacteria in fermented foods, like wine, are allergens. Although majority of people do not have problems with sulfites, those sensitive to them, especially those with asthma, can develop mild to life-threatening symptoms.

Does maternal smoking cause allergies in children?

Cigarette smoking during pregnancy has been shown to increase the incidence of allergies among the newborns. Rarely, specific allergies can be “inherited” from the parents. Studies have confirmed the assessment that avoidance by the mother of food allergens may reduce the incidence of some food allergies in infants and young children.

What is the best treatment regimen for allergies?

As with any medical condition or illness, prevention is the key.  Avoidance of all known allergens is the best regimen in dealing with allergies and asthmatic attacks. Those who have food or drug allergies must read all ingredient labels and be extra cautious before ingesting anything. Fortunately, severe allergic reactions are not very common. Those with more than mild to severe form of allergies must be trained by a physician on the life-saving technique of self-injection of 0.1 ml (one tenth of a cc) epinephrine (adrenalin) subcutaneously (under the skin) when symptoms first begin to manifest following exposure to known allergens. In this dire situation, every minute counts, and 5 or 10 minutes may spell the difference between life and death.

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Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA,  a 501(c)(3) humanitarian foundation in the United States. Email: [email protected]

Dr. Philip S. Chua

Philip S. Chua, MD, FACS, FPCS, Cardiac Surgeon Emeritus in Northwest Indiana and chairman of cardiac surgery from 1997 to 2010 at Cebu Doctors University Hospital, where he holds the title of Physician Emeritus in Surgery, is based in Las Vegas, Nevada. He is a Fellow of the American College of Surgeons, the Philippine College of Surgeons, and the Denton A. Cooley Cardiovascular Surgical Society. He is the chairman of the Filipino United Network – USA, a 501(c)(3) humanitarian foundation in the United States.

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