Dr. Joanne Yeung, MD

Pediatric and Young Adult

Allergy and Clinical Immunology

Food allergies

 

The prevalence of food allergies is increasing in North America. Up to 7% of the population has a food allergies. They commonly first appear in infants, but can appear in older children and adults.

 

The most common foods to cause allergies are peanut, tree nuts, egg, cow's milk, wheat, soy, fish, shellfish, and sesame. Common allergic symptoms include mouth itching, hives, swelling, and vomiting. Sometimes there can be difficulty breathing and fainting. The severity of allergic reactions are often unpredictable. Therefore, it is important to understand what the allergic triggers are and be prepared to handle allergic reactions. 

 

For more information on food allergies, click here and here.

 

 

Atopic dermatitis (eczema)

 

Atopic dermatitis is very common in young infants and can be bothersome throughout childhood and adulthood. There is dry, scaly skin that is very itchy. Usually it itching leads to red, inflamed rashes that can weep and bleed.

 

It is believed to be a skin barrier problem, where the proteins in the skin do not lock well together and the skin is leaky, causing chronically dry skin. The problem barrier allows irritants and germs to get in, leading to inflammation. 

 

Contrary to popular believe, eczema is rarely liked with the diet. However, poorly controlled eczema in early life can be associated with increased allergies. 

 

To learn more about atopic dermatitis, click here.

 

 

Asthma

 

Asthma can come on at any age, but often it starts in early childhood. There is chronic inflammation in the lungs causing airways to become twitchy and mucus to collect in the airways. Ashtma can be mild in some people and only come on in certain situations, but in others it can be a daily problem that needs to be controlled. 

 

Asthma symptoms include cough, feeling tight in the chest, wheezing, and shortness of breath. Common triggers are viral colds, exercise, cold air and inhaled allergies such as pollens and animal dander.

 

People who have asthma can live a normal, unrestricted life. The goal of treatment is so that all daily activities can be done with ease. 

 

For more information on asthma, click here.

 

 

Allergic rhinitis and conjunctivitis

 

This problem is common in adolescents and young adults. The symptoms can come on in grade school, but not usually before kindergarten. 

 

Allergy proteins (allergens) in the air can cause a stuffy, runny nose, sneezing and itchy. They can also cause eyes to be itchy, red and watery. Common environmental allergens are dust mite, molds, tree pollen, grass pollen, and animal dander.

 

Symptoms can be mild or quite bothersome, causing people to lose sleep and miss school or work. If the person also has asthma, poorly controlled symptoms can also make the asthma worse.

 

There are several treatment options including symptomatic treatments (helps the person cope with the symptoms) and allergen immunotherapy (common known as "allergy shots"). Immunotherapy trains up the immune system to ignore the allergen.

 

For more information on allergic rhinitis, click here.

 

 

Oral allergy syndrome

 

This is the old name for food-pollen allergy syndrome. In people who have seasonal allergic rhinitis, some may have localized oral symptoms with certain raw fruits, vegetables and nuts that are cross reactive to these pollens. For example, there may be an itchy mouth when eating fresh apples, peaches, cherries or carrots if the person is allergic to birch or alder pollen. That person would be able to eat the food in its heated or processed form, such as apple juice and canned peaches. Usually the symptoms are mild, but it is a good idea to avoid the food because there is a small chance of a more severe allergic reaction, although rare.

 

To learn more about oral allergy syndrome, click here.

 

 

Food protein-induced enterocolitis syndrome (FPIES)

 

This is a fairly uncommon condition of infancy. However, increasing awareness is helping to identify more children affected with this condition. Onset usually occurs in the first year, most often between 4-8 months. After eating a specific food, there is delayed onset of repetitive vomiting, usually 2-3 hours after eating. There may also be diarrhea, appearing very tired, and dehydration. Sometimes babies need emergency care. There is no rash or swelling, different from a "classic" type of food allergy. There is a wide variety of foods that cause FPIES, including cow's milk (including infant formula), soy, meats, grains, egg and avocado.

 

To read more about FPIES, click here.

 

 

Immune defects

 

It is normal for young children to get sick often. Healthy infants and toddlers can catch up to 12 colds per year. Sometimes they seem endless. However, there are people who have defects in their immune system, causing them to catch infections more easily, be sicker than expected when infected, and to be difficult to cure. The Jeffrey Modell Foundation published 10 warning signs to help identify children and adults who may have a primary immunodeficiency (a immune defect someone is born with). An immune problem should be suspected if there are 2 or more of:

 

In children:

1. Four or more new ear infections in 1 year.

2. Two or more serious sinus infections in 1 year.

3. Two or more months on antibiotics and not getting better.

4. Two or more pneumonias in 1 year. 

5. Failure of an infant to gain weight or grow normally.

6. Recurrent, deep skin or organ abscesses. 

7. Persistent thrush in the mouth or fungal infection on the skin.

8. Need for intravenous antibiotics to clear infections.

9. Two or more deep-seated infections such as a blood infection.

10. A family history of primary immunodeficiency.

 

In adults:

1. Two or more new ear infections in 1 year.

2. Two or more serious sinus infections in 1 year, in the absence of allergy.

3. One or more pneumonias in 1 year.

4. Chronic diarrhea with weight loss.

5. Recurrent viral infections (colds, warts, herpes)

6. Recurrent need for intravenous antibiotics to clear infections.

7. Recurrent, deep skin or organ abscesses. 

8. Persistent thrush in the mouth or fungal infection elsewhere.

9. Infection with normally harmless tuberculosis-like bacteria. 

10. A family history of primary immunodeficiency.

 

For more information on immunodeficiencies, click here.

 

 

Dr. Yeung's Office

 

Vancouver Pediatric and

Allergy Centre

305 - 1338 W. Broadway

Vancouver, BC

V6H 1H2

 

Phone: 604-336-5599

Fax: 604-210-5240 

vancouverpac@gmail.com

www.vancouverpac.com

 

Our office hours are:
Monday to Friday 9:00AM-5:00PM

Closed for lunch 12:30PM-1:30PM