Food Allergy

By
Prof.Enayat Hashem

Food allergy is a
condition that develops
when a person is
hypersensitive to certain
proteins found in food.

It is an immune response

Immnue response may be:

1) Immediate reactions (life-threatening)
Rapid appearance of symptoms often
within minutes after the offending food
eaten or before the food is swallowed.

2) Late reactions

(less severe)

Up to 48 hours between eating the

allergen food and the appearance of
symptoms as nasal congestion.

Food allergen / antigens

They are the proteins or other large
molecules from food that induce an
immune response.

The immunoglobulin E (IgE)

It is produced in response to these
foreign substances in an attempt to
rid the body from them.
IgE causes the typical allergic
symptoms that involve the skin, nasal
passages , and respirator or G.I.T.

Food most often cause allergic

reactions
Milk
Fish
Shellfish
Nuts
Berries
Chocolate
Corn

Diagnosis of food allergy

1) Medical diagnostic tests
a. Skin testing by scratching the skin

with extract of food

b. Radioallergosorbent

2) Nutritional diagnostic tests

a. Detailed allergic history for
previous 2 4 weeks
b. Elimination diets

Elimination diets
This diet contain a few carefully chosen food
with common allergens omitted. It should be
followed for 1 2 weeks. Foods are slowly
and cautiously put back into the diet, one
food at a time for a few days. If no symptoms
are noted, another food is added for another 2
days.
Nutritionally adequate diet without food
allergen is advised.

Food Intolerance
These do not involve the immune
response, but food allergies do.
They are not life-threatening.
Food intolerance can begin at any
age, while food allergy usually begins in
childhood.
Food intolerance may have a
biological basis such as lack of
digestive enzyme, or have a
psychological
basis
as
anorexia

Some common food intolerance

Lactose intolerance
Fat intolerance
Intolerance to vegetables, fruits
as legumes, lettuce
Intolerance to hot, spicy food

Role of nurse in managing food

allergies and food intolerance
1) The nurse needs to be aware of the
medical basis and unknowns when it
comes to problems with food.
2) The nurse should be supportive in
listening to patients and their families
describing food intolerance.
3) Judgments should be avoided, such
as the idea that psychosomatic illness
is all in the patients head.

4) The nurse should determine what

valid testing has been undertaken to
diagnose food allergies and intolreance.
5) Assessment should include asking
patients what foods they cannot
tolerate
6) If major groups , such as milk , are
being omitted from the diet, the nurse
or other health care professional should
refer as needed to the patients primary

physician or as a registered dietitian or

both.
7) The diagnosis should be confirmed
when needed, and patient education
should be provided to ensure good
nutritional intake.

Anorexia nervosa
It is characterized by refusal to
eat, stemming from emotional states
such as anxiety, irritation, anger, and fear.
Initially there is no real loss of appetite.
However, once severe weight loss has
occurred, hormonal changes take place
that can alter hunger recognition.
The syndrome occurs mainly in girls after
puberty, but about 10% of all cases of
anorexia nervosa occurs in boys and young
men. There is an increased risk of anorexia
nervosa among high achievers and upper
socioeconomic populations.

The cause is generally felt to be of

psychological origin, but treatment involves
more than just psychotherapy.
Some common correlates of
anorexia nervosa are:
1) An intense fear of becoming obese that
does not lessen as weight loss progresses.

2) A disturbance of body image, such as

claiming to feel fat even when emaciated.
3) Weight loss at least 25% of original
weight
4) Refusal to maintain body weight over a
minimal healthy weight for age and height

5) No known physical illness that would

account for weight loss.
6) Amenorrhea due to altered hormonal
staes
7) Bizarre eating habits such as cutting food
into tiny pieces or limiting intake to only few
foods
8) Underlying low self-esteem
9) Compulsive excerise habits

Dietary treatment
The goal of treatment is to restore
nutritional status and resolve the underlying
psycholog- ical problems.

Outpatient treatment is the preferred method

The person with anorexia who is 30% below
normal weight, fails to gain weight, is in
complete denial, or is suicidal should be
hospitalized.
All members of the health care team must
be aware of the need to individualize the care
plan.

The nurses role includes closely

supervising and encourging the patient
to eat all of the food provided.
A trusting relationship between
patient and health care professional is
absolutely essential.
It should be recognized that treatment
will require a long-term, family based
approach with considerable amount of
time needed.
Treatment is not always successful.

Bulimia
It is characterized by binge eating
followed by purging through selfinduced vomiting or abusive use of
laxatives or both.
The person is afraid of becoming
overweight and is aware that eating
pattern is abnormal. However, the
bulimic patient loses control over
eating and often eats large amounts of
food rapidly. High kilocalorie, easily
ingested foods are chosen during

Fasting then follows, often resulting

in a weight fluctuation of as much as 10
pounds.
Bulimarexia is the term used to
describe cycles of binge eating and
purging (vomiting or laxative abuse)
with undereating.

Dietary treatment
In the hospital, food intake should be
normalized to appropriate mealtimes,
with close supervision after eating to
control vomiting.

The patient must be counseled on the

importance of the need to stop
using laxatives and to accept a higher,
but normal, body weight.
Psychological assessment should
take priority, and plans should be made
for long-term, outpatient, family-based
counseling with a health care
professional trained in eating disorders.
A total health care team efforts is
essential to ensure effective treatment.

Outpatient dietary treatment of

bulimia emphasizes regular mealtimes
to satisfy hunger needs. Food is
discouraged as a mean of reward or
comfort.

Schizophrenia

It is a chronic mental disorder that

causes symptoms such as visual
hallucination and delusions of hearing
voices.
A person with schizophrenia may feel
that food has poisoned. A health care
team approach is strongly advised.
Any attempt to encourage eating may
cause the person to become even more
suspicious that the food has been
poisoned. A great deal of patience
when working with a person with
schizophrenia.