Food for thought!

Subha j rao

Among rare allergies are those involving yeast

Life is difficult for those with food allergies. But, you can learn to work around your condition and stay healthy, say doctors

Neelima led a perfectly normal childhood. It was when she stepped into her teens that the trouble began. A casual evening outing to the beach with friends for some sundal and roasted peanuts saw her breaking out into hives and struggling to breathe. Two days in hospital later, she was diagnosed as being allergic to peanuts! Now, she steers clear of walnuts too.

Mangoes used to be Prerna's favourite fruit. It's been 25 years since she tasted one. A series of violent stomach upsets and vomiting later, doctors told her to stay off it. Now in her late 40s, Prerna has added gluten to her list of to-be-avoided foods.

Sprouts, said to be a great source of nutrition, are the bane of Smriti's life. Just a spoonful of uncooked sprouts or even a sprinkling on a salad leaves her with painful itches and patches on her skin.

Neelima, Prerna and Smriti are not alone — lakhs of people the world over battle food allergies and intolerance on an everyday basis. Thanks to reportage, people know about some of the most frequent culprits — nuts (walnuts, peanuts, Brazil nuts, etc.), lactose, gluten, shell fish and eggs.

Rare allergies

But, there are some others that can leave you stumped. Says S. Barnabas Durairaj, retired Professor of Gastroenterology, Madras Medical College, and Senior Consultant, St. Isabel's Hospital: “I once saw a patient who choked after eating a burger — he was allergic to the sesame seeds on the bun!.”

Tanuja Reddy, consultant dermatologist, Vijaya Health Centre, has seen some peculiar cases too — people allergic to beer and bread (yeast) and bubblegum (an ingredient in it caused rashes around the mouth of a young boy).

Luckily, most allergies manifest themselves on the skin as urticaria (hives) and wheals. These are the easier-to-treat allergies, says Dr. Tanuja.

Some suffer severe gastroenterological issues such as vomiting, diarrhoea and stomach cramps, among others. Others choke and see their tongues swell up. These allergies are more serious in nature, and life-threatening, at times. Such patients may have to carry an epinephrine autoinjector to deal with a sudden attack.

Identify the problem

So, how does one tackle a food allergy? “Firstly, it is important to differentiate between an allergy and intolerance. Allergy is immune related and is usually congenital; intolerance is non-immune related and picked up along the way,” says Dr. Barnabas.

Diagnosing a condition as an allergy or intolerance depends on the skill of the physician and the ability of the patient to give details. Dr. Tanuja says talking to the patient is vital, because blood tests can't always determine what is wrong. “Keep talking. That's how you pick up subtle clues that will help in treatment. Once you identify the cause, things fall into place,” she adds.

Dr. Barnabas agrees. “Talking helps, else you will end up putting the patient through innumerable tests for specific allergens or through an inconvenient colonoscopy.”

What is responsible for the growing number of people with allergy or intolerance — lifestyle or awareness? “I would say awareness. People read up stuff on the Internet before coming to us. Also, we now have more doctors who are trained to deal with such issues,” says Dr. Tanuja. However, on the flip side, once they read up, people tend to worry too much, imagining the worst-case scenario, she adds.

So, what kind of precautions should someone with food allergy take? “The best course of action is to keep the offending food item away from the table. For that, it is important that you maintain a diet chart and try and pin-point what triggers the reaction,” says Dr. Tanuja.

And, Dr. Barnabas says that people should “check if they've eaten something other than what they routinely do. Then, they should go through a process of careful elimination of that product from the diet before zeroing in on the allergy-inducing food”.

In such a situation, it is but natural that nutrition suffers. For instance, if someone is allergic to both gluten and yeast, Indian breakfast staples — idli/dosa and rotis — go off the table. What does a person then eat to stay healthy? “There are other options,” insists Varsha, founder-chairperson, Indian Institute of Nutritional Science. “You just have to be innovative, and look at substitutes instead of skipping a particular ingredient altogether. Think of rice upma, idiyappam… be creative.”

“When faced with a food allergy, people are scared, and tend to ignore an entire food group. But, you need a balanced diet. So, work with a dietician so that you get your nourishment even as you stay away from the allergy-causing food item. As for those with intolerance, once the reaction-causing item is identified, it must be re-introduced in the diet once in a while to see if the system has learnt to re-accept it or not. The focus should always be on working around the issue on hand,” she advises.

(Some names have been changed on request.)

MAKE LIFE EASIER

Is it an allergy or intolerance? Talk freely to your doctor to help in diagnosis

Maintain a diet chart. Go through a process of careful elimination to identify the cause of allergy.

Don't blindly avoid food groups. Work out a diet in consultation with a nutritionist

Develop the habit of reading labels on food products. It can save your life.