Food allergy reactions are unpredictable. The way that your body reacts to a food allergy one time cannot be used to predict how it will react the next time.
Because the symptoms of anaphylaxis — a severe allergic reaction that is potentially fatal — can worsen quickly, reactions must be treated right away. Seconds count!
Symptoms of a food allergy reaction can affect different parts of the body. They can be mild (itchy nose or a few hives) or severe (trouble breathing, repetitive vomiting, etc.).
Epinephrine, which helps reverse the symptoms of a severe reaction, is the only treatment for anaphylaxis. Antihistamines may be used to relieve mild allergy symptoms, such as a few hives, but they cannot control anaphylaxis and should never be given as a substitute for epinephrine. Mild symptoms can quickly turn into a life-threatening reaction. Anyone having a reaction to a food allergen should be watched closely.
Following are the general guidelines for treating an allergic reaction, using FARE’s Food Allergy & Anaphylaxis Emergency Care Plan. This plan was developed under the guidance of FARE’s Medical Advisory Board, comprised of the country’s leading food allergy experts. Everyone with a diagnosed food allergy should work with their allergist to fill out an Emergency Care Plan that is right for them. General recommendations:
- Administer epinephrine (using the individual’s easy-to-use epinephrine auto-injector) and call 911 for any of the following severe symptoms:
- Lung: shortness of breath, wheezing, repetitive cough
- Heart: pale, blue, faint, weak pulse, dizzy
- Throat: tight, hoarse, trouble breathing/swallowing
- Mouth: significant swelling of the tongue and/or lips
- Skin: many hives over body, widespread redness
- Gut: repetitive vomiting or severe diarrhea
- Other: feeling something bad is about to happen, anxiety confusion
- Or a combination of mild or severe symptoms from different body areas
- Antihistamines may be given, if recommended by a physician, for a single mild symptom, such as:
- Nose: itchy/runny nose, sneezing
- Mouth: itchy mouth
- Skin: a few hives, mild itch
- Gut: mild nausea/discomfort
- If these symptoms worsen, give epinephrine.
Epinephrine is a safe and relatively harmless drug, and allergists advise that if you have any doubt about whether to use epinephrine, you should go ahead and use it. Your allergist may prefer that epinephrine be used before symptoms or with only mild symptoms if a food allergen was eaten.
It’s important to note that this lifesaving drug should be given first, followed by a call to 911. We also advise that you let dispatchers know that you are giving epinephrine, and that you are requesting an ambulance with epinephrine.
Again, when in doubt, give epinephrine! This is critically important. You could save a life.
For more information about food allergies, please visit www.foodallergy.org.
For more information about treatment and management of an allergic reaction, please visit http://www.foodallergy.org/treating-an-allergic-reaction.
This article was reviewed by Scott H. Sicherer, M.D. professor of pediatrics, allergy and immunology at the Icahn School of Medicine at Mount Sinai.