Food allergy treatment

First of all, it is necessary to exclude a food allergen, for the identification of which parents are advised to keep a food diary. The diary must indicate not only the name of the food product, but also its quality, method of cooking, shelf life. It is necessary to record the exact time of change in the child's condition, appetite, stool type, the appearance of regurgitation, vomiting, rashes, diaper rash and other elements on the skin and mucous membranes. If a child in the first months of life is allergic to cow's milk, it is necessary to provide him with breast milk from donors, if this is impossible, prescribe fermented milk mixtures. Such mixtures include acidophilic mixture "Malutka", "Atu", "Bifilin", "Biolact", "Acidolact", "Nutrilak acidophilic".

Diet therapy

Diet therapy is the basis for treating food allergies. Breastfeeding with a mother following a hypoallergenic diet is optimal for children with food allergies. If the mother has no milk and is allergic to cow's milk, soy formulas are used (Alsoy, Bonasoya, Frisosoy, etc.). In case of soy intolerance, formulas based on products of high protein hydrolysis (Alfare, Alimentum, Pepti-Junior, etc.) and partial hydrolysis of milk protein (Humana, Frisopep).

The introduction of complementary feeding begins with vegetable puree (zucchini, squash, cauliflower, white cabbage, potatoes). The second complementary feeding is dairy-free porridge (buckwheat, corn, rice). In case of intolerance to beef, which has an antigenic similarity with cow's milk proteins, it is recommended to use lean pork, horse meat, white turkey meat, rabbit meat.

With a strict elimination diet for one or more years, hypersensitivity to egg, milk, wheat, and soy allergens in children may disappear, although IgE antibodies remain. The period of tolerance formation in cases of severe clinical manifestations may be longer. Sensitivity to peanut, tree nut, crustacean, and fish allergens usually persists throughout life.

The duration of strict elimination largely depends on the age at which diet therapy was started. Removing dairy products from the diet in the first six months of life can limit the elimination period to 3-6 months. If treatment is delayed, the average duration of the diet is 6-12 months.

Partial elimination is permissible in pseudo-allergic reactions and secondary forms of food allergy that arise due to a decrease in the barrier function of the gastrointestinal tract and the enzymatic capabilities of the child's body.

An example of incomplete elimination is the replacement of natural milk with fermented milk products, the lower antigenicity of which is the result of partial hydrolysis of protein. Positive dynamics of clinical manifestations of food allergy with incomplete elimination indicates the transient nature and favorable prognosis of the disease.

The so-called obligate allergens are excluded from the diet of a child with food allergies, most of which are histamine liberators or themselves contain large amounts of histamine (strawberries, citrus fruits, legumes, sauerkraut, nuts, coffee, etc.). Measures that reduce the antigen-specific effect of food include compliance with the technology of preparation, conditions and shelf life of products, the use of vegetables and fruits grown without the use of fertilizers, soaking cereals and vegetables in cold water for 10-12 hours, double boiling of meat, and purification of drinking water. It is necessary to limit sugar by at least 50% and table salt.

Elimination diets require correction of minerals, in particular calcium, vitamins B6, A, E, B5. Given the insufficient activity of the gastrointestinal glands in patients with food allergies, enzyme preparations (festal, panzinorm, oraz, pancitrate, creon) are widely used in treatment. In case of dysbacteriosis, courses of biopreparations are prescribed depending on the results of bacteriological examination of feces (2 three-week courses per year). Timely detection and treatment of helicobacteriosis, giardiasis and helminthiasis are very important. The genesis and role of cholecystopathy in patients with food allergies are unclear, but choleretic therapy is an important component of complex therapy for children with food allergies.

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Food Allergy Medicines

Of the medications for food allergies, enzymes are prescribed: abomin, festal, digestal, essentiale, panzinorm, orazu. Sorbents are prescribed: carbolen, polyphepan, smecta; eubiotics - bifidumbacterin, lactobacterin, bificol; drugs that improve liver function and bile secretion: essentiale, carsil, vitamin B6 _, nicotinamide. Antihistamines are prescribed: tavegil, suprastin, diphenhydramine, pipolfen, claritin.

Prevention of food allergies

Prevention of food allergies begins with creating conditions that reduce the risk of intrauterine sensitization. It is advisable for all pregnant women to exclude obligatory allergens, industrially preserved products from the diet, and not only because of the risk of developing food allergies, but also because they contain food additives that are sometimes very harmful to the fetus. Cow's milk should be limited, replacing it with fermented milk products.

The second group of preventive measures is antigen protection of the newborn and the child of the first year of life. Dietary restrictions for a pregnant woman also apply to a nursing mother, especially in the first months of the child's life. It is very important to put the child to the mother's breast early (within the first half hour after birth). Natural feeding is much less often complicated by food allergies than artificial feeding. Children at risk for food allergies are recommended to introduce complementary foods later.

Preventive vaccinations for children with food allergies should be carried out under the protection of antihistamines.

The prognosis for life is almost always favorable, with the exception of the development of anaphylactic shock.