Living with GI Allergies – gastrointestinal issues

In my previous blogs I have discussed what is an allergy and also what is it like living with allergies that effect the respiratory system which in the extreme can make you wheeze and unable to breath. Just because you have allergic reaction to substances that you can breathe in, does not mean you will also be allergic to foods you consume. However, the chances of developing food allergies are higher if you already have respiratory allergies. Over the years I have become increasingly allergic to many substances that are in the food chain now-a-days. I am, thus, a nightmare to invite to dinner. I also have been asked how I can manage to live. I have retorted that I do not look like a poster child for malnourishment do I? However, I definitely have made it a point not go to dinner to anyone’s home unless I feel comfortable enough to make my food ‘demands’.

The first time I came out in urticarial rash (itchy raised red bumps) was around the age of 18. I could not understand what had caused this reaction and spent many hours cooling these bumps. They were mostly on my lower legs and I used to sit with them in a bucket of cold water. Just as with breathing issues one has to start by going through all that was consumed to try and identify the allergen. It took a few months but I worked it out that I had this reaction whenever there was a certain dish at dinner. This contained loads of black pepper and tamarind. Once I stopped having it, I did not get the urticarial rash. Strangely, I am neither actually allergic to any kinds of pepper as a spice, nor with tamarind as I can use it to spice food. So the reason for that allergy was never really substantiated.

The next few years the allergens to the respiratory system slowly increased but those related to food stuff did not. While the reaction was not showing up as a GI issue it was caused by the food consumed. But once again the allergies to foods consumed began to emerge. The classic trend was identified after years of experience and gives a picture of progress of severity of the allergy. Initial reaction was of abdominal discomfort, tendency of feeling bloated and a bit of wind or itchy lips or mouth. Then you also started having abdominal cramps. If you did not stop eating the specific food, it progressed to diarrhoea. The diarrhoea occurred quicker and with each subsequent exposure (went from loose stool to fluid stool ) to the food that I was allergic to. Since this is the body’s method of getting rid of harmful substance.

Surprisingly, I have never found vomiting to be a symptom. It appears that vomiting maybe more common symptom of food poisoning, at least for me. I do need to point out here that the progress described above is a picture of what happens when one slowly gets allergic to a particular substance. This is related to the repeated exposure to the allergic food that builds and becomes more sever over each exposure. Conversely, you can have a sever hypersensitivity reaction even with the first exposure to any food substance. I have has the displeasure of suffering such a reaction to having pumpkin. I have actually never liked it and had not eaten it since I was a child. Even then it was not something my mother cooked (thank god).

One day I was invited to dinner by a colleague and they made sure they got down all the items I was allergic to and that it was to be vegetarian dinner. Well they made some pumpkin curry. I felt obliged to try some for how can a grown woman and a dinner guest say I hate that. I had a table spoon of that curry. By the time we finished dinner, I felt bloated. Within half hour my abdomen was really bloated and I actually had to bend backwards to allow my lungs to fill up. Then I started feeling swelling come up my throat and was wheezing in earnest. I had only my inhaler with me and not my antihistamine tablets. Oh what a mistake that was, one I never made again in life. I used my inhaler a few times and just concentrated on my breathing. I kept a posture that would allow maximum lung expansion. My poor hosts, they were having kittens and were white faced thinking they were responsible for my condition. Strange they never asked me back! It took a couple of hours to calm down and I sat till late in their home as getting into the car and driving home in that condition was not a wise course of action. So after that anaphylactic shocked mentioned in the earlier blog, this was my second sever out of the blue reaction. I have had a couple of near brushes like this when I have not been careful.

The approach to identifying the food that acts as an allergen is equally hard as identifying those which produce respiratory allergies. Sometimes it is fairly simple, as if it is something you do not often eat then the reactions leave a much clearer trail to the cause. For example, identifying soya allergy was not too difficult as the symptoms came every time I had Chinese food. I used to enjoy it but did not have it very often. The one ingredient that we do not use in Indian cooking was soy sauce and is the main spice in Chinese cooking. I specifically cooked with all things I normally eat at home by making a stir fry and added soy sauce the first time. The second time, I did not use soy sauce. The difference was evident right away. So that was the first thing to be removed from my diet.

Subsequently I have got allergic to mushrooms, pumpkins, melons, squashes, cooked bell peppers, cauliflowers, lettuce, pumpkin seeds, goji berries and kiwi fruit. I found that in UK I could not eat bananas as it immediately caused a severe itch around my mouth and throat. Yet I could eat them when I went away on holiday. The only thing I can assume is that mostly bananas are imported into UK unripened. Then chemicals are used to ripen them and that is what I am allergic to. One would think that the spray would be only on the skin and without that it would be all right. But if I am reacting to the banana it must mean that the chemical is somehow absorbed into the fruit. I used to try a grape in the shop and if my mouth itched I would not buy it so again I link it to any chemical sprays used in growing the grapes. I also found it hard to eat apples, pears and other soft fruits hard to eat without a good washing in running water. I am a lot better at eating fruit now in Australia but I will not try the melons or kiwi fruit.

I was brought up as a child on vegetable oil / peanut oil as well as ghee (clarified butter). But I found over time if I had ghee I got the GI symptoms. I had to stop having any of the margarines as they started adding soy lecithin. I started using olive oil and that has been suitable. Indeed using the olive oil margarine is fine as it does not have soy added in it. I have had sever reaction and asthmatic attack with rapeseed oil (oh I am allergic even to the rapeseed pollen), grape seed oil, canola oil and palm oil.

Well the best tip I can give to finding out what your particular poison is by keeping a daily dairy of what you are consuming. If you have made it yourself it is easier but if you are having processed foods, takeaways, eating out often it becomes harder to identify what is being consumed. The processed foods have such long labels and words which are hard to decipher. The labelling laws are different in different countries so again they may or may not have all the ingredients listed. The additives often get written as E numbers and of course we do not keep all those numbers in our heads. I find it easiest to read the label for every product every single time (even if I buy is regularly) for any familiar allergens. I advise everyone should do the same, as once or twice I have been caught out when the manufacturers have changed the ingredients. For example, I used to have a particular brand of bread, it was healthy and not the white plastic bread. I had it for years and suddenly one day I started feeling bloated. I could not understand why as I was not eating anything different. While shopping I by chance picked up the bread and read the label……Oh my!!!! It had soya flour added as flour enhancer. I went through the whole bread aisle and found all had soya flour.

So keeping a diary will help to eliminate by trial and error. It is a slow process and if you can get medical assistance to find the allergens it would be helpful. Also form a habit of reading every single label of every single food you buy every single time before you buy. Tedious you may think but it becomes a habit soon enough. As for eating out well its hard I admit it. I try out restaurants and ask if they will cater to my needs. Most often I can get away with Indian places (the only worry being the use of different oils and ghee). However, I hear that now in India as well they are adding soy as a flour enhancer. I can have Italian as I can avoid my allergens fairly well and yes they have not started enhancing their flour with soy so pasta and pizzas are a safe bet. Similarly I can have some Mexican dishes. Some restaurants are good and will even get the chef out to talk to me and organise my meal around my allergies. Once you find these good suitable eateries stick with them.

I also always keep handy some antihistamine in my purse and of course I would keep my inhaler too when I was bad with respiratory symptoms. It is best to take then as soon as you find out you have eaten something by mistake or first symptoms makes its appearance. I have often heard people say oh you allergy is not so bad, have it and eat your antihistamine. This is dangerous and I cannot emphasis that enough, for the reaction gets stronger  and lasts longer every time you eat the food you are allergic to, just as I pointed out with respiratory allergies. The bottom line as I see it – it will kill me and then it is not so hard to let go of the foods most loved. Good luck to all of you who have food allergies.

Living with Respiratory Allergies – Breathing issues

Living with allergies can both be easy and hard. It is hard when you cannot find what you are allergic to, what you cannot avoid and what then you come in contact often. Also it is hard when medication cannot fully control the allergic reactions. It is easy to live with when you can find out what it is you are allergic to and can avoid it easily, when you only come in contact with the allergen by accident and when medication works immediately to fully control the symptoms. 

I explained in my earlier blog (Allergy - What is it?) that when the body recognised any substance as foreign it causes a reaction in the body to get rid of that substance. This is a reaction we want when the invading substance is harmful like a bacteria or virus. However, if this reaction occurs when we come in contact with what are considered harmless substances, we call it an allergy. Over the years more and more people have become allergic to more and more substances. I am not sure what it says about our life styles and our food and use of chemical in daily life. 

My first encounter with allergy was seeing my mother come out in urticaria (raised red bumps that itch a lot) upon eating a Gujarati dish called patra (made with taro leaves and besan / chickpea flour). I do believe she used to react a bit to the sourness of tamarind. But I was little and did not really understand except that she was given a tablet (Foristal) which was a common antihistamine in those days in India. 

At 18 I started a nursing degree and bed making, cleaning and dusting was part of the care (unlike now when we have auxiliary workers or aides). I noticed towards the end of the first year I used to start sneezing at soon as I started dusting. My nose was itchy and it was just annoying. It is very difficult to avoid dust, especially if you live in a country like India and with a job like mine.

I used to react with breathless feeling when I used any talc or facial powder and so I by the time I reached adulthood I had given up using that totally. I also noticed that I would react badly to some perfumes used by my friends and colleagues. I had to leave the area very quickly as I would sneeze non-stop. This allergy progressed to a point where I could not use any perfume, deodorant, any sprays for body or hair. I could actually taste it in the back of my throat and it made me feel ill and wheeze. The dust allergy used to constantly irritate the mucous membranes of my eyes, nose and throat and I was having repeated infections – tonsillitis, pharyngitis, laryngitis, bronchitis – generally needing about 3 or 4 rounds of antibiotics each year. 

I visited an allergist and decided to find out exactly what all I was allergic to. Well that turned even my allergist’s hair grey in a second as she conducted the tests. Dust being the already known allergen she carried out that test last. Just to let you that generally very dilute forms of the allergen are injected just under the skin and if you are allergic then that injection site will become a red raised weal. The size of the weal is indicative of how allergic you are. Thus a few days later the allergist will measure the size of the weals. This showed that there were about 7 different pollens that I was allergic to. Now coming to dust, which was left to the last, caused me to collapse even before the doctor has put the needle away. This is what is called an anaphylactic shock. I needed immediate resuscitation.

In relation to this severe allergy I tried going through desensitisation therapy but had to abandon it as even the extremely low dilution was causing difficulty and then my allergist moved away.

Around this time I also moved to UK and the change in the environment and the lower levels of dust made a big difference and I felt so much happier not having to wheeze or get repeated infections. A year went by peacefully and then wham hay fever hit me. By this time I was getting allergic to cosmetics like lipstick and mascara which caused the skin to peel and eyelashes to fall off. That got removed from my daily life fast. With hay fever I was taking antihistamine daily. The season started with the first cherry blossoms and ended when the grass died out at the end of summer. 

Fortunately, I used central heating appropriately so there were no mould issues as they also send me into a wheeze and tight chest. I found about that allergen when I stayed at some crappy hotel which had mouldy pillows and mattress. I had 3 showers and washed my hair before I realised what exactly was causing the problem. Needless to say I got no sleep and had antihistamine and inhaler a few times. During summer, life got adapted to be indoors more, keep windows closed and use a fan to keep the room cool and also I got an ioniser for my bedroom. They use very little energy and keeps the room free from dust motes. 

Cleaning was also something I had to think about. When we had the old hoover with dust bags I was unable to clean the carpets as it tended to send up dust particles in the air as soon as the bag was partly filled. It fell to my husband to do the hoovering. However, when we got the new bag less one I had no problems as the dust was always sucked in rather than spread around. Any dusting had to be done with a damp cloth so as not to raise and spread the dust about.

Also it becomes important to use the hoover on the mattress and also sofas and chairs covered with cloth to remove dust. I also found that I could not use down filled pillows and had to buy the hypo allergic ones. Since more people are aware and more products with regards to mattresses, mattress covers and pillows are made for people with dust allergies. I also changed my open cabinets for knickknacks to closed ones so as to avoid the dust gathering and the need to dust it often. 

My sister also used to get hay fever but was mainly related to grass pollen. She used homeopathic pills and they helped her. Whereas, that remedy did not make any difference for me. Then one day I saw a poster for massage at my local beauticians. So I made an appointment and during the session I found out that she was an aroma therapist. She agreed to use specially mixed oils to help my breathing issues due to allergy. I used to have a full body massage with the oil every fortnight. The effect was good. Sadly she stopped coming to the local place and it was hard to go to where she has moved her practice. However, I actually used to buy the mixed oils from her. Finally that was getting very expensive and I started buying and mixing my own oils. After a shower I applied the oil all over my body and massaged it in gently. After about 6 years I found that I no longer reacted to hay fever and actually did not need to use my inhaler either. These days I keep handy a bottle of cypress oil (which was one of the oils in the mix and works best for me) and use a drop should I feel that familiar twitching of the nose and sneezing starting.

So going from, when grass ha to be mowed at least a week before my visit to family who had gardens, I now have a garden and mow my own grass. I used to avoid going to park but now try regularly to have a walk around the park and see the changing seasons in nature. I find it a good exercise as well as relaxation method to see the flora and fauna.

The allergy caused by the perfumes and deodorants are harder to avoid as practically everyone uses them. I actually hold my breath or a tissue over my nose when I have to pass through the cosmetic section of any departmental stores. Sometimes you pass someone on the road and they have so much sprayed on that you can taste it. It annoys me often but unless someone suffers they have no idea what it is to live with this kind of allergy and so cannot show compassion. I had to always warn people when they were coming to see me and expected my office door to be shut for privacy or even in the classroom that I did not want people to wear any perfumes. Those who wore some sat by an open window generally. So you see some allergies can be managed better than others. 

Hope this helped those of you who have allergies that manifest in respiratory symptoms. I will tackle the food allergies in the next blog so as to keep the reading in discrete chunks.

Allergy – What is it?

We hear so many people saying they have allergies. The most common ones general public is aware of are peanuts, bee and wasp stings, shellfish and hay fever. I am not writing here an academic paper or even one which uses the scientific language. I am writing just in a plain language everyone can understand and from the point of view of one who has been suffering from allergies. 

Anything that is introduced into our body via food, drink, applications on the skin, injection or breath, is essentially foreign to our body. Mostly our body does not respond to these introductions and we can safely ingest, inject and inhale daily. If there are any harmful bacteria or viruses are introduced into the body (this is called infection) then the body’s defence system goes into action. This invader is recognised as harmful and the white blood cells recognise them as such and start the process of destroying them. This is called inflammation where the signs are redness, swelling, pain, the part is hot to touch and it can also restrict movement. 

Sometimes other things than bacteria or viruses get identified mistakenly by the body as harmful and it starts off the process of inflammation. This is called an allergic reaction. The reaction can be very mild as seen in early hay fever symptoms, which include sneezing, itchy eyes and runny nose. This can increase in intensity over time to actually red, swollen and itchy eyes, runny and itchy nose, it can feel blocked dues to swelling of the mucous membranes inside the nose, leading to difficulty in breathing, sore and itchy throat, headache and also fever. Thus any thing that causes this allergic reaction due to inhaling some irritant substance can lead to asthma. Again it can be mild and controlled with the inhalers and antihistamine drugs. Sometimes it can be bad enough to need hospitalisation and having stronger drugs intravenously.

If something that you apply on your skin like soap or creams and cosmetics can also cause itching and rashes on the skin and the perfume within the substance can give respiratory reactions as described above.

The food allergies provoke a slightly different response from itching of the mouth to bloating when the allergy is mild. As it progresses you can get stomach cramps, diarrhoea, vomiting, swelling in the abdomen, up into your gullet and throat. This can feel as if the throat is being squeezed shut and so there is difficulty in breathing as all the swollen tissue presses on to the wind pipe.

Occasionally the allergy starts with mild symptoms and progresses to stronger reactions. Sometimes it hits out of the blue with strong reaction to something you may have been using or consuming for a lot time. It must be remembered that every time you come into contact with a substance that produces an allergic reaction it becomes stronger and remains for longer and also it takes a very minute amount of the substance to produce major reaction.  The worst reaction to an allergic substance is called anaphylactic shock. Basically the body goes into shock and the blood pressure drops and you become pale cold, clammy and finally unconscious. If the person does not get adrenalin / epinephrine injection immediately they can die. Now you must have heard this called epipen that people with severe nut allergy generally carry with themselves.

Often people mistakenly call an allergy when they do not like something especially where food is concerned. Some people due to lack of understanding do not give the appropriate attention and sympathy to people who actually have an allergy. For example, I used am allergic to perfumes, so find it hard to breath when people around me have used any form of spray be it perfume or deodorants. In spite of requesting colleagues and students to avoid these when they come to my office they would ignore this and I was left gasping for breath. Once I had been on a holiday group trip to America and since most foods there have soy (which I am severely allergic to) there was limited things that I could have in my meals. My fellow travellers were so compassionate that they ate their own food as well as what little was made or bought for me.

There are no real facts about why we become allergic to certain things. One can see that the tendency to allergy can run in families. In my family we have varied allergies in some of us. My maternal grandmother was allergic but I am not entirely sure what the triggers were. My mother had some allergies to leaf of the taro plant, and sometimes to sourness of tamarind which caused urticarial (raised red bumps which itched a lot). One of my sisters was allergic to the white of an egg, and hay fever. I am allergic to 1) foods : soya and its products like soy sauces tofu, mirin, teriyaki sauce, mushrooms, pumpkin and melon family, kiwi fruit, bananas in UK (I presume they were imported unripe and ripened with chemicals and these were my problem), cauliflower (still mild reaction), cooked capsicum / bell peppers, oregano, mint leaves, pearl millet / bajra, rapeseed and canola oil, palm oil, ghee; 2) hay fever – was tested allergic to dust, grass and about 7 other pollens but cannot remember them all; 3) cosmetics – perfumes, certain shampoos and soaps (some soaps actually include soy oil), deodorants, perfumed moisturisers and creams, lipsticks, mascara, hair sprays and other hair products; 4) drugs like codeine, penicillin, all cough syrups, hydrocortisone cream and all non-steroidal anti-inflammatory drugs except ibuprofen. 

Another family member comes out in urticarial when pressure is applied to the skin as in carrying shopping bags. Another family member is allergic to chocolate, peas, chickpeas, walnuts, red lentils. My husband gets urticarial but we have not yet managed to eliminate a reason except that when he gets too hot under the duvet. His mother is severely allergic to milk and its products, cauliflower, broccoli and leafy vegetables. I know many people who are allergic to gluten, sugar, tomatoes, cilantro/coriander, oregano and so on….. the list keeps growing.

So you see there is no indication as to what one can become allergic to. And once you have started having allergic symptoms it is best to see an allergist who can do tests to check if they can identify the allergens (substances you are allergic to). Most of the time one learns through trial and error. If you suspect some food then eliminate it from your diet and see if the symptoms go away. But with any symptoms that you feel could be an allergic reaction it is always worth keeping note of what happens and speaking to your doctor. I often get people saying oh I am a bit allergic to such and such but I eat it and just have some antihistamine. This is a dangerous path to take as you never know which time will act like that straw that broke the camel’s back and give you anaphylactic shock. Many people say they do not have the will power to stop eating or using things they are allergic too. To them I say the alternative is suffering and then possibly sudden death. There is not much of an option is it? I have also heard parents say that their kids refuse to stick to a life time of avoidance of allergens and again it’s the same argument. If they eat they will get more and more ill and again possibly die. Is that an option they wish to consider just because they wish to fit in? My niece turned allergic to chocolate at the age of 3 and with explanations and having a few episodes of swelling and itching of the mouth the lesson was learnt and so I say if a 3 year old can understand that this makes me ill how can you not get an older child or adult to understand?

I hope that this short personal take on what is an allergy and what happens when you are allergic gives you an understanding of this serious health problem. Please do not ignore if you suspect you are allergic and remember despite the fact we have medicines to help and subdue the allergic reaction (which may fail to save your life sometimes) avoidance of those substances is the best and only sure way of remaining free of allergic reactions.