When sport reveals a food allergy :
Outbreak of hives, abdominal pain, cough ... that occur after eating and during sport. Food allergy-induced stress is not known although it is sometimes severe. Doctissimo an update.
We know that the signs of a food allergy may be greater if the patient performs at the same time exercise. But in certain allergy, physical activity is essential for food allergy occurs, it is called food allergy induced by stress (FAIS). A disease that were interested allergists at the 5th Francophone conference allergologie1.
Food allergy induced by stress, allergies unknown
"The AAIE is a special form of food allergy that occurs during physical exertion itself preceded by the ingestion of food. However, ingestion of the offending food and practice physical activity performed alone are causing any symptoms, "says Dr. Stephen Beaudoin, chief of allergy at the Centre Hospitalier Jean Monnet (Epinal) 2. Described for the first time in the year 803, 2-20 AAIE affect children or adolescents about 10,000 according to several Japanese studies (so far the frequency of food allergy "classic" that affects 6-8% of children ).
The risk factors of (FAIS) :
This type of allergy retains an element of mystery and clinical manifestations of this form of allergy vary from episode to episode and recurrence is not systematic. Several hypotheses have been put forward to identify the factors contributing to its occurrence. Dr. Etienne Beaudouin go through them:
The type of exercise: jogging, walking, aerobics sports activities most frequently involved while biking, downhill skiing, swimming are rarely involved. To date, no data pathophysiological can explain;
Food: Shellfish and wheat flour are the foods most frequently involved in the (FAIS) Other foods are possible: celery, peach, tomato, grape, onion, apple, nuts, kiwi, chicken, snail, poppy seed, wine, corn, celery, lentils ... meats are exceptionally involved;
Drugs: Aspirin and NSAIDs have a role in aggravating (FAIS) They increase the passage of food allergens through the epithelial barrier digestive4;
The environmental and individual factors: Some authors have noted the influence of environmental factors: effort made pollen season in patients suffering from pollen allergy, on the contrary certain (FAIS) occur in winter. Individual factors such as stress, lack of sleep, fatigue, rules can promote the occurrence of AAIE.
Food allergy induced by stress: From diagnosis to treatment :
The diagnosis is based primarily on a clinical approach. Prof. Alain Didier, head of pulmonology department at the hospital Larrey (Toulouse) 5 summarizes: "Faced with clinical symptoms suggestive of AAIE, the diagnosis should be confirmed by allergy investigations that will identify the food responsible. "
Clinical analysis: First, clinical manifestations (airway obstruction, urticaria, presence of signs: itching palms, paresthesia, sneezing, coughing, difficulty breathing, abdominal pain ...), the association ingestion of food / exercise (usually a prolonged effort) and predisposing factors (cold, some drugs ...) are searched by the doctor.
Differential diagnosis: It will then distinguish these symptoms of other disorders (pruritus palms, paresthesia, sneezing, coughing, dyspnea, flushing, abdominal pain, asthma and more difficult effort of anaphylaxis induced by exercise that does not involve the ingestion of a food allergen).
Search the offending food: The food in question are varied and to identify the culprit, examination of the patient is essential. "Skin tests can highlight awareness, but their sensitivity and specificity in the specific context of AAIE have not been evaluated," says Prof. Alain Didier. Biology research with specific IgE directed against gliadins gluten is effective in the case of wheat, but this affects only a subset of patients. The implementation challenge tests (ingestion of food + exercise test) remains controversial, due to considerations of both technical and ethical. "It seems better to reserve these tests in cases where several can be incriminated foods to avoid evictions complex especially when these foods are commonly consumed," says Prof. Alain Didier.
As for food allergies, management based on avoidance of factors causing attacks (allergen + physical effort and risk factors) and the use of symptomatic treatments against demonstrations.
While advances in biology have identified a major allergen (omega-5gliadine) for (FAIS) related and marketing of a test diagnostique7, they have not fully elucidated the origin and mechanisms of form of allergy. Today, researchers are stepping up efforts to solve this mystery and tomorrow, improve the diagnosis and management of this disease.
Outbreak of hives, abdominal pain, cough ... that occur after eating and during sport. Food allergy-induced stress is not known although it is sometimes severe. Doctissimo an update.
We know that the signs of a food allergy may be greater if the patient performs at the same time exercise. But in certain allergy, physical activity is essential for food allergy occurs, it is called food allergy induced by stress (FAIS). A disease that were interested allergists at the 5th Francophone conference allergologie1.Food allergy induced by stress, allergies unknown
"The AAIE is a special form of food allergy that occurs during physical exertion itself preceded by the ingestion of food. However, ingestion of the offending food and practice physical activity performed alone are causing any symptoms, "says Dr. Stephen Beaudoin, chief of allergy at the Centre Hospitalier Jean Monnet (Epinal) 2. Described for the first time in the year 803, 2-20 AAIE affect children or adolescents about 10,000 according to several Japanese studies (so far the frequency of food allergy "classic" that affects 6-8% of children ).
The risk factors of (FAIS) :
This type of allergy retains an element of mystery and clinical manifestations of this form of allergy vary from episode to episode and recurrence is not systematic. Several hypotheses have been put forward to identify the factors contributing to its occurrence. Dr. Etienne Beaudouin go through them:
The type of exercise: jogging, walking, aerobics sports activities most frequently involved while biking, downhill skiing, swimming are rarely involved. To date, no data pathophysiological can explain;
Food: Shellfish and wheat flour are the foods most frequently involved in the (FAIS) Other foods are possible: celery, peach, tomato, grape, onion, apple, nuts, kiwi, chicken, snail, poppy seed, wine, corn, celery, lentils ... meats are exceptionally involved;
Drugs: Aspirin and NSAIDs have a role in aggravating (FAIS) They increase the passage of food allergens through the epithelial barrier digestive4;
The environmental and individual factors: Some authors have noted the influence of environmental factors: effort made pollen season in patients suffering from pollen allergy, on the contrary certain (FAIS) occur in winter. Individual factors such as stress, lack of sleep, fatigue, rules can promote the occurrence of AAIE.
Food allergy induced by stress: From diagnosis to treatment :
The diagnosis is based primarily on a clinical approach. Prof. Alain Didier, head of pulmonology department at the hospital Larrey (Toulouse) 5 summarizes: "Faced with clinical symptoms suggestive of AAIE, the diagnosis should be confirmed by allergy investigations that will identify the food responsible. "
Clinical analysis: First, clinical manifestations (airway obstruction, urticaria, presence of signs: itching palms, paresthesia, sneezing, coughing, difficulty breathing, abdominal pain ...), the association ingestion of food / exercise (usually a prolonged effort) and predisposing factors (cold, some drugs ...) are searched by the doctor.
Differential diagnosis: It will then distinguish these symptoms of other disorders (pruritus palms, paresthesia, sneezing, coughing, dyspnea, flushing, abdominal pain, asthma and more difficult effort of anaphylaxis induced by exercise that does not involve the ingestion of a food allergen).
Search the offending food: The food in question are varied and to identify the culprit, examination of the patient is essential. "Skin tests can highlight awareness, but their sensitivity and specificity in the specific context of AAIE have not been evaluated," says Prof. Alain Didier. Biology research with specific IgE directed against gliadins gluten is effective in the case of wheat, but this affects only a subset of patients. The implementation challenge tests (ingestion of food + exercise test) remains controversial, due to considerations of both technical and ethical. "It seems better to reserve these tests in cases where several can be incriminated foods to avoid evictions complex especially when these foods are commonly consumed," says Prof. Alain Didier.
As for food allergies, management based on avoidance of factors causing attacks (allergen + physical effort and risk factors) and the use of symptomatic treatments against demonstrations.
While advances in biology have identified a major allergen (omega-5gliadine) for (FAIS) related and marketing of a test diagnostique7, they have not fully elucidated the origin and mechanisms of form of allergy. Today, researchers are stepping up efforts to solve this mystery and tomorrow, improve the diagnosis and management of this disease.
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