Allergy Testing

It's winter and parents begin worrying when the first asthma attack occurs and you hear the nightly wheezing that keeps your child awake. Back in the recesses of your mind, you ask yourself, should this be? No, but what do you do about it? Asthma, allergies, and other respiratory diseases can occur and actually be caused by mold exposure. Not recently this scenario occurred. I went to see a friend. She was giving her daughter a nebulizer treatment because she wheezes at night. My friend had a"Flovent" a preventative inhaler sitting on the counter to keep her asthma in check. Every winter this family has the same respiratory problems: asthma, colds, flu and pneumonia with the last condition quite serious. Doctors treat the asthma, pneumonia but not much is done to prevent the problems in the first place. There is something wrong with house and the air in it.

Two years ago that same friend's finished basement flooded after a 5 day heavy rain. The basement was carpeted, with furniture and boxes of toys. There are several rooms that are used for storage and are kept closed; a musty smell was apparent when opening the door. Some things were tossed; other prized should be pitched but porous possessions were kept. The prized stuffed animal had to go but it was kept. Anything porous and wet needed thrown away. The basement was never fully cleaned; but the floors and the flooded part of the basement were. When one says "fully cleaned", it means all surfaces wiped down with a mild detergent, a hepa vacuum used on all surfaces and a dehumidifier for basement running. A dehumidifier was installed which was a step in the right direction. Another thing to consider,how did the water get in? What type of mold is still in the basement could only be found by testing by a reputable lab. This house is 1 of over half the homes and buildings that have water intrusion and mold according to the ( NIOSH )(National Institute for Safety and Health)

The correlation between asthma, allergies and other respiratory infections to mold has been established. Many asthma patients react to mold. Mold is not easy for allergists to test. To discover mold allergy exists, it often requires subjecting a patient to several doses of mold before a reaction occurs. However, while some patients show an allergy to mold, they react to the allergy shot. Not everyone has mold allergies but can have a genetic defect that causes the body not to clear neurotoxins when exposed top mold which are able to effect every system in the body according to Dr. Ritchie Shoemaker.This condition is a "Biotoxic Reaction to Mold". This reaction causes asthma, airway restrictive disease and other respiratory ailments among a whole host of conditions.. Common sense can prevail. If you get sick in a damp building, you are reacting to mold. Asthma can continue to worsen when constantly exposed to offending agents like mold. Many parents keep their houses very hot which is an also an offending factor in asthmatic lungs: hot, dry air.

Asthma can also be triggered by strong scents like perfumed laundry detergent or air fresheners. The whole house needs to have cool,fresh air void of chemicals. Parents need to be the one that realize that the lungs of asthmatics are quite sensitive. Asthmatics must have a mold air purifier constantly running in their bedroom and through the house.There are many benefits to using mold air purifiers including getting killing mold, bacteria, germs and viruses and eliminating chemicals from the air. Use a hepa vacuum to properly clean surfaces of contaminants and not release contaminants back into the air as regular vacuums do.

Folks need to start thinking about how healthy is the air inside my house? Some simple things to do to help with mold, indoor air pollution and organic contaminants:

1. Let sun shine in as often as you can. Mold loves dark and does not grow in sunlight.


2. Leave bathroom door open after a shower. If possible, crack the window.


3. Do not shut any doors in the basement because it creates an area for mold to grow.


4. Place mold air purifiers throughout the house and run them year-round.


5. Dehumidify your basement with dehumidifier for basement.


6. Purchase a hepa vacuum; empty it outside.


7. Instead of air fresheners which add to indoor air pollution and trigger asthma attacks, buy a small air purifier for the bathroom and actually clean the air.


8. Since carpeting has over 120 chemicals ( including formaldehyde), pitch it and go with hardwood flooring. The underlayment for carpeting wears down and disintegrates gathering dirt and mold spores.


9. Buy the least amount of cleaning chemicals as possible.


10. If harsh chemicals including paints, hobby products, sealants etc are applied, open the window and have the asthmatic stay somewhere else for a few days.


11. Wear more clothing in the winter and keep it cool.


12. Make sure you have your heating system serviced and the ducts cleaned. Heating systems can blow mold everywhere.


13. Spray the shower down with straight vinegar. It will smell for a bit but kills mold.


14. Be a minimalist. Throw out or give away things that are not necessary. The less you own, the less chemicals in the air.


15. Make sure the humidity level in any room is below 50%, chemical off- gassing occurs as humidity rises.


16. Do not smoke around children and especially in a closed up car. Do not smoke in the house. Smoking is certainly correlated with respiratory diseases including second-hand smoke on young developing. lungs. Change the way you think and: Live healthy....Be Happy!

Oral allergy syndrome (OAS) is a well-recognized but little known condition. It is characterized by a burning sensation or mouth pain and swelling when you eat specific foods that cross react to pollens to which you are allergic. Interestingly, the specific foods causing this reaction are well established to cross react with certain trees, grass, or weed pollens, house dust mite or latex. There are common groups of foods that cluster with certain nasal allergies. For example, ragweed allergy commonly causes an oral or gut reaction after eating melons or bananas but usually not other foods. Birch tree pollen is commonly associated with reactions to numerous foods as is latex allergy. The explanation for these reactions include similarities in protein structures as well as some chemicals in the foods.

Though this reaction is well documented in the allergy literature it is not commonly recognized or diagnosed by most doctors including some allergy specialists and many stomach specialists. Various allergy web sites include lists of the common foods associated with certain pollens, dust mite or latex. However, a comprehensive list that is easy to read or interpret can be difficult to find. Also, the names of some pollens or the common links between a group of pollens and a group of foods can be confusing.

In its classic form OAS should be easy to recognize. After eating a food associated with a pollen to which you are allergic you experience near immediate burning sensation in your mouth or throat with or without swelling. However, it is commonly recognized that frequently in medicine, symptoms do not occur in the "classic" or typical manner in a specific person. Worded another way doctors are taught "patients don't read the textbooks". Therefore, you may experience variations of the reaction such as throat swelling or tightening, burning when swallowing, a lump in the throat or a sense of swallowing difficulty but not make the connection to what you ate or what is happening to you.

You or your doctor may misinterpret your symptoms. Frequently people just assume it happened because they were having a choking spell on food that was poorly chewed, swallowed too fast, or eaten or drank while too hot or cold. Commonly, it is assumed that an esophageal (swallowing tube) disorder, especially acid reflux with a hiatal hernia is the cause. Acid reflux can cause an esophageal constriction called a stricture or ring that can result in a food sticking sensation, but this is usually associated with heartburn symptoms or food getting stuck which then prompts an upper endoscopy or scope exam. Other times, especially if occurring in an elderly person, a neurological condition like stroke or Parkinson's disease is blamed. Sometimes doctors decide that your symptoms are due to a nervous reaction or neurosis that historically was called as globus hystericus. The hystericus portion of the term is usually dropped these days to the shorter term globus or globus sensation especially since it is not proven it is due to a psychiatric problem. However, globus may be the diagnosis arrived at if your complaint is that you feel a lump in your throat and an 'evaluation" appears to turn up nothing even if OAS was not considered or excluded.

An unusual condition that has been more recently recognized in the field of gastroenterology (diseases of the stomach and intestines) that may be related to or a variant of OAS is called eosinophilic esophagitis (EE) or allergic esophagitis. It was first described in the pediatric population but is now known to occur in adults. Classically described in teenage boys and young men who presented with food sticking episodes without heartburn or acid reflux symptoms, it is associated with a strange appearance of the esophagus on endoscopy (lighted scope exam of the upper gastrointestinal tract). What the doctor doing the scope sees is that the esophagus resembles a cat's esophagus. That is it looks like it has rings (cats have cartilage rings in their esophagus, we do not) and this is referred to as "ringed esophagus" or felinization of the esophagus. On biopsy of such a ringed or felinized appearing esophagus (that is also often narrowed resulting in food sticking) microscopic signs of allergy are noted. The lining shows numerous eosinophils, a reddish pink appearing white blood cell, characteristic of allergic conditions. These eosinophils release chemicals like histamine that trigger swelling, pain, and damage to tissue.

Food allergies are commonly found to present in EE though sometimes the search for a food allergy by traditional skin tests or IgE blood tests is negative. Treatment is avoidance of known food allergens and swallowed nasal steroids sprays that are designed for use in the nose for nasal allergies. Though not specifically proven yet, eosinophilic esophagitis (EE) may be a variant of OAS.

Eosinophilic gastroenteritis and eosinophilic or allergic colitis also exist and can be diagnosed by biopsies of the stomach, small intestine and colon respectively. Allergic colitis is typically seen in infants who have a cow's milk protein allergy. It presents as colic type abdominal pain, diarrhea, weight loss and bloody diarrhea in an infant on cow's milk formula or sometimes in breast-fed infants whose mom is drinking a lot of cow's milk.

Allergic gastroenteritis occurs in any age group presenting typically as abdominal pain, with or without intestinal blockage or perforation; diarrhea; anemia; weight loss; and microscopic bleeding in the intestinal tract also known as occult blood in the stool. Such bleeding is detectable only by special stool chemical tests known as fecal occult blood tests (FOBT) or stool guaiac testing.

At least some people with food intolerance that does not make sense on limited diet diary information, blood tests, biopsies, or allergy testing, may have a form of OAS. In other words, the presence of known pollen or latex allergies may be predisposing to reactions to foods known to cross react with allergies noted in OAS. However, instead of classic oral allergy syndrome symptoms other stomach and intestinal symptoms or even non-gastrointestinal symptoms may result.

Support of this concept can be found in detailed screening of individuals for food intolerance. Those with known pollen or latex allergies, any known food allergies or intolerance including gluten intolerance (celiac disease) and casein intolerance, are asked to complete a series of symptom assessments and severity rating scales followed by a strict elimination diet. This is followed up by re-assessment of response of symptoms while re-introducing foods one at a time while monitoring for recurrence.

This type of analysis is the basis for the Neopaleo Specific Diet. In the near future online symptom assessments and screening for food intolerance along with dietary recommendations specific to individuals will be available at www.thefooddoc.com. An online diet symptom diary will also be available. A simplified table illustrating the common foods that may cross-react with the broad categories of pollen allergens and latex allergy is available. Food intolerances are more commonly being recognized as a common cause of illness and symptoms. Individualized specific diet recommendations and elimination diet trials may be more helpful in discovering any possible links to what you are eating and how you feel.

Copyright 2006 The Food Doc, LLC. All rights reserved.

German Shepherds, like any other living animal, can develop allergies to things around them. Sometimes these allergies are inherited through genetics and other times these allergies affect only your dog and can occur even though your dog's lineage does not have any of these conditions in it. It can be frustrating but one of the first ways to handle German Shepherd allergies is to be able to identify them and know what they are. The symptoms can vary sometimes but the behavior can be consistent enough that you can let your vet know what is going on and hopefully stop it.

One common allergy is called atopy. Atopy is a skin allergy that is usually inherited from previous generations. Some symptoms are foot biting, excessive cleaning in areas such as the armpit, and your dog may even develop conditions that make it difficult to breath or cause a lot of noise when the dog is trying to breathe. Sometimes this can be cured with a change in diet but consult your vet for the answers you need.

Another in the list of German Shepherd allergies is potential food allergies. Sometimes a German Shepherd is not able to digest some proteins or other nutrients properly and this can cause an allergic reaction. The symptoms are biting at the coat and any kind of digestive symptom such as vomiting, diarrhea or both. If you notice that your dog just cannot keep its food down the contact your vet, as your vet will need to put a program in place that tries to narrow down and identify the nutrient that is causing the problem and then adjust your dog's diet accordingly.

This one just needs to be said in an article like this and that is to avoid giving your dog chocolate. Chocolate in any form, whether it is in bars or cake, can be potentially lethal to your dog so avoid your dog ingesting chocolate at all costs. This is not a myth and while it is true that some dogs can tolerate certain levels of chocolate it really is not something that you want to try and experiment with, as you never know what the results could be.

Some German Shepherd allergies are not as easy to figure out as others and a fleabite causes one of the more sneaky allergies. This is why you should always pay a lot of attention to your dog because sometimes allergies to fleabites can show up in places where fleas bite, like the stomach, but you rarely look. Flea bite allergies usually show up in the form of what is known as hot spots where there are patches of your dog's skin that seem warm to the touch and maybe even oozing liquid. If you find a hot spot get your dog to the vet immediately.

Allergies can pop up at any time and you need to keep an eye on your dog so that you can recognize the symptoms and get your dog the help it needs from your vet. Sometimes treatment can be as easy as a change in diet while in other cases medication may be required. But either way it is important to treat your dog's allergies immediately.

Types of asthma and common triggers of asthma attacks:

There are three main types of asthma, allergic, idiopathic, and mixed asthma.

The first main type of asthma is allergic asthma. This type of asthma is caused by airborne and seasonal allergens. Some of these Allergens include pollen, mold, pet dander and dust mites. Once you are exposed to an allergen, it acts as a trigger for an asthma attack, causing coughing, wheezing and shortness of breath. By avoiding the allergen, the asthma can be controlled.

The second main type of asthma is idiopathic or non-allergic asthma. This type of asthma is not related to any specific allergen or substance. Common triggers for idiopathic or non-allergic asthma include the common cold, a respiratory tract infection, exercise, emotions, environmental pollution or some food additives such as sulphates. Over time, asthma attacks can become more frequent and severe if left untreated. This type of asthma can also develop into a more serious respiratory condition, such as chronic bronchitis, or emphysema.

The third main type of asthma is mixed asthma. An individual could have a combination of both allergic and idiopathic (or non-allergic) asthma. This is the most commonly diagnosed.

Different treatments for asthma:

It is important to know what your personal asthma triggers are. Preventative medications do not stop an asthma attack, they only help improve your day to day functioning. Therefore, knowing your personal triggers is a must. Triggers can include weather conditions like extreme temperatures, pet dander, dust, mold, pollen, dairy products, emotions, and exercise. It is possible to eliminate some triggers like pet dander, dust mold, pollen and dairy products. Pets can be bathed to help with their dander. Frequent cleaning for dust and mold problems helps along with keeping windows closed and running the air conditioner during the spring and summer seasons.

Bedrooms are good rooms to target to get rid of a lot of dust. Dust and dust mites collect in pillows and mattresses. There are covers for pillows and mattresses that help to eliminate dust mites. Also the regular cleaning of sheets, blankets and curtains will help. It is recommended when possible not to have carpet or throw rugs as these items also collect dust and present problems.

According to medical theory, asthma is a hypersensitivity reaction of the lung. The bronchioles of the lungs start to constrict when triggered by stimuli. When your body is weak, the hypersensitivity reaction is more extreme and the asthma attack is more severe. Once the lungs become hypersensitive easily, it is almost impossible to remove these reactions. In Chinese concept, asthma is most likely triggered when the body is weak. According to Chinese alternative medication, eating a certain Chinese bird nest which can only been found in a cave is very good at controlling asthma. It is a bird's salivary secretion which contains lots of minerals. Some believe there are some Chinese herbs which are good for asthma also.

Some asthmatics try Chiropractic care not just for symptomatic relief of asthma and allergies, but for a complete change in how the body responds to allergens and infections. The nervous system controls all of the functions of the body and allergies are an inability to respond properly to something we are sensitive to. It's not the pollen or mold or food that gives us the allergy it's the way the body responds to the allergen. So the medication that helps with our symptoms is suppressing the body's response to something we are sensitive to. A Chiropractor performs an adjustment in a patient's spine which provides more comfort and freer breathing. They also recommend a change to a more natural diet with whole foods. It is recommended to take the most natural approach possible. First make sure your nervous system is doing exactly what it should. Get checked by a Chiropractor who will be able to recommend nutritional supplements which will help strengthen the glands in the body that have the most to do with allergy response, the adrenal glands. They put out adrenaline, which is a hormone that, when injected into the body, will immediately stop an allergic response.

You have eczema and you want to do something about it. Perhaps you've tried pharmaceuticals or various home and natural treatments. Maybe you've had good results and perhaps your results haven't been so good. Maybe, like a lot of people, you've done some research on treatments available and have been so overwhelmed by the sheer number of remedies available that you don't know where to start. Let's take a brief look at some of the most common adult eczema treatment options, with their upsides and downsides, so that you will be better able to make an informed decision when you search for an eczema treatment.

- Pharmaceuticals

The first thing most people think of when they want relief from their eczema is to visit their doctor. S/he can prescribe antihistamines, or cortisone creams and pills. The upside is that relief is often virtually immediate. The downside is that the body eventually builds a tolerance to these medications so dosages and types of medicines must be changed periodically. Cortisone suppresses the immune system, opening the sufferer up to other infections. It also thins the skin when used for long periods of time. Prescription medication can be expensive.

- Homeopathics

Homeopathic remedies can stimulate the body to overcome symptoms of an illness by exposing the body to a homeopathic dose of the substance that causes the symptom. The upside is once the correct homeopathic remedy is identified, eczema symptoms will moderate or even disappear altogether. The body does not build up a tolerance to homeopathics, so dosages don't have to be changed. There are no adverse physical effects. The downside is that it may take a lot of testing to find the right homeopathic remedy because the remedy must be matched to specific symptoms, not just broadly to "eczema." Once the right homeopathic is identified, relief may not be immediate.

- Diet and Environmental

The symptoms of adult eczema are usually caused by reaction to an allergen. The allergy may be to a food or something in a person's environment such as cleaning products, animal dander, or molds. The upside is, like with homeopathics, once the allergens are identified and removed from a person's diet or environment, eczema symptoms can go into complete remission. Relief can be very quick. The downside is that allergy testing is generally required and this can be expensive. A person may find it difficult to make the diet or lifestyle changes necessary to keep the eczema at bay.

- Skin creams, moisturizers, and proctectants

Lotions, creams, and moisturizers will help keep the dry, itchy skin moist and will replenish lost moisture. This helps relieve the itching and flaking associated with eczema. The upside is that relief is fairly quick. Depending on what types of creams and lotions you buy, they are not terribly expensive. The downside is relief doesn't last very long; the creams and lotions must be reapplied regularly to maintain relief. Creams also only address the symptom, not the cause.

- Home remedies

There are literally hundreds of home remedies for eczema, everything from special soup recipes to oatmeal baths. The upside is, they have been proven over time to work. They are generally quite inexpensive, many items being common household supplies. The downside is that it is such a vast subject that it may take a great deal of time to find a home remedy that works for you. The reason that there are so many remedies is that every person is different, so what works for one person may not work for you.

Armed with this information, knowing the pluses and minuses of each option, you can pick and choose an area or areas that most closely match your needs. You now have a tool to help you relieve or remove completely the symptoms of adult eczema.

Mastocytic enterocolitis is a new clinical entity characterized by increase mast cells of 20 or more per high-powered field in the duodenum or colon. Jakate et al. described 47 patients with intractable diarrhea and abdominal pain without other cause who had elevated mast cell numbers in intestinal biopsies and responded to therapy directed at mast cells. The patients generally met criteria for diarrhea predominant irritable bowel syndrome (IBS). Normal subjects had much lower levels of mast cells of an average of 12 per HPF. My experience indicates that this condition may be another hidden epidemic that should be added to the that of celiac disease and non-celiac gluten sensitivity (NCGS). My colleague Dr. Rodney Ford has suggested the term 'gluten syndrome" for the broader problem of non-celiac gluten sensitivity and I agree that this may be a more appropriate term. Now, I am suggesting that mastocytic inflammatory bowel disease (MIBD) be considered as a better term for the newly recognized mastocytic enterocolitis. I review my reasons below.

Until recently the presence of increased mast cells was either missed due to lack of ability to see mast cells on biopsies in the background of normal cells or was only noted in association with inflammatory bowel diseases and celiac disease. A few pediatric studies have noted increase mast cells in the esophagus in association with eosinophilic esophagitis or "allergic esophagus". Systemic mastocytosis has been known for years and has been associated with bowel symptoms such as abdominal pain and diarrhea. Now two new studies are shedding more light on this covert cell and its role in postoperative ileus and association with stress. Mast cells have been linked to diarrhea predominant IBS in a few studies but it wasn't until the Jakate article that a distinct entity defined.

The problem with linking mast cells with IBS and other digestive symptoms has been hampered by the difficulty seeing these cells in intestinal biopsies. However, now commercially available special stains utilizing immunohistochemistry for the enzyme tryptase allows the mucosal mast cells to be seen and counted in intestinal tissue obtained from routine random intestinal biopsies. Over the past year I have been asking the pathologists to perform mast cell stains on intestinal biopsies in my GI patients with diarrhea and abdominal pain. Recently, I began expanding this to include as many patients as possible as well as requesting these stains be done on biopsies performed previously in patients who I suspected might have this condition.

I have now accumulated fifty patients meeting criteria for mastocytic enterocolitis or mastocytic enteritis. These patients are in various stages of evaluation and treatment. I am collecting and analyzing the clinical information with the intent to submit the data for publication. What I have observed on initial review is that appears to be a higher than expected prevalence of the celiac disease risk genes DQ2 and DQ8. In particular, DQ8 appears to be overrepresented compared with the incidence in the general population. There also appears to be an association with celiac disease, non-celiac gluten sensitivity and multiple food intolerance.

The latter finding of multiple food intolerance determined by mediator release testing abnormalities (MRT, Signet Diagnostic Corporation and Alcat) makes sense. The principle of these tests is the detection of changes in cell volumes that occur due to chemical mediator release from cells present in the blood. The tests are not specific for the mediator or mediators released but is assumed that the greater the reaction the greater the number of mediators released and more likely a particular food, chemical or food additive can cause an adverse reaction.

The laboratories that provide mediator release testing report great success in treating a variety of symptoms commonly attributed to food intolerance or chemical/additive sensitivity. It is my belief that mast cells are heavily involved in this process. This would make sense since success with conditions now being associated with mast cells are reported to respond favorably to dietary elimination of foods or substances with abnormal MRT reactions. Classic examples include IBS, headaches, and interstitial cystitis that have been linked to mast cells as well as stress that is now linked to increase mast cells and mast cell degranulation releasing mediators.

Mediator release tests are criticized by some U.S. doctors, in particular quackwatch.com as being unproven or not validated for "food allergy" evaluation. However, they are not food allergy tests. Food allergy is an IgE mediated type I immediate immune response known as allergy. MRT tests for non-immune delayed type reactions resulting from mediator release from immune cells. The point is that mediator release testing is not a form of food allergy testing. MRT is a form of non-immune food intolerance or sensitivity reaction.

New articles published in the January 2008 issue of the journal Gut reveal exciting new associations of mast cell degranulation with postoperative ileus and a link to a stress hormone. The first study may be the first to show that mast cells in human bowel release mediators when the bowel is handled during surgery resulting in temporary bowel paralysis known as postoperative ileus. The minimally invasive surgery technique of laparoscopy results in less mechanical stimuli to the bowel and has a lower incidence of postoperative ileus.

Stress association with IBS and inflammatory bowel diseases (Ulcerative colitis, Crohn's disease) has been long known but a mechanism had not been determined definitely. In the same issue of Gut investigators showed that the stress hormone corticotropin-releasing hormone (CRH) regulates intestinal permeability (leaky gut) through mast cells. The investigators even identified specific receptors on mast cells. This new information sheds new light on the possible link of leaky gut and mast cells with IBS, IBD and celiac disease.

So, how do I believe this new information may help us? Since stress can increase mast cells in the bowel and these cells can release mediators that cause gut injury and symptoms, stress reduction important. These cells can cause abdominal pain, diarrhea, and constipation as well as other symptoms outside the gut so they are important. Yet, the significance of these cells is generally not recognized because most doctors, including gastroenterologists and pathologists are unaware of their presence and importance.

These cells cannot be seen in the intestine without special stains done on intestinal tissue obtained during upper endoscopy or colonoscopy. Those stains are not routinely done but generally require the doctor performing the biopsy to request them. If no biopsy is performed then obviously these cells cannot be found. There may be a genetic predisposition for what I think may be better termed mastocytic inflammatory bowel disease (MIBD) rather than mastocytic enterocolitis. There also may be the same genetically determined white blood cell protein patterns that are associated with Celiac disease playing an important role in MIBD.

As note above, stress reduction and probiotic therapy may be helpful to reduce mast cells and leaky gut but what about once the mast cells are increased in the gut. Once elevated mast cells are present, treatment may include medications and dietary interventions. Antihistamines, both type I (e.g. Claritin, Allegra, Zirtec) and type II (e.g. Zantac, Tagamet, Pepcid) to block histamine effects have been used successful in reducing abdominal pain and diarrhea in people with mastocytic enterocolitis. A very specific mast cell stabilizer, sodium Cromalyn (Gastrocrom), also has reduced symptoms. It is an accepted therapy for the more severe condition of generalized mastocytosis.

Searching for food allergies and food intolerance (by mediator release testing) followed by dietary elimination of problem foods until leaky gut resolves and mast cell numbers in the bowel reduce is also helpful in my experience. Food allergy testing consists of skin testing and IgE RAST antibody tests. These tests do not exclude non-allergic food intolerance and sensitivity. Antibody tests for IgG in blood or IgA in stool or saliva have been used for food sensitivity. In my experience MRT tests are much more helpful as they look for any abnormal mediator release to a variety foods, chemicals, or additives, regardless of the nature.

Stay tuned for new developments about the role of mast cells and look for more interest in mastocytic enterocolitis in the future. I propose that the GI community should adopt the broader term mastocytic inflammatory bowel disease since there is information indicating mast cells have an important role in allergic esophagus and stomach problems.

Selected References:

The, FO et al. "Intestinal handling-induced mast cell activation and inflammation in human postoperative ileus." Gut 2008; 57:33-40

Wallon, C et al. "Corticotropin-releasing hormone (CRH) regulates macromolecular permeability via mast cells in normal human colonic biopsies in vitro." Gut 2008; 57:50-58.

Jakate, S. "Mastocytic Enterocolitis: Increased mucosal mast cells in chronic intractable diarrhea." Arch Pathol Lab Med 2006; 130:362-367.

Copyright 2008 Dr. Scot M. Lewey http://www.thefooddoc.com

Foods may cause irritable bowel syndrome (IBS) symptoms: In the U.S., most doctors have been, and continue to be, skeptical that foods cause symptoms of (IBS) and elimination of specific foods can improve these symptoms. This is despite almost 70% of people diagnosed as having IBS reporting symptoms related to specific foods. There is accumulating evidence, though still criticized because of limitations of studies that make it difficult to prove, that specific foods may be the cause of symptoms in many people labeled as having IBS.

Food intolerance testing and elimination diet based on IgG antibodies may be beneficial: Atkinson et.al. (Gut, 2004) randomized people to either an elimination diet based on elevated IgG antibody levels (YorkTest Laboratories) for specific foods or a sham diet. Those who avoided specific foods based on their IgG antibody tests had improvement in IBS symptoms (10-26% reduction) and global rating of quality of life significantly improved. Re-introducing foods for which they tested positive resulted in worsening. Zar et.al. (Am J Gastro, 2005) reported significant improvement of IBS symptoms such as pain, bloating, and alterations in bowel habits based on six month elimination of elevated food-specific IgG4 antibodies in 25 people.

Irritable bowel syndrome (IBS) is very commonly diagnosed in adults: No diagnostic tests can confirm IBS. It is a diagnosis of exclusion. It is a syndrome, that is, a collection of symptoms that cannot be explained by other diseases resulting in the diagnosis of IBS. Common missed diagnoses that are blamed on IBS include lactose intolerance, Celiac disease, gluten sensitivity or gluten intolerance, colitis, Crohn's disease, parasite infections such as giardia, bacterial overgrowth in the intestine or alterations in gut bacteria levels and types (dysbiosis), food allergies, food intolerance, and food hypersensitivity.

Celiac disease, colitis and Crohn's disease should be excluded before diagnosing IBS: Celiac disease, colitis and Crohn's disease can be diagnosed or excluded by blood tests, stool tests, and biopsies of the intestine. Food allergy, intolerance and sensitivity are not only more difficult to confirm or exclude but frequently missed because of limitations of blood tests, stool tests, allergy skin tests and biopsies. Adverse food reactions have to be considered as a potential cause of the symptoms attributed to IBS.

There are common foods that cause adverse food reactions: Common foods reported by IBS sufferers, whose symptoms improve with elimination, are wheat, barley, and rye (gluten); dairy including cow's milk protein (casein) and/or lactose (milk sugar); the legumes (peanut) and soy; yeast used to bake or brew foods; corn; shellfish and fish; nuts (almond, Brazil nut, cashew, and walnut); fruits (apple, orange, and strawberry); vegetables (celery, cabbage, and lettuce); the meats (pork, beef, and chicken); and nightshades (potato and tomato).

Individual specific and food-specific elimination diets are based on a variety of tests and a food-symptom diet diary: Elimination diets based on the common foods causing allergic reactions and non-allergic food reactions have been used for quite some time and are often prescribed with or without a food symptom diet diary. Interestingly, to my knowledge, no one has looked at approaching these people and their adverse food reactions individually, based on tests for Celiac disease, gluten intolerance or sensitivity (elevated blood gliadin IgA or IgG antibodies and/or stool gliadin IgA antibody without diagnostic blood tests or biopsy for Celiac), casein intolerance (stool IgA anti-casein antibody or blood IgG antibody), oral allergy syndrome (OAS) history and thorough food allergy testing (skin prick testing, IgE RAST or CAP RAST tests, intradermal skin testing or patch skin testing).

Specific food elimination diet trials based on such information (see the table at www.thefooddoc.com) has been helpful in my experience. Food-pollen cross reaction in OAS is well documented. A diet symptom diary combined with specific food elimination based on results of food allergy tests, food intolerance of food sensitivity tests, and known pollen allergies should be considered as a possible approach to elimination diet. This should not exclude evaluation for and treatment of established Celiac disease, lactose intolerance, dysbiosis, colitis or Crohn's disease.

Bibliography

Atkinson W, Sheldon TA, Shaath N, Whorwell PJ. Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled study. Gut 2004;53:1459-1464.

Choung RS, Talley NJ. Food allergy and intolerance in IBS. Gastroenterology & Hepatology October 2006;2(10):757-760.

Zar S, Benson MJ, Kumar D. Food-specific serum IgG4 and IgE titers to common food antigens in irritable bowel syndrome. American Journal Gastroenterology 2005;100:1550-1557.

Zar S, Mincher L, Benson MJ, Kumar D. Food-specific IgG4 antibody guided exclusion diet improves symptoms and rectal compliance in irritable bowel syndrome. Scandinavian Journal of Gastroenterology. 2005;40:800-807.

You can be intolerant to a food to which you are not "allergic". Food intolerance or sensitivity is much more common that food allergy. It estimated that somewhere between 6-10% of people are allergic to a food or foods but between 30-60% of people are intolerant to one or more foods or the additives or chemicals in food.

Food allergy testing will be negative if you are not allergic even though you are intolerant or sensitive to a food, additive or chemical. Food allergy is an abnormal immune response or reaction to a food protein. It is due to the same response to inhaled pollens or allergens. It results when the body makes a specific type antibody or immunoglobulin, known as IgE, to a food. When the food is eaten the IgE antibody recognizes the food protein as foreign and triggers the release of chemicals, especially histamine, from allergy cells in the body. This results in characteristic symptoms of swelling, itching, rash or hives, wheezing, shortness of breath, cough, low blood pressure and rarely death when the food is eaten.

Testing for food allergy consists of blood tests for the IgE antibodies (RAST) or the presence of a hive like reactions produced from histamine released at the site of skin prick, injection or patch contact with the food. The many food reactions that are not due to an allergic immune response involving IgE or histamine will have normal RAST IgE antibody levels and negative skin testing. Some of these food sensitivity or intolerance reactions are due to other antibodies such as IgA, IgM, or IgG. These antibodies may be detected in the blood, stool or saliva though such tests are not as well validated, accepted or available, especially in the U.S.

Diet treatments involving elimination of foods based on elevated IgG, IgM or IgA antibodies in the blood, evacuated stool samples, saliva or intestinal fluid retrieved from the body have shown mixed or to moderate success in people with rheumatoid arthritis and irritable bowel syndrome. The most well understood but still under recognized autoimmune food sensitivity with a genetic basis is gluten sensitivity, also known as Celiac disease. Non-celiac gluten sensitivity is much more common than Celiac disease but even less well recognized. Lactose intolerance is the most common food intolerance and often confused with the second most common food sensitivity, cow's milk protein or casein sensitivity. Gluten free casein free diet is now commonly employed as a treatment for autism. The medical community has generally been slow to accept gluten free casein free diet for autism, considering it unproven, though there is substantial scientific and experiential data to support this safe and often dramatically effective treatment.

Testing for IgG antibodies to foods in the blood is available from a few commercial laboratories. Saliva IgA antibody testing for foods is also available through several laboratories. These tests are generally not universally by health insurance and are often rejected as not valid or reliable by many doctors. Stool testing for IgA antibodies to gluten, tissue transglutaminase, dietary yeast, cow's milk protein (casein), soy, and chicken egg is available from Enterolab. This laboratory does not contract with any health insurance and most will not reimburse for the cost of testing. Most doctors either are unaware of this testing and either don't accept the tests as valid or don't know how to interpret the results.

Testing for mediator release (MRT) testing looks for an evidence of release of chemical mediators from immune blood cells triggered by foods, additives or chemicals. The presence of such a reaction is presumed to indicate sensitivity to such foods, additives or chemicals that can produce various symptoms and when substances producing such reactions are avoided or eliminated symptoms are suppose to improve significantly or resolve. MRT is available commercially through Signet Diagnostic Corporation (www.nowleap.com). Several insurance carriers pay for at least a portion of the cost of this testing however because it is considered "out of network" for most plans patients are usually responsible for payment of the service. Some carriers consider the testing "experimental" or not validated and therefore do not cover the testing.

The principle of MRT testing is that certain foods, additives and chemicals are capable of triggering non-allergy immune-based reactions. These reactions release various immune chemical mediators into the blood. If an immune reaction is triggered and these mediators are released, changes occur in the ratio of solids (cells) to liquid (blood serum) that can be measured. The white blood cells and platelets shrink and the volume of the liquid increases. The degree of change can be measured and reported as mild or moderate to severe corresponding with the degree of sensitivity to that particular food, additive or chemical.

Signet claims success with reducing or eliminating a myriad of symptoms or conditions including migraines, headaches, autistic behavior, anxiety, depression, ADD, sinus and ear, nose and throat problems, irritable bowel syndrome, vomiting syndromes, Celiac, chronic stomach aches, bladder problems, fibromyalgia, arthritis, eczema, hives, and chronic fatigue syndrome. The testing includes a comprehensive color report booklet containing a results specific diet plan with detailed information supplemented with several hours of personalized counseling from a dietician.

Of all the food intolerance or sensitivity testing MRT is the most broad and comprehensive. It looks for actual reaction produced by the body in response to foods or chemicals. Signet provides testing for 150 foods or chemicals (123 foods and 27 chemicals) including nitrates, nitrites, MSG and various food dyes. The limitation of all these tests is lack of universal acceptance by physicians and coverage by insurance. However, for those with suspected intolerance to foods or chemicals in whom available testing is negative or indeterminate, such testing can be quite helpful.

Traumatic injuries cause damage to tissues. The incidental rupturing of ancillary and primary blood vessels supplying these tissues causes internal bleeding at the site of injury. The blood supplies normally bring nutrients and oxygen to the tissues and remove waste materials along with metabolic by-products from tissues. With damage though, the delicate piping systems of vessels burst at smaller capillary, arteriole, or venule vessels--or even in larger vessels causing heavy bleeding.

This bleeding is what causes swelling at the site of the person's injury. The injury is enclosed within the skin, creating increased fluid and blood pressure inside the body at the injured site. When the trauma site fills and expands with bleeding, it tamponades the traumatic site. This may depress or cut off circulation. This occurs by increasing the site's inner body pressure at or above the person's normal blood pressure. This pressure is what naturally stops the bleeding at the site.

The heart pumps blood out to the tissues by way of the arteries. About 99% of all blood pumped out of the heart is returned by the venous return system. Being an enclosed plumbing system, the arterial pressure within the capillary bed drives the blood back to the heart by the pressure in the enclosed venous system. The generally low right-sided heart pressure allows naturally decreased pressures to direct blood from the venous systems back into the heart. This, in turn, allows the blood to be re-circulated and be pumped again and again back to the heart. The remainder of blood plasma is returned by the lymphatics.

In addition to the heart, artery, and venous systems, there is a passive lymphatic pipe system carrying the tissue fluids back to the heart. This lymphatic system acts as a cleaning sewage system allowing extra fluid to drain from the capillary beds and injured sites, via the venous system and then to the heart. Lymphatic vessels, like veins, have one-way valves which act as pumps. Passive pumps called lymph nodes are located behind joints or at sites of pressure from physical movement. They are much like a hose with a bulb and a valve attached to another hose. When the bulb is squeezed, the system pumps fluid in one direction only: towards the heart. When a joint is flexed and extended, the bulb is naturally compressed and it pumps moving fluids from the extremity towards the heart. This naturally removes blood, fluid, and potential infections fluid from the site of the injury. This reduces the on-site pressure after bleeding is stopped to allow new circulation and healing.

The elevation of a traumatic point is applied by measuring from the floor directly vertical to the heart, and then measure from the floor directly vertical to the site of injury. This means that the point of injury should be elevated approximately 12-16 inches higher than the position of the heart at any time and from any position, i.e. sitting in the chair with your foot on an ottoman if the foot is the site of injury, is not elevated. The distance to the floor from the foot must be less than the heart to the floor by 16" or more. Laying flat on a couch with your foot up high on the back of the couch at the head level is elevation of a traumatic site, decreasing pain and removing the fluids for healing.

Runny nose, watery eyes? Sneezing all the time? Do you have a dog allergy? Maybe your best friend is what's got your allergies going. After all there really is no dog breed that is truly non allergenic because they all produced dander, urine, and saliva.

Some dogs are less likely to cause allergies because they have less dander. There is a misconception that it is the fur that causes the allergies so the heavier the dog sheds the more likely you are to suffer. This is not the case. It is all about the dander. That is what actually causes the dog allergy.

Urine is generally more of a problem with cats than dogs because dogs go outside. And all dogs salivate. The pet hair becomes a problem when it collects other common allergens such as dust, pollen, dander causing a dog allergy.

The problem goes even deeper than what you are allergic to. You see people with allergies have an immune system that is super sensitive so it reacts to things that are harmless like pet dander. A dog allergy can cause wheezing, fatigue, coughing, headache, itchy watery eyes, sneezing, and in some cases asthma attacks. It can happen as quickly as five minute or be a delayed reaction occurring much later. And some people are allergic to only certain breeds.

There are also skin care products that you can use on your dog to reduce the amount of dander your dog produces. And there are some breeds that just by nature produce less dander so they can be a good choice for anyone with a dog allergy.

There are several things you can do to help reduce your dog allergy. For starters you can choose a natural product to help boost your immune system. You might also consider doing a detox to remove toxins from the body. Over the years our bodies build up large amounts of toxins which affect our immune system and can play a role in it short circuiting.

A dog allergy is just one of the allergies you might be suffering with that are environmental. Keep the dog dander to a minimal in your home. Run a HEPA filter in each room and use a vacuum with a HEPA filter. Vacuum at least once a day and don't forget to vacuum in the vents where hair, dander, and dust gather. Also vacuum the furniture. HEPA filters make a huge difference.
Keep the dogs out of the bedroom. If you don't want to close the door then install a baby gate to keep them out. Consider removing carpets and installing flooring. It reduces all kinds of allergies and is a known asthma reducer in children.

Bathe your dog at least once a week and wash dogging bedding and toys once a week. Spray areas where the dogs spend time with an anti allergen spray which helps deactivate allergens. Keep dust to a minimal.

You can also receive immunotherapy allergy shots if testing showed a pet allergy to begin with although it's not as effective as they would like to see it. You can also use over the counter medications to reduce symptoms and of course there are some excellent natural products that are worth trying if you have a dog allergy.

A dog allergy can develop out of nowhere. Or it can be something you have lived with for years that got worse over the years. Whatever the reason you now suffer with a dog allergy you can reduce the effects of that allergy using natural products and these tips.