Let's learn about the newest treatment for food allergies - Oral Immunotherapy (OIT).

Imagine your baby is allergic to peanuts. So every time you take him to a party or drop him off at school, you have a terrible fear in your mind. "Oh, what if someone gives you a piece of cake with peanuts in it? What will happen if a small piece goes into your baby's mouth by accident?" This fear, this pressure, is probably very familiar to you. Only those who have experienced it know how difficult it is to live with such food allergies. But, have you heard of a new treatment that can help you say goodbye to this fear? That's what we're going to talk about today.

Simply put, what is Oral Immunotherapy (OIT)?

Although the name may sound complicated, the concept is simple. Oral Immunotherapy (OIT) is a treatment for food allergies. It involves giving you very small amounts of the food you are allergic to (medically called an allergen) under the close supervision of an allergist.

Think of it this way. You are given the food you are allergic to, like a medicine, under the watchful eye of a doctor. First, you start with a very small amount that you can't even see. Then, over time, you very carefully increase the amount.

The main goal of this is to gradually "disease" your immune system to the food you're allergic to. Normally, your body mistakes a protein in the food for a "dangerous enemy" and starts fighting it. That's what causes an allergy. But in OIT treatment, we gradually introduce the "enemy" to your body, so over time your immune system realizes, "Oh... he's not that dangerous." We call this ``desensitization.'' That is, the body becomes less sensitive to that food.

What preparations should be made before starting OIT treatment?

This is not something you can just go and start. It needs to be done in a very planned manner, after talking to your doctor. Usually, you will have to complete these things before this.

How does this treatment process happen?

This entire process can be divided into two main phases: the "escalation phase" and the "maintenance phase."

1. Updosing Phase

This is the most active period of treatment.

• Day 1: You will first need to go to the doctor's office or clinic. There, under the doctor's supervision, you will be given a very small amount of the allergenic food. The doctor will explain everything about how much to eat and how to measure it. They will also be ready to treat you if you have any reactions.
• At home: Then, that first dose that the doctor prescribed, you should take it at home every day. It's best to take it at the same time as possible.
• Every two weeks: You will be asked to come back to see your doctor every two weeks. There, again under medical supervision, your dose will be increased slightly. Then you will go home and take the new dose every day.

In this way, the dose is gradually increased every two weeks until the doctor reaches a target dose.

2. Maintenance Phase

Once you reach that target dose, the "maintenance phase" begins.

• What happens here is that you continue to take the highest dose you last successfully took every day .
• This maintenance dose should be taken for at least six months.
• After six months, your doctor will do another blood test to see if the level of antibodies in your body against that food has decreased.
• Sometimes, you can also do a "Food Challenge Test." This means that in a hospital setting, under medical supervision, you are given a small amount of the allergenic food to see if you have a reaction.
• Based on the results of these tests, your doctor will decide whether you should continue to take the maintenance dose every day, or if taking it a few days a week will suffice.

What rules should be followed during treatment?

For the success of this treatment, and for your own safety, there are a few things you must follow. Following these exactly can reduce many unnecessary risks.

What do you do if you have a sudden reaction?

This is the most important part that everyone should know. Your doctor will give you a clear set of instructions on what symptoms to look out for, when to use the EpiPen, and when to go to the hospital's Emergency Department (ETU).

If you experience one or more of the following dangerous symptoms , don't delay .

• Swelling of the face, lips, tongue, or throat
• Difficulty breathing
• Feeling of tightness in the chest
• The appearance of many large blisters (hives) all over the body
• Vomiting
• Numbness in the hands, feet, or lips
• Body weakness, dizziness, fainting
• Feeling of impending doom (a feeling of great fear, like "something is going to happen to me").

If you experience any of these symptoms, use your EpiPen immediately and go to the nearest hospital Emergency Department (ETU) as soon as possible.

Are there no risks to this treatment?

Like any medical treatment, OIT has some risks.

• The main risk is the severe allergic reaction called ``anaphylaxis'' that we talked about earlier. That's why this treatment should always be done under medical supervision and should never be attempted at home alone .
• In addition, minor reactions such as small blisters on the skin and minor stomach upset may occur.
• Another rare but serious risk is a condition called Eosinophilic Esophagitis . This is an inflammation of the esophagus. If you experience symptoms such as vomiting or a feeling of food getting stuck in your throat, you should tell your doctor immediately. Young children may refuse to eat. This condition usually resolves once OIT treatment is stopped.

What are the benefits and success rates of OIT treatment?

The main benefit of this treatment is that it takes a lot of the pressure off your life. The only great thing about living without the fear of a serious accident if you accidentally eat a piece of allergic food. Some people, especially children who start treatment at a young age , even get used to eating that food normally without any fear after completing OIT.

In terms of success, studies show that this treatment is very effective in children under the age of 4. For example, in a study of OIT for peanut allergy, more than 70% of children between the ages of 1 and 4 were able to eat the equivalent of a peanut kernel of protein without any problems.

Your doctor is the best person to decide if this is right for you or your child. This is a treatment that requires a lot of commitment and takes time. Therefore, it is important to discuss all your questions and fears with your doctor and make an informed decision.