Have you ever seen or heard of someone suddenly having difficulty breathing, their body turning red, their eyes and lips swelling, and they are panicking? It could be a severe allergy. Today we are going to talk about such a dangerous, life-threatening condition. This is what we call anaphylaxis in medicine. Today we will talk about what exactly this is, why it happens, and what to do if it happens.
What is Anaphylaxis simply?
Simply put, anaphylaxis is a very severe, sudden allergic reaction. It's like our body's immune system goes into overdrive and starts harming itself. This condition can be life-threatening if not recognized and treated promptly.
Usually, we are more likely to have a severe reaction like this when we are allergic to a food, an insect bite, certain medications, or things like latex.
The most important thing is that the only treatment for anaphylaxis is an epinephrine injection . This comes in a form that can be injected into the thigh. However, even if this injection is given, you should definitely go to the nearest hospital emergency room. With prompt treatment, most people make a full recovery.
What happens inside the body when anaphylaxis occurs?
When you are allergic to something, it means that your immune system is overreacting to it. When this happens, certain cells in our body suddenly release large amounts of chemicals like histamine .
Imagine, when an enemy comes to a country, it's like the whole army attacks at once. But this time, the "enemy" could actually be something that doesn't really harm us (like peanuts, for example). So it's because of these chemicals that symptoms like swelling, itching, difficulty breathing, and difficulty swallowing appear. Sometimes this can affect more than one part of the body.
Important: If you or someone close to you shows signs of anaphylaxis, even if you have been given an epinephrine injection, call 911 or go to the nearest hospital immediately.
What are the stages of anaphylaxis?
Anaphylaxis is a condition that occurs suddenly and unexpectedly. Sometimes it can occur without any warning signs. However, some people may first experience mild symptoms, such as hives or redness of the skin. Doctors talk about four stages of this:
1. Stage one - Mild anaphylaxis: This is the most basic, less severe stage. Symptoms may include skin rash, redness, and itching.
2. Stage two - Moderate anaphylaxis: Symptoms are a little more severe here. There may be things like skin rashes, mild swelling of the lips or tongue, etc.
3. Stage three - Severe anaphylaxis: Now the situation is serious. Symptoms include difficulty breathing, severe swelling, a weak pulse, and dizziness. A person in this stage may have a condition called 'anaphylactic shock' .
4. Stage four - Life-threatening anaphylaxis: This is the most dangerous stage. The patient may lose consciousness, become unable to breathe, and blood flow to vital organs may be disrupted. If a person in this stage does not receive immediate medical attention, death may occur.
What is 'anaphylactic shock'?
When a person has an anaphylaxis reaction, their blood pressure can drop dangerously. This is when they go into a state called anaphylactic shock. The bronchial tissues that help them breathe swell, causing difficulty breathing and even loss of consciousness. This is a life-saving condition that requires immediate treatment.
How common is anaphylaxis?
The statistics on this vary, but according to the latest data, the lifetime risk of anaphylaxis in the United States is between 0.05% and 2%. This condition is also becoming more common in Sri Lanka.
What are the symptoms of Anaphylaxis?
Anaphylaxis usually starts with skin symptoms. For example, you may experience hives or itching. Within minutes, you may experience more severe symptoms such as:
- Swelling of the throat, lips, and tongue.
- Shortness of breath.
- Skin rashes (Hives).
- Difficulty swallowing.
- Redness of the skin.
- Abdominal pain.
- Chest tightness.
- Body pain, cramps.
- Diarrhea.
- Feeling of great fear or anxiety (Feeling of doom or dread).
- Vomiting.
- Wheezing.
What are the symptoms of severe anaphylaxis?
If you experience any of these symptoms, seek medical attention immediately, or use your allergy medicine. If left untreated, more serious, life-threatening symptoms can develop, such as:
- Dizziness and loss of consciousness due to low blood pressure.
- Increased heart rate.
- Sudden weakness.
- Unconsciousness.
- Cardiac arrest.
When do symptoms start?
Most of the time, symptoms start within 5 to 30 minutes of exposure to an allergen. For example, when you get a bee sting or eat a food you are allergic to (like peanuts). But sometimes symptoms can start as soon as an hour later.
What is 'Biphasic anaphylaxis'?
This is a bit special. 'Biphasic anaphylaxis' is when the initial symptoms subside, followed by a second wave of symptoms. This second wave can occur hours or even days after the first. This condition affects about 20% of people who experience anaphylaxis. That's why even with epinephrine, you need to go to the hospital.
What are the causes of Anaphylaxis?
Food allergies are the leading cause of anaphylaxis. Some foods that can cause such a severe reaction are:
- Cow's milk.
- Eggs.
- Peanuts.
- Seafood (Shellfish) (like shrimp, lobster).
- Soy.
- Tree nuts (like cashews, almonds, walnuts).
- Wheat.
- Seeds (like sesame seeds, sunflower seeds).
Anaphylaxis can also be caused by other allergens:
- Some medications , for example penicillin, nonsteroidal anti-inflammatory drugs (NSAIDs), and some dyes used in CT scans.
- Latex : These are found in things like disposable gloves and catheters.
- Insect stings . When animals like bees, wasps, and hornets sting.
Who is at higher risk of anaphylaxis?
People with asthma and those who have previously had a severe allergic reaction are at the highest risk of developing anaphylaxis.
Allergic reactions can be unpredictable. Even if the first time you have no major symptoms, the second time you have a reaction can be life-threatening. That's why it's important to always carry an epinephrine injection if you have a severe allergy.
Does pollen cause anaphylaxis?
Anaphylaxis is very rare from things like pollen that we breathe in. They can cause allergic symptoms (like a cold), but the risk of them progressing to anaphylaxis is very low.
What are the possible complications of anaphylaxis?
Severe anaphylaxis is a potentially life-threatening condition, especially in people with underlying medical conditions such as heart disease or lung disease (especially asthma). It should be treated as a medical emergency to reduce the risk of serious complications.
How is Anaphylaxis diagnosed?
If you have an allergic reaction (even a mild one) to a food or an insect bite, see a doctor immediately. A doctor can diagnose anaphylaxis based on your symptoms. He or she will refer you to an allergist. That doctor can do more tests to find out exactly what triggers you are allergic to and teach you how to avoid them.
Taking these steps can protect your health and possibly even save your life. This applies to anyone with any type of allergy.
What tests are used to diagnose anaphylaxis?
An allergist may recommend a skin test or a blood test. This can help confirm your allergy and find the specific trigger. A skin test involves putting a small amount of the allergen on your skin and seeing if you have a reaction. A blood test involves taking a sample of blood from a vein in your arm.
How is Anaphylaxis treated?
If you have had a severe allergic reaction to a food or an insect bite, your doctor will prescribe an epinephrine autoinjector (EpiPen® or similar). This is a device that looks like a large marker pen. You should keep it with you at all times. Some people keep two of these injections, perhaps in case they need to be injected twice to control their symptoms, or if one doesn’t work.
If you have an anaphylactic reaction, you should inject this medicine into the large muscle on the outside of your thigh. Epinephrine works very quickly and controls the symptoms.
After taking the medicine, seek medical help immediately, or call 1990. If symptoms do not subside within 5-15 minutes, take a second injection if you have another injection available. The effect of epinephrine is short-lived. Therefore, even if symptoms subside after taking the injection, you should still seek medical attention immediately.
How do you know if someone is having an anaphylactic reaction?
Keep an eye out for these symptoms. They usually appear in the nose, mouth, skin, or digestive tract:
- Skin rash (hives) or swelling of the eyes, lips, or tongue.
- Difficulty breathing.
- Symptoms of low blood pressure: weak pulse, confusion, loss of consciousness.
- Stomach upset: vomiting, diarrhea, stomach cramps.
What do you do if someone goes into anaphylactic shock without an EpiPen?
If someone near you is having an anaphylactic reaction, call 911 or seek medical help immediately. The person may also need to be given CPR (cardiopulmonary resuscitation).
Other ways you can help:
- Lay the person down on the floor. But if they are having trouble breathing, help them sit up. That will make it easier to breathe.
- If the person is unconscious, turn them on their side. Lift their chin and open their airway.
What other anaphylaxis treatments may be needed in an emergency?
If the patient is not breathing, emergency responders may do the following:
- Inserting a tube into the airway through the nose or mouth.
- An emergency surgery, called a tracheostomy, involves placing a tube directly into the windpipe.
Doctors may use the following to treat shock:
- Intravenous fluids (IV fluids).
- IV medication to strengthen the heart and circulatory system.
- Once the patient is stabilized, antihistamines and steroids can be used to reduce symptoms.
Can Benadryl stop anaphylaxis?
Antihistamines, such as Benadryl®, can treat mild, non-anaphylactic allergy symptoms, such as hay fever. However, they are not a substitute for epinephrine when treating anaphylaxis.
What is the future for those who have had an anaphylactic reaction?
If a person is not treated in time, anaphylaxis can lead to loss of consciousness and even death. But if you get treatment quickly with epinephrine, your chances of recovery are much higher. You are more likely to make a full recovery.
How long does anaphylactic shock last?
The exact time varies from person to person, but it usually peaks between 5 and 30 minutes. However, even with treatment, symptoms can sometimes last for several hours.
The most important thing is not to wait for anaphylaxis to go away on its own. Time is of the essence when someone is in this situation. Even a small delay can be life-threatening.
Does anaphylaxis go away?
Unfortunately, allergies that cause anaphylaxis can be lifelong. Anaphylactic reactions can be controlled with the quick use of epinephrine. However, if you have had a severe allergic reaction, you can expect to have the allergy for life.
Can Anaphylaxis be prevented?
Anaphylaxis cannot be completely prevented, but you can take several steps to reduce your risk of accidentally ingesting an allergen.
These tips can help you avoid allergens:
- Food: Read food labels carefully. When eating out at restaurants, ask what ingredients are in the food and how it is prepared. (Sometimes, even if a food you are not allergic to is prepared in the same container that you are allergic to, it may be prepared in the same container.) If your child has an allergy, inform the school and other caregivers about it.
- Medication: If you are allergic to any medication, or have had an allergic reaction in the past, tell your doctor. They can then give you a safer alternative. If there are no alternatives, they may try a procedure called 'drug desensitization.'
- Insect bites: Avoid walking barefoot on grass. Also, it is not wise to drink from open cans, as insects can live in such places. Avoid wearing bright, floral-patterned clothing and using perfumes, hair oils, and lotions that may attract insects. Allergists can offer a treatment called 'venom immunotherapy' for people who are allergic to insect bites.
If you have severe allergies, carry an epinephrine injection with you everywhere you go. You need to know what you are allergic to. Also, tell your friends and family where you have the injection.
What is 'drug desensitization'?
Sometimes, you have to take an allergy medicine. There may be no safe alternative. A procedure called 'drug desensitization' is used to temporarily get your body used to the medicine. An allergist will give you small, increasing doses of the medicine until you get the full dose. You have to keep taking the medicine. While you do this, you are temporarily allergy-free. As soon as you stop taking the medicine, you become allergic to it again.
What is 'venom immunotherapy'?
This is a very effective method used to eliminate or greatly reduce anaphylactic reactions to insect bites. An allergist injects small doses of the insect's venom under your skin. You have to get a series of injections like this. This reduces your sensitivity to the allergen.
What is 'oral immunotherapy' for food allergies?
This is a new treatment. It can reduce the sensitivity to foods in people with severe allergies. Oral immunotherapy is performed by an allergist who specializes in food desensitization. The doctor first gives you very small amounts of the food you are allergic to, and then gradually increases the amount over several months. Oral immunotherapy does not "cure" food allergies, but it can reduce the severity of the reaction if you accidentally ingest the food that causes anaphylaxis. People who have oral immunotherapy should keep their epinephrine injection with them.
How to live well with anaphylaxis?
If you know you have a severe allergy to a food or something else, be prepared in advance:
- Keep your injection with you: Always keep your epinephrine injection kit with you.
- Wear an identification tag/jewelry: Wear a piece of jewelry or keep a card with you that says your allergy. This could save your life in an emergency.
- Don't delay getting your shot: If you have an allergic reaction, get your epinephrine shot right away. Don't wait until the reaction is severe.
- Tell your doctors: If you have any allergies to medications, tell your doctor before any test or treatment, even your dentist .
- Inform your loved ones: Tell your family and friends about your allergies and what triggers you are allergic to. Make sure they know how to recognize the signs of anaphylaxis. Also, teach them how to use the vaccine so they can help you in case of an emergency.
When should I use my epinephrine injection?
If you think you are having an anaphylactic reaction, don't delay getting your vaccine. Instead, don't wait to take an antihistamine. Get your vaccine right away.
Your life depends on acting quickly. You may need to call 911 or go to a hospital. Even after you get the vaccine, you will need medical evaluation and treatment.
If you are not sure if you are truly having an anaphylactic reaction, it is best to get the vaccine. The risk of getting a vaccine is much lower than the risk of not getting the medicine in time.
If you accidentally inject yourself with an epinephrine autoinjector, your blood pressure and heart rate may increase. If this happens, call your doctor or seek medical attention.
What should I do after an epinephrine injection?
Call 911 immediately or find a way to get to a hospital. If you have an anaphylactic reaction, you should go to the nearest emergency room.
When should I see an allergist?
An allergist is a doctor who is specially trained to diagnose and treat people with allergies. If you have an allergic/anaphylactic reaction, or if you think you may have one, you should see an allergist. They can confirm that it is caused by an allergy and identify the triggers. They can also tell you about treatment options and how to avoid the allergen. They can also give you a plan for managing an anaphylactic reaction if you accidentally ingest something you are allergic to.
If my child has allergies, what should I do?
If your child has allergies, take these steps to protect him:
- Inform him about the allergy.
- Make sure he has his vaccine and knows how to use it.
- Inform your child's school staff about the allergy and share the treatment plan with them.
- Inform any adult who cares for your child about the allergy and how to use the vaccine.
Finally, what to keep in mind
Knowing that you could have an allergic reaction to a food you eat every day can be scary. But there are things you can do to reduce your chances of having a severe reaction. If you experience symptoms of anaphylaxis, inject epinephrine immediately. Then, call 911 or go to the emergency room. Prompt anaphylaxis treatment can save your life. Carry your vaccine with you everywhere you go. Try to avoid your triggers. If you have allergy symptoms that are difficult to manage, or if you think you are going into anaphylactic shock, talk to your doctor. I hope this information is helpful to you. Stay healthy!
` Anaphylaxis, allergy, epinephrine, epipen, anaphylactic shock, allergic reaction, emergency
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