Have you ever seen someone eat food, take medicine, or get stung by an animal like a wasp and suddenly their whole body starts to itch, they can't breathe, their face swells up, and they panic? Maybe you've had that happen to you. Many people think this is a normal allergy. But it can be a much more serious, even life-threatening condition. In medicine, we call this anaphylaxis . Today, we'll talk about everything in simple terms.
What exactly is Anaphylaxis?
Simply put, anaphylaxis is an extreme, severe, and immediate reaction by our body's immune system to something that is normally harmless (like food or medicine). This is not like a normal allergy. This is a medical emergency . If left untreated, this condition can be fatal.
The most important thing to do in such a situation is to give a medicine called epinephrine as soon as possible. It is also called adrenaline. This medicine can control severe symptoms within a few minutes. Sometimes a second dose may be needed within 30 minutes.
The most important thing is that in a case of anaphylaxis, it cannot be controlled by just giving antihistamine tablets (which we know as Piriton in Sri Lanka) that are commonly used for allergies. Therefore, it is dangerous to give such a thing and wait.
This condition is rare, but some people are at higher risk. If you have had a severe allergy like this before, if someone in your family has had it, or if you have asthma, you are also at higher risk.
How symptoms get worse gradually
Anaphylaxis doesn't peak all at once. It usually progresses rapidly through several stages. It's important to be aware of these stages so we can take action quickly.
| Stage | Commonly seen symptoms |
|---|---|
| Stage 1 (mild symptoms) | The body itches, red bumps (hives) appear on the skin, and a runny nose. At this point, many people think that this is just a normal allergy. |
| Stage 2 (most widespread symptoms) | The rash spreads throughout the body. The face, lips, and tongue swell. Tears come from the eyes. It becomes difficult to swallow. Stomach pain, vomiting, and diarrhea may occur. At this stage, immediate medical help should be sought. |
| Stage 3 (severe symptoms) | It becomes very difficult to breathe. You feel pain or tightness in your chest. Your pulse rate becomes weak. You feel dizzy and may faint. This is what we call 'anaphylactic shock' . |
| Stage 4 (life-threatening situation) | Blood pressure drops to very low levels. The pulse is very weak. The airways swell, causing breathing to stop completely. This condition can lead to a heart attack or even death. |
Some people also remember having a sense of doom before the reaction . Also, some people can have a second, more severe reaction within 12 hours of the first reaction. This is called biphasic anaphylaxis .
What are the main causes of anaphylaxis?
This happens because our body's infection-fighting antibodies overreact to something harmless (a trigger). There are many things that can cause this.
- Food: For young children, the main culprit is food. Peanuts, milk, eggs, soy, wheat, and shellfish are the main culprits. For adults, seafood and various tree nuts (such as cashews, walnuts, and almonds) are the main culprits.
- Medications: Medications are the leading cause of anaphylaxis in adults. Antibiotics such as penicillin, some anesthetics, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen are among the most common.
- Insect stings: In Sri Lanka, we often hear about severe allergies caused by animal stings such as wasps and hornets. Bee stings can also be a cause of this.
- Latex: Some people also have severe allergies to latex, a material made from rubber. It is found in things like gloves and balloons used in hospitals.
Sometimes the cause of this cannot be found. We call this idiopathic anaphylaxis .
Emergency treatment and management - this is the most important part!
If you or someone you know begins to experience symptoms of anaphylaxis, you need to act without delay .
1. Give epinephrine immediately: If you are at risk, keep an epinephrine auto-injector pen or nasal spray prescribed by your doctor. Inject this into the back of your thigh as soon as symptoms begin. Ask your doctor for instructions on how to use it.
2. Go to the hospital immediately: Whether or not you have been given an epinephrine injection, you should definitely call an ambulance or go to the nearest hospital emergency department (ETU) immediately. This is because symptoms may reappear once the effect of the medication wears off. As mentioned earlier, a biphasic reaction is possible.
3. Hospital Treatment: In the ETU, you will be given oxygen, intravenous fluids (saline), additional doses of epinephrine, steroids, and antihistamines as needed. If you have difficulty breathing, you may need to have a breathing tube inserted.
If something like this happens to you, be sure to see an allergist to find out exactly what caused it and get the advice you need to protect yourself in the future.
How can we protect ourselves from this situation in the future?
The best thing to do is to know exactly what triggers you and stay away from them completely. In addition, be sure to do these things.
- Keep an Emergency Kit: Always carry at least two epinephrine pens prescribed by your doctor with you wherever you go. Also, be aware of their expiration dates.
- Wear a Medical Alert Bracelet: Wearing a bracelet or necklace that says you have this condition can help others know about your condition, even if you are unconscious.
- Inform everyone: Make sure your family, friends, office staff, and every doctor who treats you (including your dentist) are aware of your allergy.
- Read labels: If you have food allergies, read the labels of everything you buy at the store. When eating out at a restaurant, ask if the food contains any ingredients you are allergic to.
Even with all of this, you can still accidentally ingest something you're allergic to. So, you and those around you need to have a good plan for what to do if that happens.
Take-Home Message
- Anaphylaxis is not a common allergy, it is a medical emergency that can be life-threatening.
- Severe symptoms may include difficulty breathing, swelling of the face/lips/tongue, rash, and loss of consciousness.
- The only and first emergency treatment for this is to immediately administer an epinephrine injection.
- Even if epinephrine is given, you should definitely go to a hospital's Emergency Treatment Unit (ETU) .
- If you are at risk, identify and avoid your triggers. Keep your emergency kit (epinephrine) with you at all times.
- Talk to your doctor and develop a clear action plan for what to do in an emergency.
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