LifeCare Chiropractic

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food allergy

Ear infections and allergy – (06-26-00)

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Ear infections and allergy

The relationship between ear infections and food allergy is a very important one, and should be evaluated in EVERY child with ear infections.

Allergy 55 (5), 435-441 The inflammatory response by eosinophils, neutrophils, and mast cells in the middle ear was distinctly different between atopic and nonatopic patients (P<0.001). This study provides evidence that eosinophils and mast cells, both essential to a Th–2 driven immune response, are present in the majority of ears with chronic OME, and supports the hypothesis that middle–ear mucosa, like that of the rest of the upper respiratory tract, is capable of an allergic response.

Surgery Advocated as Primary Treatment for Many Cases of GERD – (10-18-01)

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Surgery Advocated as Primary Treatment for Many Cases of GERD

I consider this topic, and this article, especially disturbing. To Western medicine, there are only two options to reflux disease: acid blockers or surgery. My gosh!! Have we forgotten that food allergy is known to play a strong role in lower esophageal tone? Cow’s milk allergy and GERD are well accepted bedfellows in infants–why do we forget this concept when the patient becomes an adult? How about avoiding the nightshade vegetables, caffeine and alcohol long before any pharmaceutical intervention?? Remember–it is not the acid causing the problem, it’s acid getting where it’s not supposed to be…

87th Clinical Congress of the American College of Surgeons Surgery is the only way to cure gastroesophageal reflux disease (GERD) and should be the preferred treatment for Barrett esophagus, according to Dr. Jeffrey H. Peters of the University of California, Los Angeles. Dr. Peters made the case for Nissen fundoplication during a debate on surgical versus medical management of GERD at the 87th Clinical Congress of the American College of Surgeons. In an interview with Reuters Health, Dr. Peters challenged a recent report in The Journal of the American Medical Association, in which Dr. Stuart Jon Spechler and others concluded that antireflux surgery does not obviate the need for medications in most GERD patients. According to Dr. Peters, Dr. Spechler’s group reported that 40% of GERD patients treated with surgery died within 10 to 13 years, and most of the surviving patients required proton pump inhibitors. Dr. Peters challenged the accuracy of those data and said that most of the surgery patients who were put on medical therapy following surgery had no indication for treatment. “If you look carefully at these patients, you will find that only 10% had acid indications that required proton pump inhibition,” he said. Dr. Peters added that surgery should be offered to patients with pH-positive, non-erosive GERD and said surgery is the “preferred treatment for patients with endoscopic esophagitis — but it should be the primary treatment for Barrett’s esophagus.” He said, too, that successful GERD surgery is often more dependent on “repair of the hiatal hernia rather than lower sphincter repair.” Dr. Joel Richter, head of gastroenterology at the Cleveland Clinic Foundation, represented the medical side of the debate and disagreed with Dr. Peters’ claim that surgery can cure GERD. “In some patients you may get a good result for 5 or 10 years, but these patients are going to once again become symptomatic. I think it is more accurate to call surgery a functional repair.” He added that “abdominal stressors don’t go away just because you perform surgery.” But Dr. Peters responded, “In a sense abdominal stressors do go away, because after a good repair, these patients can’t vomit.” Dr. Richter pointed out that surgery is “very dependent on good surgeons performing good operations on the right patients.” Before a standing-room-only crowd of surgeons, Dr. Peters’ remarks received long ovations, while Dr. Richter’s remarks were greeted with polite applause.

Food allergy/intolerance: associations with other manifestations of atopy – (11-29-01)

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Food allergy/intolerance: associations with other manifestations of atopy

This is another wonderful article packed full of interesting concepts. First is finding out just how common food allergy is in the general population. This article also gives some common food allergens found which includes certain nuts, milk and fruits. Another common theme arises here as well–systemic manifestation of food allergy resulting in reactions in the GI tract, skin and oral cavity. Skin reactions were found in 28.7% of the allergic patients. This brings to mind one of my patients with eczema whose PCP told her that food does not have any relation to her symptoms. According to this study that’s just plain not true. Any patient with dermatological problems should be put on an elimination diet to see if food allergies has any contribution to symptoms. What does the patient have to lose?? Maybe the skin lesions…. Synergy : Allergy 56 (12), 1172-1179

Read entire article here

Food hypersensitivity: association with atopic diseases – (05-20-03)

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Food hypersensitivity: association with atopic diseases

I still feel that food allergy is a very commonly overlooked contribution to chronic diseases. Here we see further report for this contribution with dairy being second on the list (kiwi #1). One thing I find interesting is that milk allergy was almost twice as common as peanut, and yet peanut allergy is always getting lots of press and warnings are seen on all types of labels. Although there is the danger of anaphylactic shock from peanuts, the chronic contribution of dairy allergy to disease is still a foreign concept to most clinicians.

Read entire article here

Gastroesophageal Reflux and Cow Milk Allergy – (11-07-02)

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Gastroesophageal Reflux and Cow Milk Allergy: Is There a Link?

As with any condition in infants (skin problems, chronic diarrhea, allergies) food allergies need to be ruled out first unquestionably. That would include dairy, soy and corn (wheat doesn’t normally get overexposed until later), and any other food that an infant is bombarded with while their delicate immune systems are developing.

Pediatrics — Abstracts: Salvatore and Vandenplas 110 (5): 972

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WAYS TO HANDLE FOOD ALLERGIES AND ECZEMA – (10-20-04)

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Food allergy and atopic dermatitis in infancy: an epidemiologic study

The connection between the gut and the skin is not well accepted, despite quite a bit of research actually supporting this link.

This study further supports the relationship with food allergy (which would be mediated via the GI tract) and eczema. My personal opinion is that, if you can address it very early, food allergies and eczema can be easily handled. As that baby gets older, the pathways of inflammation and allergy get “burned in” and resolution becomes more difficult. In addition to identifying food allergies, research also suggests the use of probiotics to add an additional protective barrier between our environment and the interior of our body.

Food allergy and atopic dermatitis in infancy: an epidemiologic study – Pediatric Allergy Immunology, Vol 15, Issue 5, pp. 421-427 –

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Eosinophilic Esophagitis Treatment with the Esophagitis Diet

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Say that 3 times fast…Eosinophilic Esophagitis Treatment with an Esophagitis Diet. This autoimmune condition has been on the rise, especially in children.

Overall, most autoimmune disorders, especially those tied to the gut (think Crohn’s disease, ulcerative colitis and eosinophilic esophagitis) have been on the increase.  The scare thing is that this rise has been playing out in children more so than adults.  I have no doubt that our sterile “hygienic” lifestyles are to blame.  The combination of antibiotics and vaccinations to try to wipe out every possible communicable disease, coupled with antibacterial wipes, lotions, facial tissues and toilet paper (ok..maybe not toilet paper, but only because they couldn’t find a good market for it…), has left our immune systems dysfunctional.

Another strong player in the autoimmune circuit is food allergies.  Actually, let me correct that.  When I think of allergies, I think anaphylactic shock from peanuts, skin prick testing and allergy shots.  What seems to play a larger role is food sensitivity.  Allergies are hard-wired into our immune system, but sensitivites come and go based on the overall health of the individual.

Eat a food you’re sensitive to day in and day out for years and you’re systems not going to be very happy with you.  Avoid that food for several weeks and your immune system begins to calm back down.

So how do we determine if we are sensitive to a food?  I can tell you that I’m not a big fan of skin scratch testing or even bloodwork such as a RAST panel.  Blood allergy testing can get very expensive (it’s easy to rack up a $1,000 bill).

I prefer elimination diets.  Approximate cost?  $0.  Accuracy?  Pretty darn high if done correctly.  High enough to be considered the gold standard for allergies and sensitivities.

Basically, in an elimination diet, you avoid all commonly sensitive foods (principally dairy, wheat, eggs, corn and soy) for 2 weeks.  If you begin to feel better in this time period (based on whatever symptoms caused you to try the elimination diet in the first place), you reintroduce one of these foods at a single point and check for symptoms to return within a few days.

This is considered elimination with subsequent food challenge.

So what does this have to do with the tongue twisting eosinophilic esophagitis? 

Researchers have already determined that food allergies play a huge role in flare ups and symptoms of esophagitis in children.  I remember writing a blog on the relationship between celiac disease and reflux esophagitis in March of 2003, almost a decade ago.  This is not new news.

So, since the relationship between food allergies in children is well established, someone decided to ask if the same relationship was present in adults.  What brilliant thinking from the researchers, because most GI docs don’t make too many recommendations on food elimination diets.

In this particular study looking at food elimination diets in adult with eosinophilic esophagitis, the results were nothing short of shocking:

  • Common symptoms of EoE included dysphagia (96%), food impaction (74%), and heartburn (94%)
  • The number of eosinphils (white blood cells related to allergy) dropped 76% with the diet
  • Symptom scores decreased in 94% of those on the program (yes–you read that right–94%, as in “almost all”)
  • After food reintroduction, eosinophil counts returned to pretreatment values
  • Foods most problematic were wheat (60%) and milk (50%), soy (10%), nuts (10%), and egg (5%)
  • Skin-prick testing predicted only 13% of foods (in other words, just short of worthless)

Realise that NONE of the patients in this study realized that they had food allergies / sensitivities prior the program.  Which also means that their gastroenterologists likely never brought the subject up.

Remember that 94% of patients complained of heartburn, despite being put on acid suppressive drugs like Nexium or Prilosec.  This means that ACID WAS NOT THE PROBLEM.

Did I mention that acid was not what was causing the reflux symptoms in these patients?

So, by giving acid suppressive drugs, not only did their physicians completely disrupt healthy digestion, but they did not address the real problem.  These food allergies, left to run rampant for decades create the chronic inflammation associated with other diseases such as osteoporosis, dementia, cancer, heart disease and stroke.

So, if you deal with reflux, regardless of whether is it eosinophilic esophagitis or not, have you identified any foods that contribute to your symptoms?

PROBIOTICS CAN LOWER INFLAMMATION FOUND IN GI TRACT – (02-21-05)

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Probiotic effects on faecal inflammatory markers and on faecal IgA in food allergic atopic eczema/dermatitis syndrome infants

I know I’ve always gotten wonderful results in children/infants with eczema using probiotics.  The results are usually not so great in adults.  I feel that as these harmful patterns persist, they are much harder to reverse with simple methods like probiotics.

This study supports what I see in practice–that something as simple as probiotics can lower the inflammation found in the GI tract.

Read entire article here