Severe Allergic Reactions After Eating Out: Causes and Solutions

Severe allergic reaction and respiratory distress after eating out?

Hello, Dr.
Gao.
I usually experience skin rashes when consuming MSG, but after eating out yesterday, I developed a condition within 15 minutes that included widespread redness, itching, numbness of the tongue, and breathing difficulties.
I quickly took medication, but I cannot seem to avoid this situation.
This time, it even triggered my respiratory issues.
Could these allergies be caused by food, or are there other factors involved? Thank you, Dr.
Gao.

Mr. Chen, 30~39 year old female. Ask Date: 2013/12/29

Dr. Gao Jiankai reply Internal Medicine

Hello Mr.
Chen, thank you for your question.
The rapid onset of symptoms is indeed very likely to be caused by an allergy.
Severe allergies can affect the respiratory system, leading to symptoms similar to an asthma attack.
Allergies that cause systemic symptoms are often triggered by food allergens, while inhalant allergens more commonly cause respiratory symptoms, with systemic symptoms being relatively rare unless the exposure is significant.
In addition to food, the excessive use of additives in modern food could also be a potential cause of allergies.
When standard allergy tests do not identify a trigger, this possibility should be considered.
Therefore, for patients with allergies seeking to identify their triggers, it is important to not only undergo testing and pay attention to ingredients but also to consistently dine at the same establishments and note their seasoning practices, as this can help uncover potential causes and provide clues.
The Allergy, Immunology, and Rheumatology Department of Changhua Hospital, Ministry of Health and Welfare, is here to support you.

Reply Date: 2013/12/29

More Info

Severe allergic reactions after eating out can be alarming and potentially life-threatening. Based on your description, it seems that you experienced a rapid onset of symptoms, including widespread redness, itching, tongue numbness, and respiratory distress shortly after consuming food. These symptoms are indicative of an allergic reaction, and it is crucial to understand the potential causes and management strategies.

Firstly, it is essential to recognize that allergic reactions can be triggered by various food components, including common allergens such as shellfish, nuts, dairy, eggs, and gluten. In your case, you mentioned that you have a known sensitivity to monosodium glutamate (MSG), which is often used as a flavor enhancer in many dishes, especially in Asian cuisine. While MSG is generally recognized as safe for most people, some individuals may experience adverse reactions, including skin rashes and respiratory symptoms. This phenomenon is sometimes referred to as "Chinese Restaurant Syndrome," although it is not universally accepted as a true allergy.

The rapid onset of your symptoms—within 15 minutes of eating—suggests that you may have encountered a food allergen or an ingredient that you are sensitive to, possibly exacerbated by the presence of MSG or other additives. It is also worth considering that cross-contamination in food preparation areas can lead to exposure to allergens that you may not be aware of. For instance, if the same utensils or cooking surfaces are used for allergenic foods and your meal, this could trigger a reaction.

In addition to food allergens, other factors could contribute to your symptoms. Environmental allergens, such as pollen or dust mites, can also provoke respiratory issues, especially if you have a history of asthma or allergic rhinitis. Stress and anxiety related to dining out or the anticipation of potential allergic reactions can further exacerbate your symptoms.

To manage and prevent future allergic reactions, consider the following strategies:
1. Identify Triggers: Keep a detailed food diary to track what you eat and any symptoms that arise. This can help you identify specific foods or ingredients that trigger your reactions.

2. Consult an Allergist: An allergist can perform tests, such as skin prick tests or blood tests, to identify specific food allergies or sensitivities. This information is crucial for avoiding allergens in the future.

3. Communicate with Restaurants: When dining out, inform the restaurant staff about your allergies. Ask about the ingredients used in dishes and how they are prepared to minimize the risk of cross-contamination.

4. Carry Emergency Medication: If you have a history of severe allergic reactions, it is vital to carry an epinephrine auto-injector (EpiPen) and antihistamines. In case of an allergic reaction, prompt administration of these medications can be life-saving.

5. Avoid High-Risk Foods: If you know certain foods trigger your symptoms, it is best to avoid them altogether. This includes being cautious with foods that may contain MSG or other additives that you are sensitive to.

6. Consider Dietary Changes: If you suspect that MSG is a significant trigger for your symptoms, consider preparing meals at home where you can control the ingredients and avoid additives.

7. Follow Up with Healthcare Providers: Regular check-ups with your healthcare provider can help monitor your condition and adjust your management plan as needed.

In conclusion, your symptoms are likely related to an allergic reaction, possibly triggered by food components or additives. Identifying specific triggers, communicating with food establishments, and having a management plan in place are essential steps in preventing future reactions. If your symptoms persist or worsen, seeking immediate medical attention is crucial.

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