For 15 million Americans with food allergies, strict avoidance of their allergen is the key to staying safe and avoiding an allergic reaction. Accidental exposures happen, however, so it’s critically important to be prepared for food allergy reactions, which are unpredictable.

A range of reactions

An individual with a food allergy can have a history of experiencing only mild reactions, and then suffer anaphylaxis, a serious and potentially life-threatening reaction, without warning. Because symptoms of anaphylaxis can progress quickly, reactions must be treated right away.

Symptoms of a food allergy reaction can affect different parts of the body. They can be mild (itchy nose or a few hives) or severe (trouble breathing, repetitive vomiting).

“It is generally advised that if you have any doubt about whether to use epinephrine, you should go ahead and use it.”

An answer

Epinephrine, which helps reverse the symptoms of a severe reaction, is the only treatment for anaphylaxis. Antihistamines may be used to relieve mild allergy symptoms, such as a few hives, but they cannot control anaphylaxis and should never be given as a substitute for epinephrine.

Mild symptoms can quickly turn into a life-threatening reaction. When a reaction warrants administration of epinephrine, it also warrants a trip to the emergency room to be observed in case symptoms persist or return.

Individuals with a diagnosed food allergy (or other severe allergy such as insect stings) should work with their allergist to fill out an individualized emergency care plan. During a visit with the allergist, patients should discuss what to do in case of an allergic reaction, specifically outlining the steps that should be taken when anaphylaxis occurs. It’s important to have a written plan in place that outlines symptoms and treatment instructions and provides emergency contact information.

Using epinephrine

Epinephrine is proven to be safe and effective. It is generally advised that if you have any doubt about whether to use epinephrine, you should go ahead and use it. If there is a history of anaphylaxis, an allergist may advise that epinephrine be administered even if there are no symptoms, but it is known that the food allergen was eaten.

It’s also important to note that this lifesaving drug should be given first, followed by a call to 911. Dispatchers should be informed that an allergic reaction is suspected, and an ambulance with epinephrine should be requested.