Food Allergy Desensitization Questions and Answers
Do you or your child have food allergies? Dr. Vasif C. Kalfa, MD at Allergy and Asthma Clinic of Maryland provides oral immunotherapy for food allergies to help you overcome food sensitivities. For more information, please call us or book an appointment online. We serve patients from Silver Spring MD, Ammendale MD, Takoma Park MD, College Park MD, Langley Park MD, and Rockville MD.
An estimated 15 million people suffer from food allergies in the US. Food allergies come in many different forms, from peanuts and shellfish to sesame and gluten. Allergies occur when the body reacts to a seemingly harmless substance and the immune system is activated. While most allergies are not serious, some can be life-threatening.
What is oral immunotherapy for food allergies?
Oral immunotherapy (OIT) is a form of desensitization designed to treat food allergies. It consists of daily ingestion of the food allergen in question, which is precisely measured, following a schedule starting with minimal doses (below the threshold reactive dose of each patient) and progressing to doses equaling normal food portions. The patient can continue to ingest the food on a regular basis in order to maintain protection once these maintenance doses are achieved.
The three potential benefits of oral immunotherapy are:
- Protecting against reactions in case of accidental exposure to the food in question
- The ability to reintroduce the food into the normal diet
- Definitive resolution of the allergy (sustained tolerance)
The rates of success for the first two objectives are approximately 80% in studies, and can exceed 90% in private clinics, possibly because of an increased flexibility of existing protocols. The achievement of these objectives is associated with a major improvement in the reduced quality of life associated with food allergy, notable with regard to the emotional impact, hypervigilance, social limitations, and anxiety related to eating.
Sustained tolerance (the 3rd objective), which is defined as the persistence of tolerance to the food after a prolonged interruption of daily maintenance doses, may follow after 4-5 years of treatment in about half of patients treated for peanuts and eggs. This rate can be significantly higher in younger children (12 to 48 months) who are allergic to peanuts.
Because it is associated with certain risks of reaction when taking the doses, OIT must be performed under strict medical supervision. According to studies, between 50 and 95% of patients report allergic symptoms when taking doses of the food, although predominantly minor (oral itching, gastric upset) and easily controlled with antihistamines in 95% of cases. Between 2 and 5% of patients will need to administer an epinephrine auto-injector while undergoing treatment, generally because of asthma symptoms. Finally, 2.7% of patients can develop an inflammation of the esophagus with this treatment (eosinophilic esophagitis). However, this inflammation is temporary and has disappeared when stopping the doses in all cases reported to date.
How effective is oral immunotherapy?
Oral immunotherapy (OIT) has proven to be an effective treatment for the majority of patients with a success rate of 60 to 80 percent of studied patients when treated for allergies caused by eggs, milk and peanuts.
Are there side effects of OIT?
While oral immunotherapy is a safe and effective treatment, there are some side effects involved, such as cramping, abdominal pain and vomiting. Typically, side effects involve the gastrointestinal tract as the immunotherapy is taken orally.
If you or someone you know has one or more allergies, come to Allergy & Asthma of Maryland today! Our specialized team of allergists can help you have a better quality of life by eliminating your food allergies! To get in touch with an expert, contact our office today. To schedule an appointment with one of our specialists, call us or visit us online!