Arthritis Case Examples Center
Gerrard, a prominent Canadian allergist, summarized the problems of evaluating food allergy: "... foods can cause not only classical IgE-mediated allergy but also the irritable bowel syndrome, migraine, arthritis, and disturbances of behavior. The identification or confirmation of IgE-mediated allergy is simple, for it correlates well with skin prick tests and antibody test results. The identification of other adverse reactions to foods is more difficult and is sometimes hampered by preconceived ideas both on the part of the patient and the physician. We admitted patients to a hostel unit where they have first been fasted for four days on spring or filtered water, and have then been given single foods one by one so that adverse reactions to them might be recorded by both the patient and the physician. The patients studied had for the most part a combination of symptoms that included nasal stuffiness, headaches, irritable bowel syndrome, arthralgias, eczema, and neurological problems such as depression and lassitude. Thirty-three patients have been investigated so far. In 6, symptoms persisted unchanged, the presenting symptoms being headache in 3, neuralgia in 2, and asthma in 1; symptoms cleared completely in 12 and diminished to 50-90% of previous levels in 15. When foods were reintroduced, the reactions were unexpected, both by the patient and by the attending physician, for neither knew beforehand that foods, let alone which foods, were precipitating symptoms.”
Knicker's advice is worth repeating: "To diagnose adverse reactions to foods, the clinician chiefly needs to be satisfied that the ingestion of a food predictably and repeatedly causes disease. It is not necessary to know the precise triggering mechanism or which mediators of inflammation are activated. Such information is difficult to obtain, often requiring considerable laboratory investigation beyond the scope of clinical practice."
Arthritis, Heartburn, Insomnia
A 48 year old woman developed an acute inflammatory arthritis after years of digestive symptoms and muscle aches. Her wrists and knuckle joints were swollen and painful. Her elbows, shoulders, and knees were also aching but were less severely involved. Anti-inflammatory drugs and wrist splints gave her only a little relief, but she could not sleep at night and was unable to work for the past year. For years she had constant heartburn, abdominal bloating, and constipation. Associated symptoms included nose and sinus congestion, and fatigue. She returned after two weeks of clearing, reporting an "unbelievable" experience; first a severe withdrawal - six days of increased pain, exhaustion, and headache; followed by a "fantastic" improvement in all her symptoms. Her joint pains had cleared, hand swelling had disappeared with return of finger mobility. Her energy had increased dramatically and she was sleeping through the night for the first time in years. Slow, careful food introduction maintained her recovery.
Hives, Migraine, Arthritis, Indigestion
A 64 year old woman presented with the problem of hives (urticaria) of
seven months' duration, associated with generalized swelling and joint
pains. She first developed hives when she was traveling in England. The
eruptions continued on a daily basis when she came home. Increased upper GIT
disturbance, fatigue, and cold symptoms, particularly recurring laryngitis,
were associated with recurrent eruptions of hives. She developed alarming
symptoms with occasional swelling of her lips and face. She was fortunate
not to have breathing problems. Apparently, she saw Dr... who did skin tests
but found no skin test reactions and made no significant recommendations for
therapy other than taking an oral antihistamine which did not help. Hives,
with associated swelling reactions, are best explained as ingested allergy.
Allergens, usually in the food supply, find their way into the circulation
and excite a variety of immune responses. Allergen encounters with
sensitized mast cells in the skin and mucous membranes, for example, can
trigger the swelling and itchy, red eruptions. Aching and joint pain often
accompany hives, since the reaction is internal as well as on the skin
surface, and can be attributed to food allergy. She followed the Alpha
Nutrition Program and within three weeks cleared remarkably; her major
symptoms remitted with no further occurrence of arthritis or hives. She felt
best on Phase 1 and 2 foods.
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