FCAAIA Notes: There is still a great deal of debate about the best way to treat eosinophilic esophagitis (EoE). I believe that debate will continue because one size does not fit all.
When an individual food or a limited number of foods are identified as triggers, the avoidance diet might be sufficient. For others, nothing but extreme dietary intervention (few or no solids and an amino acid based formula) is very useful. That is an unpleasant and impractical alternative. Topical esophageal steroids (e.g., steroid inhalers or nebulizer medications that are swallowed, not inhaled) are the first choice of medications for EoE.
So what foods to eliminate when trying? I think there are several reasonable approaches Continue reading “FOOD ELIMINATION DIETS ARE EFFECTIVE FOR LONG-TERM TREATMENT OF ADULTS WITH EOSINOPHILIC OESOPHAGITIS”
FCAAIA Notes: Itch is sometimes but not always from allergy. Histamine released from certain cells in the skin is one cause of itch. In those cases, antihistamines might be useful symptoms relievers. When itch is from allergy, topical or oral steroids might be helpful.
But what about itch from other causes? For instance, molecules released from nerve endings (“neurotransmitters”) can also trigger “neurogenic” itch that will not respond to antihistamines or steroids. In those cases, topical capsaicin might help. Capsaicin is the molecule in chili peppers that gives them their heat. When used on the skin Continue reading “ANTIPRURITIC EFFECT OF PRETREATMENT WITH TOPICAL CAPSAICIN 8% ON HISTAMINE- AND COWHAGE-EVOKED ITCH IN HEALTHY VOLUNTEERS”
FCAAIA Notes: In pediatrics, most medications re dosed by weight. Now, there is an auto-injectable epinephrine dosed for infants and toddlers. However, if you have a baby and have a 0.15 mg auto-injector, I would not discard it. First of all, Continue reading “FDA OKS EPINEPHRINE AUTO-INJECTOR FOR SMALL CHILDREN”
FCAAIA Notes: Here’s another one of those chicken and egg questions. Are children at risk for allergic disease more likely to require antibiotics (for ear infection, for instance) than those without great risk? Or, do the antibiotics increase the risk? Or both
Antibiotics (and other things) change the human microbiome (the bacteria that normally live in and on us). Alterations of the microbiome have been associated with numerous diseases (including allergies and asthma) over the last several years and is a major area of on-going research.
My vote on the chicken/egg question here? “Both.” Continue reading “EARLY‐LIFE ANTIBIOTIC EXPOSURE INCREASES THE RISK OF DEVELOPING ALLERGIC SYMPTOMS LATER IN LIFE: A META‐ANALYSIS”