Hives or Urticaria
From the Book of Skin
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Hives or urticaria are common allergic reactions. They are itchy, elevated, red blotches of varying size that appear suddenly and disappear mysteriously after hours to days. Hives may be associated with dramatic swelling reactions; swelling of the lips, eyes, and ears can suddenly and grotesquely alter the appearance of an allergy victim.
Marked swelling especially of facial tissues is referred to as angioedema and is often associated with urticaria. Swelling of the lips and tongue may occur immediately after eating a food and may be life-threatening because of airway obstruction.
Foods and drugs are the common causes of hives. Some patients get hives occasionally only when they ingest a specific food or food additives. Other get hives as a chronic problem which can go-on for years. Most studies of chronic hives suggest a low % of food allergy causes usually because diet revision attempts were inadequate to reveal the hidden food causes.
Acute Urticaria is Immediate Hypersensitivity
The type I version of urticaria tends to occur in acute discrete attacks and may follow the ingestion of specific foods, over-the counter medications, or prescription drugs. Atopic children with eczema and rhinitis are prone to urticaria from food. Hives are associated with high IgE and occur usually as acute food reactions. Hives also occur as a feature of anaphylactic reactions. The itchy, erythematous welts, typical of acute urticaria can occur in any distribution in the body. Infants may develop facial wheals on contact with food. Adults often have a single bout of hives when they encounter an unusual or seasonal food or take a drug. Hives following a strawberry feed in the summer or after a eating prawns at a sea-food restaurant are typical examples.
Treatment of acute hive attack may requires antihistamine for a few days. An injection of adrenaline can stop the hives in minutes and can be life saving if the hives are associated with swelling, wheezing, and shortness of breath. Drug therapy for UR involves antihistamines both H1 and H2 blockers may reduce the activity. If hive activity is recurrent or becomes chronic then prednisone will produce the most dramatic remission of symptoms, but the urticaria often flare after the dose of prednisone is reduced below a threshold level - in adults usually below 10 mg per day. Complete diet revision should be undertaken to remove food causes if the hives recur frequently or become chronic.
Delayed Hypersensitivity
Chronic urticaria is a different disease, occurring in a continuous or continuously intermittent series of skin eruptions, often associated with other symptoms. Most patients are not aware of the source of the hives. Although most patients' symptoms can be controlled with drug therapy, many suffer from symptoms for years. Numerous factors have been suggested for causing this disease such as allergy to foods, azo dyes, food preservatives, candida in the gut and traces of penicillin in dairy products. Occasional patient may benefit with elimination of single foods, but often, the cause of the disease remains obscure and multiple factors are likely to be involved.
Charlesworth stated (1) " Urticaria and angioedema are frustrating for patients as they go from one physician to another in hope of finding that extraordinary physician who will be able to identify the cause, eliminate the culprit and thus cure their hives. Physicians treating hives are equally frustrated...."
Both patient and physician would be less frustrated if they used the Alpha Nutrition Program - a standardized method of eliminating the culprit and redesigning the diet to avoid hive recurrence.
Chronic urticaria should be classified as a delayed hypersensitivity disease and fits into the type III pattern of food allergy. There is no necessary association with Atopy, IgE, and skin tests are not helpful to locate the culprit (s). Hive may be the most obvious expression of an underlying food allergy (delayed pattern) which causes other symptoms but the connection may not be recognized.
Urticaria associated with CICs occurs with drug reactions and with infections such as hepatitis B. Chronic urticaria may be associated with a perivascular lymphocyte and mononuclear cell infiltrates and sometimes merges with more serious inflammatory skin lesions such as erythema multiforme, urticaria pigmentosa, dermatitis herpetiformis and bullous pemphigoid.
Investigations should be carried out to rule out hidden diseases, although seldom are these investigations helpful - complete blood counts; a stool sample for ova and parasites, liver and kidney function tests can be done if there is concern about underlying disease.. Skin prick test and intradermal skin tests may be positive but have limited utility in predicting which substances cause the hives. Challenge tests with food coloring agents and preservatives may be helpful, but are not definitive and do not replace adequate diet revision. Chronic urticaria may be slow to clear and a selective elimination diet often fails because of reactions to retained foods.
Tolerance to antihistamine therapy may develop in a patient whose symptoms are previously under control. This tolerance cannot be overcome by increasing the dosage or by changing the antihistamine. The cause of tolerance is thought to be due to the down regulation of the H1 receptors. Ketotifen and oral sodium cromoglycate have been used with some success.
The Solution -Alpha Nutrition Program
Complete diet revision is essential to solve the problems of chronic urticaria since many food antigens and food borne chemicals may be involved. There is no reliable test to identify them. Serious hives require serious efforts to fix them.
For Adults, order the Skin Rescue
Pack with the supplemental text
on skin disorders. You will receive the program manual and a 500 Gram bottle of Alpha ENF, try it,
get used to the formula and then decide if and when you are ready for a food holiday. O
For Infants and Children order the Children's Starter Pack
Order Children Rescue Starter Pack