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Wann man sich über eine allergische Reaktion Sorgen machen sollte

Allergies are complicated. They happen when your immune system, which usually helps your body fight off infection and other intruders, over-reacts. They're also very common - affecting around one quarter of people in the UK at some point. About half of people with allergies are children but you can develop an allergy at any age. While many are mild - an itchy nose from mild hay fever is one of the commonest - others can be life-threatening. So how do you know the difference?

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What causes anaphylaxis?

The most severe kind of allergic reaction is Anaphylaxie. Up to half a million people in the UK have had an anaphylactic reaction to bee or wasp stings; and nearly half as many again have an anaphylactic allergy to nuts. To make matters worse, if you've had a severe allergic reaction to one thing, you're at higher risk of developing the same symptoms after being exposed to something else.

Anything that causes an allergic reaction is called an allergen. The most common allergens that cause anaphylactic reactions in children are foods, whereas in adults it's more likely to be medicine. The most common culprits for anaphylaxis are venom from insect stings; food - especially peanuts, some other nuts, sesame seeds, shellfish, eggs, milk and certain fruits; latex; and medicines, including Penicillin and strong painkillers or aspirin.

Der symptoms of anaphylaxis come on very quickly after you've been exposed to whatever you're allergic to. The symptoms include:

  • Wheezing and hoarseness as your airways swell and narrow.

  • Swelling of your lips, tongue and throat.

  • An itchy rash like a nettle rash.

  • Feeling faint or dizzy.

  • Ein Gefühl drohenden Unheils.

  • Herzklopfen.

  • Atemnot.

  • Feeling or being sick, diarrhoea and tummy pain.

In severe cases anaphylaxis can lead to confusion, collapse, loss of consciousness and can even be fatal.

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If you ever have an anaphylactic reaction to something, you must be referred to an allergy clinic to find out what caused it. You must avoid coming into contact with the slightest trace for ever and must carry an adrenaline auto-injector pen which you use at the first sign of another similar reaction. The team at the clinic can explain what to look out for and what to do.

If you've ever had a very severe allergic reaction, your medical team will probably advise you to wear an allergy bracelet or necklace in case you collapse. By the time help arrives, there's a chance you may be unconscious or unable to explain the issue - an allergy alert will do this for you.

If you have a food allergy, you'll need to get into the habit of reading food labels carefully and always advising restaurants of anything you're allergic to. The medical charity Allergy UK provides useful allergy alerts for food products which have been recalled because they were found to contain potential allergens not included in the list of ingredients. You can also sign up with them to receive email alerts about food products.

Your immune system usually helps you fight off invaders, such as viruses or bacteria. It does this through a complex system of cells and chemicals which communicate with each other. Antibodies are produced by your immune system - the antibodies involved in many allergic reactions - hay fever, some types of asthma, most cases of anaphylaxis - are called immunoglobulin E (IgE) antibodies. These recognise a very specific invader and trigger your body to respond to it. Once the body has been primed to recognise that allergen, it produces large quantities of tailored IgE antibodies.


That means that next time you're exposed to the allergen, you may get an allergic reaction within minutes. How severe that reaction is depends on how much the immune system is primed, and in some cases how much allergen you're exposed to. In severe allergy, a miniscule amount of allergen - for instance, dust from Erdnüsse carried in the air in an aircraft when someone opens a packet of peanuts - can cause anaphylaxis. Some allergic reactions are called 'non-IgE' reactions - most children who have Kuhmilchallergie have the non-IgE form. This also triggers your body to attack the allergen, but the reaction is often delayed for several hours.

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One of the main responses of your body to being exposed to an allergen is to release a chemical called histamine. In Heuschnupfen, for instance, this is released just in your nose and eyes, when you come into contact with pollen. As part of its attempts to get rid of the allergen, it triggers inflammation, sneezing and itching. In other allergies, it's released into the bloodstream and can lead to more widespread reaction like an itchy rash.

That's why Antihistaminika - in tablet or spray form - are so widely used to treat allergy symptoms. If you get mild allergic reactions, keeping antihistamines to hand may prevent or solve the problem. But avoiding the trigger is even more effective.

As if teasing out the different types of allergic reaction wasn't hard enough, there's also huge confusion between allergy and side effects. For instance, some Antibiotika - such as erythromycin - can make you feel very sick if you take them on an empty stomach. Many people find the Typ-2-Diabetes medicine Metformin makes them feel sick or have diarrhoea, especially if taken before food: that's not an allergy -it's your stomach, not your immune system, reacting.

The difference is very important. You can often reduce drug side effects - for instance, by changing the time you take them or taking them with food - and can often continue taking your medication. If you have a severe allergic reaction to a medicine, by contrast, you must avoid it completely for ever.

There are also important differences between intolerance and allergy. Lots of people are intolerant to food - milk, wheat, high fibre foods. Nahrungsmittelunverträglichkeit mostly causes gut symptoms - bloating, wind, feeling sick or tummy pain. It's never life-threatening and you can often tolerate a small amount of that food without getting any symptoms. For instance, if you have mild lactose intolerance you may feel fine after a cup of tea with milk but vomit after a whole glass of milk.

There are lots of local allergic reactions - I have a mild allergy to wool, meaning my skin itches and my eyes start to stream if I wear anything containing it.

Local allergic dermatitis - skin inflammation - is commonly caused by nickel, especially in jewellery and belts - you develop a sore, itchy, painful rash after the slightest contact with it.

Heuschnupfen, which affects about one in five people in the UK, is due to an allergy to pollen. The medical name is 'allergic rhinitis' because it mostly affects the nose, leading to itching, sneezing and blocked or runny nose. However, it can also lead to irritation and itching in your eyes and throat when they come into contact with pollen.

Perennial or persistent rhinitis leads to similar symptoms to hay fever, but it's most often due to allergy to house dust mites. That means people with persistent rhinitis can get symptoms all year round. If allergy is to blame, treatments are similar to those for hay fever.

Mit Dank an das Magazin 'My Weekly', in dem dieser Artikel ursprünglich veröffentlicht wurde.

Häufig gestellte Fragen

If I've had a severe allergic reaction to one allergen, does that mean I'll react to many other things too?

If you've experienced a severe allergic reaction to one substance, you are at a higher risk of developing similar symptoms if exposed to something else. It doesn't necessarily mean you'll react to everything, but it highlights a predisposition to severe reactions.

Can I have anaphylaxis without developing a skin rash?

Yes, anaphylaxis symptoms are varied and can include wheezing, swelling, feeling faint or dizzy, heart palpitations, shortness of breath, stomach issues, and a sense of impending doom. While an itchy nettle-like rash can occur, it's not the only symptom and you can experience other severe reactions without it.

What is the role of an allergy clinic after an anaphylactic reaction?

After an anaphylactic reaction, you must be referred to an allergy clinic to identify the exact cause. The clinic team will also provide guidance on how to avoid the allergen, explain what symptoms to look out for, and advise on what to do in case of another reaction, including the use of an adrenaline auto-injector pen.

If someone opens a packet of peanuts on an aircraft, can the dust really cause anaphylaxis?

Yes, in severe cases of allergy, even a minuscule amount of an allergen can trigger anaphylaxis. This includes dust from peanuts carried in the air, for example, on an aircraft when someone opens a packet.

Does taking antihistamines prevent or treat anaphylactic reactions?

Antihistamines are useful for mild allergic reactions, helping to prevent or resolve symptoms like itching and sneezing. However, for severe reactions like anaphylaxis, avoiding the trigger completely is more effective, and an adrenaline auto-injector pen is essential for treatment. Antihistamines alone are not sufficient for anaphylaxis.

If I have food intolerance, do I need to carry an adrenaline auto-injector pen?

No, food intolerance differs significantly from food allergy. Food intolerance typically causes gut symptoms like bloating, wind, or tummy pain and is never life-threatening. Therefore, an adrenaline auto-injector pen is not needed for food intolerance, as it is only necessary for severe allergic reactions like anaphylaxis.

What is the difference between hay fever and perennial rhinitis?

Hay fever, also known as allergic rhinitis, is typically caused by an allergy to pollen and mainly affects the nose, eyes, and throat with symptoms like itching, sneezing, and a blocked or runny nose. Perennial rhinitis presents with similar symptoms but is most often caused by an allergy to house dust mites, meaning symptoms can occur all year round.

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Dr. Sarah Jarvis

SEO-Manager

MA (Cantab), BM, BCh (Oxon), DRCOG, FRCGP, MBE

After training in medicine at Cambridge and Oxford, Dr Sarah Jarvis MBE became a GP.

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Dr Krishna Vakharia, MRCGP

Chief Medical Officer for Health, Optum UK

MBChB, MRCGP(2013), BMedSci (hons), DFSRH, DRCOG, PGDipDerm (Distn)

Dr. Krishna Vakharia ist eine NHS-Hausärztin. Sie ist auch regelmäßige Prüferin für das postgraduale Diplom in Praktischer Dermatologie an der Cardiff University und zudem Chief Medical Officer für Gesundheit bei Optum UK.

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