elimination diet/food trial questions

Katie - posted on 05/25/2010 ( 5 moms have responded )

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My son was diagnosed with eosinophilic esophagitis last year, had a gtube placed 6 months ago and is on a formula only diet. We just got the OK to start doing food trials a few months ago: chicken, rice and apple. He has only eaten a few bites of chicken twice, a handful of rice chex once or twice and some apple slices and apple juice over the past few months. He started doing this thing where he clears his throat really really loudly like it is irritating him. I also have to constantly remind him to drink water to keep his throat from getting dry. I called his doctor and she thinks it is just a dry throat causing the throat clearing.

The doc said we could add fruits and veggies in one by one if he didn't react to the initial three foods so I figured potatoes would be a good choice since i could bake some french fries for my son. He has eaten 4-5 fries twice over the past two weeks. And he is still doing the throat clearing thing.

Tonight he ate two fries around 6pm. I heard him in his room about 30 minutes ago coughing and choking. I ran in to find him sitting up in bed crying, looking like he might throw up. I got him to drink some water and he laid back down. But for the past 20 minutes he has been clearing his throat.

I'm unsure if it was a reaction to the potato or just a dry throat. He doesn't have another endoscopy/biopsy until the end of next month.

I know that sometimes it takes a few exposures from a food before a reaction can occur, but i'm not sure that is what is happening.

So i guess my overall question is how long after eating an allergenic food can a person have a reaction? Has anyone else gone through food trials, and how did you know your child was having a reaction to a specific food?

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Melanie - posted on 07/11/2010

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A reaction to food can be pi-phasic (happens actually at two different times)- once when the food is ingested or shortly there after (after being taken into the mouth) and then within a few hours after the food is being digested. My son had an allergic reaction to a sip of milk and began coughing, had hives, clearing his throat, and itching within a few minutes of having the milk in his mouth. We took him to get medical treatment and his reaction got worse until he got medicine. We also saw vomiting, more coughing, and the hives worsened. After the meds, he improved, but they kept him for a few more hours to make sure his reaction was under control given that there can be 2 responses (an immediate and a delayed response). Fortunately we didn't have the delayed response because the meds helped. I have not done food trials, but I would be nervous about the coughing. Does he do formula orally? What does he do orally (besides the water)? Just the few foods that you noted? I am wondering if he is just having a hard time with taking things orally- not an allergic reaction, but with the proper swallowing of things. I think I would ask for a skin prick test to common foods to see- try some of the ones you have tried and see if the reactions you were seeing were allergic or just coughing spells related to the espohagitis or dry throat. Maybe that will give you some answers. Good luck and I hope things get easier- I will be thinking of you! Let us know how he is doing! :)

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Melanie - posted on 08/02/2010

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Katie, I was just thinking about you and wondering how everything turned out. You are such a trooper- because you never give up! Keep up the great work and being so diligent! Your son is blessed to have you as his mom. I will keep sending good thoughts your way and hope that results were better than expected!

Katie - posted on 07/11/2010

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thank you so much Melanie. he does have severe reflux that he is taking omeprazole for. and most of his reactions are delayed. the only ones that have been immediate are peanuts and onions. we do scratch/patch testing on wednesday. and we've had a swallow study done already to make sure everything is working properly and it is. he just had another endoscopy done and his eosinophil count is elevated so that means he was reacting to the foods we gave him. but they also found red spots in his stomach that they biopsied and we'll find out the results of those this week.
trial and error is so hard, for so many reasons. incredibly frustrating. but hopefully after the allergy tests we should know more. we stopped all food after a really bad coughing attack that happend while i was cooking some onions and the coughing at night has stopped.
thanks again!!!

Melanie - posted on 07/11/2010

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I was just re-reading your post and I am wondering if he just had some reflux issues after going to bed. I had severe reflux years ago and bed time was the worst- whatever i had eaten would come back to haunt me in the form of severe heartburn that would make me cough and my ears burn. Could that be what he is having? Just another idea to think about. Does he sleep on an incline to help keep acid in his tummy and not in his throat? I had to for a while and with a bland diet for a few months (and some reflux meds), I was able to get back to other foods I had eaten before. Just food for thought. :)

Cheryl - posted on 06/07/2010

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Well my daughter is very allergic to nuts all of them and soy i dont not let her go near the nuts she goes to an allergy specialist so we have to carry the epipen where ever we go

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