Food Allergy, Eosinophilic Esophagitis (EoE), Drug Allergy, and Anaphylaxis
Food allergy is a group of various diseases that pose different risk factors for patients. Acute IgE mediated food allergy and food protein enterocolitis (FPIES) can be associated with the risk of acute life-threatening or otherwise severe reaction, eosinophilic esophagitis is linked with the risk of irreversible fibrosis. Many patients with food allergies are generally controlled if they avoid the known food that causes an issue. Delayed or deferred treatment in short to intermediate-term (a few weeks to even a few months) may not change the outcome of these diseases6,7.
Follow up can be delayed or done via telehealth.
Food challenges can largely be delayed except for peanut challenge in infants for peanut introduction due to LEAP protocol or for introducing a food critical for appropriate nutrition to avoid intervention like G tube or NG tube placement.
During Pandemic treatment for Anaphylaxis and FPIEs have also been slightly modified to avoid exposures to COVID-19 in the healthcare setting as those risk and reduced with control of the infection normal. Patients are advised during anaphylaxis episode to self-administer epinephrine and to call 911 only if symptoms do not resolve or worsen after first epinephrine dose; otherwise, they are advised to stay home.17
Similarly, patients are advised to treat FPIEs acute episode at home unless severe dehydration ensue.18
One challenge during pandemic is to find food allergen-free or of a particular brand that patients are accustomed to, therefore referral to nutrition to address the nutritional needs of patients may be warranted.19