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Question
Hello,
1 My age is 22 y ears old. I am female.
2. Having this problem for aleast 6 or 7 years.
My area around the eyes and the area around

upper lips swells.
3. Everyday.. If i eat the foods, milk and

sugar,then the swelling is visible on my face

everyday
4. Attack is just in a form of swelling on face..
   and if i only consume 1 teaspoon of honey, i

really had to bear a strong pain in my upper part

of stomach..(the same case with banana and eggs)

well, this pain problem is since my childhood.
6.. No symptoms when swelling starts..
7. Swelling depends on the quantity of sugar,

spices and milk I consume. But most probably,

milk, sugar are everyday
consumable foods, so swelling is on my face every

day.. As it makes my skin sensitive..

Milk is my favourite beverage. .My studies are

tough. I skipped milk, sugar but as a result,
i feel weak and not active..
I am so sad.. I cant live without milk..
I just want to consume milk and without these

skin allergies..
Please help.
Waiting for your reply..
Thank yousooooo much

Answer
Please accept my apologies. I thought I had answered your 2nd email, but it was obviously not received. I only got your email of 30 July today 4th August.

To summarise: You have had this problem since before you were 14 years old. Episodes include attacks of upper abdominal pain and swelling of your lips and around the eyes. You do not say if other parts of your body become involved. You are suspicious of milk as a culprit, but also think that banana's and eggs do much the same. You do not say whether you had eczema as a child, nor whether you have ever had other typical features of allergic diseases such as asthma, or nose problems such as nose itching and/or sneezing. The latter would strongly support the tendency to get allergies. So on the face of it, you could well have one or more food allergies.

However, you are from the Punjab. The commonest cause in the world of abdominal pain coming on after food(+/- bloating, swelling of the stomach and quite often diarrhoea) is acquired lactose intolerance. This is a genetic normal variant in which the enzyme Lactase (which splits the milk sugar lactose to make it absorbable) is lost any time after 3 years of age. The presence of this state is 100% in Chinese and about 50% in India as a whole. I am uncertain the extent to which it varies within the many racial groups in India. It occurs in only 5% of Europeans. There are several ways to diagnosis. The simplest of which is a "Lactose tolerance test". In this, the patient drinks 50G of pure lactose and blood glucose (split off from lactose by lactase enzyme) is measured in the blood over the next 2 hours. However the last is not essential if several blood tests are limited by the expense. Most people with the problem get an acute attack with this dose. It does not put your life at risk, as might a true allergic reaction.

People with lactose intolerance can have yoghurt without a problem as lactose is digested in the process. They can usually also tolerate other milk products like cheese for the same reason. Alternatively, Lactase solutions and powders are available commercially to remove the lactose from a proposed meal.

Whether or not you have lactose intolerance, your pattern is suggestive of a true allergic reaction. Nevertheless, the story is a bit confusing. True allergy to simple sugars never occur. It is physically impossible. The allergy is to specific milk proteins and these antibodies cross react with milk from all mammalian species except human. This allergy usually starts in infancy and in the overwhelming number of cases, it is grown out of. Only rarely does it persist to your age. But very rarely it does. The same can be said for egg allergy. There is no safe alternative to these specific allergies except avoidance. Milk is a very important general food source, but most specifically as a source of calcium for growing bones. That is the reason why one must be very critical to prove the diagnosis by objective tests. Any female who is capable of giving birth, who is avoiding milk should have lifelong calcium and vitamin D supplements, both to protect her own bones and to provide calcium for growing baby bones.

The story about banana's and honey is very interesting to me. It does suggest several possibilities. But I think asking the proper questions about the above is essential before doing anything else. In other words take things a step at a time. And most importantly to get your general health and nutritional status normal. Most people going allergen exclusion diets get some degree of malnutrition if they are avoiding more than 1 major food group and such diets have a high risk of causing energy deficiency as well as iron and vitamin deficiencies. Such could well explain your general tiredness etc.

My advice would be to visit your doctor to have routine blood tests to make sure your are not anaemic and that sort of thing. You will probably need supplements of general vitamins, iron, calcium and most of all energy. If an allergy specialist would be able to do skin prick tests for some things if one is available. But be warned such tests are only suggestive and they need expert interpretation. If you do have any done, get back to me to discuss the results. Get tested for airborn allergies of the type most common in your part of the world if possible. For reasons I do not have the time to discuss here, these can be useful in some uncommon types of food allergy.

Get back to me in due course with details of how things progress.

Food Allergies

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David Pearson

Expertise

Any in the field I believe. Only experience of questions that get asked will tell.

Experience

I am a retired medical academic from the UK. I have done major research on Food Allergy and have been a government adviser in the area. 30 years experience running an allergy clinic. And undergraduate and post-graduate teaching.

Organizations
Well, apart from the FRCP, I'm no longer active in the area. I'm too busy writing books. And I no longer have the cash to go to international meetings. But was active in many.

Publications
Will 120 scientific papers help? Chapters in books. Patient advisory materials. Magazine articles. TV appearances. Live and recorded. National and international invited lectures, etc. It was my job for 40 years. Do you think I count!

Education/Credentials
MD, PhD, Postgraduate Diplomas etc. Fellow of the Royal College of Physicians. etc. But I don't want that put out on the net! Just to let you know!

Awards and Honors
irrelevant.

Past/Present Clients
Too many to count, patients of course and a large number of all sorts of corporate consultancies and considerable work as an expert witness in the Courts. I'm volunteering because your Greek expert has been so helpful, I thought I'd offer something back.

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