Brief Answer:
Please provide more details

Detailed Answer:
Hello XXXXXXX

Thank you for asking at HCM. I went through your history and got an impression that you have urticaria related to sour foods containing tamarind or kokum.

However, this may or may not be a true allergy, hence I would like to know more about your symptoms as follows:

a. Since how long have been having this problem?

b. What is the frequency of the symptoms? - almost daily/more than once a week/less than twice a month/less than once a month

c.Which parts of the body are involved commonly? Where does it begin?

d. Do you have swelling of lips/tongue/fingers/toes etc (angioedema)?

e. How long do the symptoms last? < 1 hour/1 hr-24 hours/> 24 hours

f. Do the symptoms respond to antihistamines (such as Allegra) immediately?

g. Do you always have symptoms related to tamarind or kokum? or sometimes you consume them and still you don't have itching/symptoms?

h. Have you ever had the symptom even if you have not consumed tamarind or kokum?

i. Do you have any other allergies - running nose, sneezing, etc?

j. Do symptoms increase during a particular season?

k. What is the most common time of onset of symptoms - within 1 hour after lunch/dinner, evening, midnight, early morning, etc?

l. How is your digestion/stomach? Is your appetite normal? Do you have any problems like constipation, diarrhea, flatulence, abdominal pain, acidity, sour risings, etc?

m. Do you live a sedentary life or a physically active life? Do you exercise? Is stress an important factor in your life?

n. Do you perspire a lot or normally? Is your skin dry or oily or normal?

o. Do you have any other medical condition? Do you take any other drugs on frequent/regular basis?

p. Have you been investigated? If yes, please attach reports.

Above details will help you to understand your symptoms better, to come closer to diagnosis, and therefore to make better suggestions.

At present, I can tell you only that you have urticaria and antihistamines like fexofenadine (Allegra) or others are used to control the symptoms. However, they do not correct the underlying cause of the urticaria, but they can be safely used for your symptom control. Please let me know if you have experienced any side effect due to the medicine.

Please provide the details on the follow up and please feel free to ask further queries, if any.

Wish you best of the health ahead.

Thank you & best regards,

Dr Parin N Parmar
Allergist-Immunologist

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Brief Answer:
antihistamine for symptom relief, testing for diagnosis, improve digestion

Detailed Answer:
Hello XXXXXXX

Thank you for providing the details.

When sour foods cause itching and urticaria/angioedema, there are two possibilities: either you have allergy to tamarind and kokum or the "sourness" of tamarind/kokum exceed your digestive capacity.

If the cause is allergy, then avoidance is the only option. If the cause is inability to digest, you can improve your digestion.

Were I treating you, I would think of digestive cause first, because true "allergy" to both tamarind and kokum is uncommon.

Hence, I would make suggestions for my such patient as follows:

1. For relief from symptoms, I would agree with your doctor to take an antihistamine such as fexofenadine (Allegra) or other alternatives. You can take a single tablet when you develop symptoms.

2. Take plenty of liquids during the day, so that itching-causing metabolites can be excreted in urine.

3. Also, take a diet containing good amount of fibers and daily walking for 30-40 minutes to improve digestion and colon movements.

4. I would also prescribe my such patient a good probiotic daily for 2-3 months to help improving digestion.

5. I would suggest my such patient following tests:

a. Specific IgE to tamarind
b. Specific IgE to kokum (if available)
c. Serum Vitamin D

The tests a and b will help to confirm or rule out allergy to tamarind and kokum respectively. If you don't have true allergy, there is a chance that you can consume them after improving your digestion.

If serum vitamin D is low, I would supplement my patient with vitamin D. It helps to improve both immunity and digestion.

6. After confirmation of diagnosis (after results of the above mentioned tests), I will prescribe my such patient a good multivitamin-multimineral supplement to improve metabolism.

Hope above suggestions will be helpful to you.

Should you have any further query, please feel free to ask on follow-up.

Wish you best of the health ahead.

Best regards,

Dr Parin N Parmar
Allergist-Immunologist

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