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Suggest Treatment For Swollen Lips, Diarrhea, Abdominal Pain And Food Poisoning

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Posted on Tue, 16 Aug 2016
Question: My 4 years old son used to get cold(rhinitis) for past 2.5 years for 10 times an year for 7-8 days. For past 1 year he is also getting cough followed by cold. He would get 20-25 days of cough and cold every 3 months.

His pediatrician suggested comprehensive allergy test. Allergen - Phidiatop Infant Serum test. This test says that any value above 0.1 kUA/L for a material means there is some amount of allergy.

My son has tested positive for wheat with 0.88 kUA/L and milk with 0.46 kUA/L.

I have following questions:

1. My son has been eating wheat and milk since past 3 years which is 70% of his daily diet. 100 days a year he will get cough and cold. Remaining 265 days he is fine mashallah despite eating wheat and milk everyday. So, what is the accuracy and reliability of this test? My son also won't get other symptoms associated with food allergy such as swollen lips or vomitting.

2. Is 0.88 kUA/L and 0.46 kUA/L value large enough to stop wheat and milk completely? I think it is is a low value, but not sure. Or should we reduce it by 30% or so?

3. How this allergy will go away in future? Will this reduce with age or something else needs to be done?

Thanks for your advice in advance.
doctor
Answered by Dr. Drkaushal85 (37 minutes later)
Brief Answer:
Allergies do reduce with age in 50% of children.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
Honestly speaking, food allergy tests are not that accurate. Exact percentage of reliability and accuracy are not possible but roughly they are in 30-40% range which is very low.
I don't think you should stop or reduce wheat and milk as he is asymptomatic on remaining 265 days despite of taking milk and wheat.
And food allergy often cause swollen lips, diarrhea, abdominal pain etc. All these are absent in his case. So I don't think he is having food allergy.
Rhinitis and cough are more suggestive of dust, pollen, chemicals allergy. Has he tested for these?
And allergies do regress after the age of 15 years. But it is not 100%. Only 40-50% children (with allergy) show improvement after the age of 15 years. It is very difficult to predict which child will improve and which won't.
Please let me know if he is taking any medicines.
I will be happy to help you further. Wishing good health to your son. Thanks.

Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Drkaushal85 (23 minutes later)
Thanks for quick advice. Yes he is tested for following in Dust panel: House dust XXXXXXX dermatophagoides pternyssinus, dermatophagoides farinae and cockroach. All values for this are negative and below 0.05 kUA/L. He is also tested for outdoor panel with English plantain and cultivated rye and tests are negative. for mold panel, aspergillus fumigatus and candid albicans are tested and is negative. in animal panel, dog dander, rabbitepith and cat dander were tested and results are negative. Should we test for something else too?
doctor
Answered by Dr. Drkaushal85 (20 minutes later)
Brief Answer:
Has he tested for eosinophil count and serum IgE levels?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
So detailed allergy testing is done in his case.
Has he ever undergone eosinophil count and serum IgE levels?
If yes then please let me know the values.
I will be happy to help you further. Wishing good health to your son. Thanks.
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Drkaushal85 (30 minutes later)
No. There is nothing on eisonophil count and serum IgE is report. Please find the report attached.
doctor
Answered by Dr. Drkaushal85 (9 minutes later)
Brief Answer:
Is he taking any medicines?

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
I can have gone through the reports you have attached. No need to worry much for these reports.
I have asked about medicines in first answer.
Is he taking any medicines?
Please reply me answer of above asked question, so that I can guide you better. I will be happy to help you further. Wishing good health to your son. Thanks.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Drkaushal85 (2 hours later)
Hi, When he had cough n cold in March, pediatrician had prescribed Budecort inhaler 100 mcg two shots twice a day for a month and then gradually reducing over next month. She had also prescribed Duolin for 10 days and Relent syp 2.5 ml twice a day for 10 days. Additionally Montair 4 tab was given for 1 month at night time. My son got well in 10 days on this medication and had been well since April 1st week till XXXXXXX last week.

Since XXXXXXX last week his cough and cold is recurring in 5-6 days. Doctor has again prescribed Budecort inhaler for 1 month and then gradually reducing. We had given Duolin for 15 days and then stopped it on Jul 16th. Allegra 5ml twice was also given for 7 days in between. He was well from Jul 16th till Jul 23rd evening, after which he is again having cough.

Current medication: Budecort inhaler going on for last 1 month. Relent 2.5 ml twice since last 3 days. Delpomont syrup 5 ml at night for past 13 days. That's all. Should we ask doctor to provide additional syrup such as any sulbutamol or Tuspel LS? He was complaining about slight throat pain once in a while, but there is no fever. Couple of days ago his doctor had said that there is no chest congestion. He is getting cough because of runny nose.
doctor
Answered by Dr. Drkaushal85 (1 hour later)
Brief Answer:
Intranasal spray containing fluticasone will be more helpful.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
In my opinion, you should give 6-8 months of regular treatment.
And for runny nose better to give intranasal spray containing fluticasone. It is the treatment of choice for allergic rhinitis.
Has he ever taken this?
You should also get done PFT (pulmonary function test) to rule out asthma in him.
Has doctor talked about this test?
And it is better to give drugs for longer time, 6-8 months because he is symptomatic after stoppage of drugs.
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wishing good health to your son. Thanks.

Above answer was peer-reviewed by : Dr. Priyanka G Raj
doctor
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Follow up: Dr. Drkaushal85 (32 hours later)
Thanks for the advice doctor. He has never been given fluticasone, but 5 months ago he was given momeflo spray (mometasone) for 10 days, which I think is similar category of steroid for rhinitis.

Yesterday evening, we visited his pediatrician. She said that his chest is 100% clear, and throat is also not infected. She says and I also believe that my son gets cough because of running nose. First he gets allergic rhinitis, after 3-4 days of cold he gets heavily runny nose and then cough follows. Most of the times, touchwood mashallah, his chest is clear when he has cough. So, it is basically because of mucus from nasal cavity dripping in throat which causes irritation. His pediatrician has again given Momeflo spray and Allegra 30 mg syrup. And Mashallah his cough is 50-60% better as runny nose has reduced a lot.

His pediatrician had tested him for Chest X-ray and Tb skin test 6 months ago and Alhamdulillah results were negative. Asthma management is one of her two specialties and she thinks that my son doesn't have asthma. It's all primarily rhinitis. So, she has not suggested PFT.

Thanks for your advice and really appreciate your suggestions and information you provided.
doctor
Answered by Dr. Drkaushal85 (48 minutes later)
Brief Answer:
Thanks for your kind words.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, now I also don't think that he is having asthma.
Possibility of allergic rhinitis is more.
And yes, momeflo (mometasone) and fluticasone are from group of drugs.
So he can take momeflo. No harm in it.
Thanks for your kind words.
I am truly obliged by your words.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar.
Wishing good health to your son. Thanks.
Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Drkaushal85

Pulmonologist

Practicing since :2008

Answered : 15005 Questions

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Suggest Treatment For Swollen Lips, Diarrhea, Abdominal Pain And Food Poisoning

Brief Answer: Allergies do reduce with age in 50% of children. Detailed Answer: Thanks for your question on Healthcare Magic. I can understand your concern. Honestly speaking, food allergy tests are not that accurate. Exact percentage of reliability and accuracy are not possible but roughly they are in 30-40% range which is very low. I don't think you should stop or reduce wheat and milk as he is asymptomatic on remaining 265 days despite of taking milk and wheat. And food allergy often cause swollen lips, diarrhea, abdominal pain etc. All these are absent in his case. So I don't think he is having food allergy. Rhinitis and cough are more suggestive of dust, pollen, chemicals allergy. Has he tested for these? And allergies do regress after the age of 15 years. But it is not 100%. Only 40-50% children (with allergy) show improvement after the age of 15 years. It is very difficult to predict which child will improve and which won't. Please let me know if he is taking any medicines. I will be happy to help you further. Wishing good health to your son. Thanks.