(gluten-free, milk-free, egg-free, wheat-free) Tomato Sauce

Add celery and onions to tomatoes and simmer for 10 minutes. Fold in ketchup, brown sugar, and vinegar. Simmer until vegetables are cooked. (This mixture may be thickened with a gluten-free flour if desired.)

If you are an allergy patient or the parent of an allergic child, the information presented in this chapter should help you understand better some of the more common problems involved in food allergy and cooking for those with food allergies. Before following any of the advice given in this chapter, however, check with your allergy physician to see whether it is appropriate for your particular situation.

Infants and young children may suffer from a red, flat, scaly rash. Itching is intense and can lead to what is known as "weeping" lesions, caused by the oozing of serum from underlying small blood vessels. Typical places for this to happen are the cheeks, the creases behind the ears, and at the bends of the arms and legs. Commonly called eczema or atopic (allergic) dermatitis, the rash can spread enough to become disabling. During the healing stages, the affected skin thickens and becomes dry and cracked; some bleed­ing may also occur. A local infection that takes the form of skin boils is serious and should be considered a threat. Hives Raised bumps, ranging in size from that of small peas to siz­able portions of the body, may appear anywhere on the body. Each lesion may last only a few hours, but new ones can appear at frequent intervals. The itching may become so intense that it is difficult to perform a task or sleep soundly.

Otitis media is an inflammation of the middle ear, frequently seen in young children. It may also be found in children with allergic symptoms and may be complicated by sec­ondary bacterial infections. In children with severe allergies, control of the allergic problem is often associated with improvement of the otitis media. If fluid accumulates behind the tympanic membrane (ear dram), hearing may be affected.

Almost anything that causes narrowing or obstruction of the bron­chial tree may be associated with wheezing and similar symptoms. Foreign matter, trauma, pneumonia, and tumors can produce such narrowing. Some forms of heart disease resemble asthma, and cardiac failure is sometimes diagnosed as wheezing. Blood clots that move from the legs to the lungs, and tumors that produce chemical sub­stances, can also provoke wheezing. Poisoning by insecticides or other cholinergic drugs can induce bronchoconstriction. Certain environ­mental exposures can bring on asthmalike symptoms, while other dis­eases such as Loffler’s syndrome and polyarteritis nodosa sometimes resemble asthma. In some foreign countries, parasitic infestation of the lungs must also be considered a possibility among people appar­ently suffering from asthma. Finally, the upper airway obstruction sometimes found after a tracheotomy can cause wheezing that is au­dible throughout the lungs. The two most common pulmonary problems that are confused with asthma are chronic bronchitis and emphysema. Although the mecha­nisms involved in these diseases appear to differ, the symptoms are remarkably similar. Chronic bronchitis is an inflammation of the bronchial airways resulting in coughing and excessive mucous secre­tion. Bronchospasm may also be a major factor, in which case treat­ment would be similar to that of chronic asthma. Many patients with chronic bronchitis later develop emphysema. A sustained, low level of oxygen in the blood, along with cardiac problems, is more charac­teristic of a patient with chronic bronchitis than of a patient suffering from asthma. Diagnosis of emphysema, another disease commonly confused with asthma, should be applied to a destructive process in the lungs in­volving the air sacs and air ducts. Air sacs that are unaffected often compensate, becoming larger and larger and resulting in a decrease in the blood surface exposed to the gas in extended air sacs. The re­sult of this process is a diminished capacity for the exchange of oxy­gen and carbon dioxide, accompanied by a loss of elasticity in the tissue, so that the patient cannot inflate and empty the lungs spon­taneously. The lungs of an emphysema patient seem to remain in­flated. Because emphysema rarely exists in isolation, asthma is sometimes mistaken for emphysema. In either case, the reversible symptoms are all that can be treated.

Drug allergy is a major cause of illness; it sometimes even results in death. Scientific knowledge of the physical characteristics of drugs known to cause allergic reactions is growing, however. The types of drugs most likely to cause reactions are the large, complex molecules, the small molecules that easily link with carrier proteins after ad­ministration of a drug, and drugs metabolized to molecules, which also link easily to carrier proteins. Reactions are also classified by type of immunologic reaction: anaphylactic, cytotoxic (cell killing), serum sickness, and cell-mediated immune. In addition, there are nonspecific drug reactions, which, so far, are poorly understood. Because of such factors as genetics, infections, the route of ad­ministration, and tissue injury, some people being treated with drugs are at greater risk than others. It is hoped that research in several areas of drug allergy will soon diminish the number of drug reactions. For example, it may be possible to screen for susceptible reactors by administering predictive tests before a drug is prescribed. For many types of drug, skin and laboratory tests designed to define the drags that cause particular reactions must be expanded. To accomplish this, research must de­termine the components and metabolic products that stimulate adverse reactions. Someday, blocking compounds may be available that can thwart an allergic reaction in an individual known to be sensitive to a particular drug.

One research area that has stimulated great interest among parents ш recent years is the effect of food consumed by children on their behavior. Dr. Ben Feingold, for example, maintains that significant amounts of food dyes and preservatives in a child’s diet can con­tribute to hyperactivity and other types of negative behavior. This claim met with great criticism from the medical community, members of which replied that Dr. Feingold’s statements about behavior were sweeping, suggesting that a large proportion of children were being adversely affected; that his observations were not supported by con­trolled trials, but rather seemed to suggest biased reporting; that the diets recommended by Dr. Feingold were restrictive and difficult to follow, raising the possibility that sacrifices in daily life would be greater than the rewards; and that the term allergy had been adopted by followers of the Feingold diet who claimed that children were "allergic" to the dyes and additives, when, in fact, no specific aller­gens had been noted. While Dr. Feingold’s claims continue to require clarification, and while the criticism remains valid, some investigators have documented that additives and preservatives do increase aberrant behavior in a small group of children considered hyperactive. The mechanism by which these additives work is not an immune or an allergic mecha­nism, but a toxic one: large doses of the chemicals in additives and preservatives seem to modify nerve function, and certain dyes have been shown to change the releasing of neurotransmitters from the nerves. Some investigators have reported that the Feingold diet has been effective in a small group of hyperactive children. At the same time, however, research has rejected allergy as the mechanism by which dyes, preservatives, and other chemicals modify behavior. A word of caution is in order. Parents attempting to impose a restrictive diet on their children (or themselves) should be aware of the nutritional deficiencies that can result from the proposed regimen and of the nutritional supplements that should be taken to correct the de­ficiencies. In a diet that goes beyond simply eliminating "junk food," Dr. Feingold advocates omitting dyes and preservatives; certain fruits, vegetables, and spices; and extracts containing salicylates.

A psychosomatic disorder is one in which nonorganic or mental processes influence or directly cause an organic disease.

Allergic pneumonia is an inflammation of the lungs resulting directly from an allergy, usually to some type of or­ganic dust. See also Hypersensitivity Pneumonitis.

Exercise urticaria is a newly described, poten­tially serious development of itchy hives, swelling, and, at times, col­lapse (anaphylactic shock) following such strenuous exercise as jogging. Such patients should carry Adrenalin kits and avoid over­exertion, especially on hot days.