ALLERGY FOR ALCOHOL: HOW TO MANAGE AND HOW TO TREAT.
Sensitization (increased sensitivity of the body) can be on various substances and compounds. Allergies to alcohol also belong to the category of such disorders. Moreover, hypersensitivity may develop not just on some kind of alcoholic drink, but on its individual components. Symptoms of such an allergy are similar to signs of other types of allergic reactions. Diagnosis is sometimes difficult due to a number of nuances that will be indicated in this article, as well as due to the fact that patients may hide the fact that they drink alcohol – but special tests will help establish an accurate diagnosis. The principles of treatment – as with other types of allergies.
1.REASONS AND DEVELOPMENT OF PATHOLOGY
The causes of the described pathology depend on the type of allergic reaction that developed with the entry of alcohol into the body. Such reactions can be:
- true – appear less frequently;
- pseudo-reactions (false) – occur more often (according to some reports, in 80-95% of all patients with an identified allergy to alcohol).
With the development of a true allergic reaction, the body reacts to protein components that are:
- used in the production of alcoholic beverages;
- formed as intermediate components or final components of alcoholic beverages.
A very small amount (residue) of intermediate components of alcohol production is enough to provoke an allergic reaction in humans when they take an alcoholic drink.
Such components remain when:
- violation of the technological process due to its misunderstanding;
- the use of cheap (and therefore, often of poor quality) raw materials;
- the production of alcoholic beverages on clandestine lines or in general at home artisanal conditions, due to which the technological process is disrupted, the quality of the final product suffers.
In the latter case, moonshine (home-made vodka), which contains a large number of fusel oils, can cause, among other negative consequences (irritation of the stomach and intestines, damage to the pancreas), an allergic reaction. Often such consequences are summarized, but since the allergy is in some cases unexpressed, its manifestations may not be noticed, in a hurry to stop the signs of acute alcohol intoxication.
A true allergic reaction when taking alcohol occurs less frequently than pseudo-allergy. She, in turn, can develop as a reaction:
- immediate type;
- slow type.
Immediate hypersensitivity occurs when antibodies are activated, structures whose function is to neutralize antigens (foreign proteins). Such a reaction develops literally a few minutes or hours after drinking. The main tissue and cellular changes in this case are:
- increasing the permeability of their walls for large molecules;
- exudation – the accumulation of fluid in the tissues, which leads to their swelling.
In the late stage of immediate hypersensitivity, cells of the immune system are activated – eosinophils and neutrophils, therefore, the presence of this stage can be determined by laboratory analysis.
Slow-type hypersensitivity develops due to the interaction of a foreign protein-antigen (it is an allergen in this case) with macrophages (“devourer” cells) and some types of lymphocytes (they are also part of the immune system). An allergic reaction of a hypersensitive type develops, as a rule, after 24-72 hours from the moment the allergen (alcohol) enters the body. The main tissue and cellular disorders that are observed are:
- densification of tissues due to the fact that they are infiltrated (“saturated”) by immune cells, like a cream cake;
- inflammatory process in the tissue, manifested by such classic signs as redness, swelling, increased local temperature, pain, impaired function. Inflammation is also caused by tissue infiltration with T-lymphocytes and macrophages.
Two other known varieties of allergic reactions (anaphylactic and cytotoxic) do not occur with alcohol allergies.
What specific components cause a true allergic reaction to alcohol? These are protein inclusions of plant origin:
- hazelnut and others.
As a rule, when a true allergic reaction to alcohol occurs, class E immunoglobulins (IgE) are involved, less often – class G.
The reaction of the pseudotype with an allergy to alcoholic beverages manifests itself more often than true. It is launched in response to additional substances that are used in the manufacture of alcoholic beverages:
- flavors that mimic the smell of any additives (they are often abused in the production of cheap alcoholic beverages);
- odor enhancers;
In 80-85% of all cases, pseudo-type allergy provocateurs are additives used in the production of alcoholic beverages to give them an original taste.
In the reaction of the pseudotype, antibodies do not attack antigens, and the mechanism of inflammatory damage is immediately triggered. But it is noted that some true allergens can also provoke a pseudo-allergy to alcohol – in total there is an increased allergic effect, a person who has not previously complained about allergic manifestations can suffer quite the same. One of the most powerful tissue allergy provocateurs is histamine.
As a rule, it is found in alcoholic beverages such as:
- beer-based punch;
- fermented wine (in particular, its red varieties); cocktails based on red wine.
Often, allergens that are found in an alcoholic product, in themselves, provoke the development of a not very strong reaction. But in a drink may be present substances that cause an increased release of histamine into the blood, thereby enhancing the allergic reaction. They are called histaminolibrators.
The strongest of them are:
In addition, such provocative products are found in food that a person can take after taking a portion of alcohol (bite it).
- chicken protein (eggs, meat);
- products from wheat flour;
- citrus fruits;
- crayfish, shellfish, shrimp and other seafood and so on.
Such nuances should be considered when studying the causes and development of the mechanism of allergy to the same type of alcoholic drink in different people. Other factors that contribute to the development of alcohol allergy are also highlighted.
- regular alcohol abuse;
- Immunity violation – immunodeficiencies congenital and acquired;
- autoimmune diseases – pathologies in which the body perceives its own tissues as a foreign agent and fights them;
- infectious diseases – they require the participation of the immune system and provoke its physiological “aggression”, which may affect the formation of an allergic response when drinking an alcoholic drink;
- chronic diseases of the gastrointestinal tract.
In the latter case, it is:
- gastritis – an inflammatory lesion of the gastric mucosa, against which true and pseudo-antigens more easily penetrate the wall of the stomach, and then into the bloodstream;
- An ulcer of the stomach and duodenum – the appearance of a deep defect in their wall. The principle of involvement in the described disease is the same;
- pancreatitis is an inflammatory process in the tissues of the pancreas. Against this background, the synthesis of pancreatic enzymes suffers, due to which the mechanisms of absorption of food products that are able to act as histaminolibrators “break down”;
- cholecystitis is an inflammatory lesion of the mucous membrane of the gallbladder with subsequent violation of the secretion of bile. The mechanism is the same as with pancreatitis;
- inflammatory lesion of the bile ducts. The mechanism is the same.
In addition, an allergic reaction to alcohol can form due to the use of some components in its production – these are:
- certain sulfur compounds – used to inhibit the processes caused by bacterial
- microflora (souring, fermentation);
- elements of aspirin;
- sulfites – produced as a result of fermentation of wines, used to ensure the safety of bottled alcoholic beverages.
2.SYMPTOMS OF ALLERGY ON ALCOHOL
The manifestations of an allergy to alcohol can be very different – while the clinical picture depends on factors such as:
- the component that caused the allergic reaction;
- its amount ingested;
- features of the reaction of a particular organism;
- the presence of histaminoliberators;
- age of the patient;
- the presence of other types of allergic reactions;
- various concomitant diseases and pathological conditions of varying severity – especially from the immune system.
The clinical picture, which manifests the described pathology, with all its diversity, is almost the same with true and false allergies.
Manifestations of an allergy to alcohol are:
- respiratory (respiratory);
- anaphylactic (general).
Most often, an allergy to alcohol is manifested by skin symptoms.
Signs of the described pathology are:
As a rule, the rash is similar to the one that occurs with urticaria – these are vesicles with the following characteristics:
- by localization – in different parts of the skin, but most often on the skin of the face and upper half of the chest;
- in size – small, the size of a millet seed;
- by quantity – multiple;
- by the nature of the mutual arrangement – they can form groups, and with a large number of merge;
- in color – pale pink;
- in shape – flat.
Pseudo-allergy to alcohol is manifested by a richer clinical picture:
- rashes are more extensive and extend to the skin of the face, body, arms and legs;
- The “spectrum” of primary elements is wider – in addition to an eruption, as with hives, papules (plaques slightly elevated above the skin surface), erythema (red spots), macula (skin areas with discolored coloration), pinpoint hemorrhages, large blisters are detected.
Respiratory symptoms in an allergy to alcohol are similar to those that occur when:
- allergic rhinitis;
- bronchial asthma.
In the first case, this is usually:
- liquid colorless transparent discharge from the nose;
- difficulty in nasal breathing;
- itching and burning in the nasal passages.
The clinical picture of alcohol allergy, reminiscent of bronchial asthma, is:
- shortness of breath – difficulty breathing in and out;
- choking – a feeling of lack of air.
Symptoms of an allergy to alcohol, reminiscent of that in diseases of the gastrointestinal tract, are:
- itching and burning in the mouth;
- numbness of the tongue, the feeling that it is enlarged;
- nausea and vomiting, which does not bring relief;
- stomach ache;
- deterioration in appetite or its absence;
Symptoms of anaphylactoid type with allergies to
- alcohol will be as follows:
- general weakness;
- lowering blood pressure;
- difficulty breathing.
The clinical picture of pseudo-allergy to alcohol may be similar to a vegetative-vascular type reaction with symptoms such as:
- redness of the skin;
- a feeling of heat throughout the body;
- severe migraine headaches;
- feeling of lack of air;
- DIAGNOSIS OF ALLERGY ON ALCOHOL
Diagnosing an allergy to alcohol can be difficult – such a violation often manifests itself in a clinical picture, the signs of which may resemble a non-allergic pathology. This is especially pronounced when exposed to the body of various components of alcohol – factors that provoke an allergic reaction. In addition, manifestations of an allergy to alcohol can be inexpressive against the background of other disorders associated with its ingestion into the body – namely:
- from the gastrointestinal tract and so on.
The main difficulties of diagnosis are to identify among the many components of alcohol the same allergen that provoked the reaction of the body.
Based on this, any information will be useful – patient complaints, details of the medical history (history) of the disease, results of additional research methods (physical, instrumental, laboratory).
When studying the medical history of the disease, the following nuances should be clarified:
- whether the patient was drinking alcohol;
- what alcohol and in what quantity was consumed;
- where the alcoholic beverage was made;
- whether the intake of alcohol was accompanied by the use of
- food products, and if accompanied, then which ones;
- how long after taking alcohol the first manifestations of allergy occurred;
- have the patient previously had similar reactions;
- whether other allergic reactions were previously detected in the victim.
The results of a physical examination can be very different – they depend on the type of allergy to alcohol (skin, respiratory and so on). In this case, the following can be detected:
- upon examination – redness of the skin, the presence of a rash (vesicles, papules, large blisters), traces of scratching;
- with palpation (palpation) – an increase in the temperature of the skin with skin manifestations of allergies;
- with percussion (tapping) – without features;
- with auscultation (listening) of the lungs – with the respiratory type, weakened breathing, wheezing, with a reaction from the gastrointestinal tract – increased intestinal peristaltic murmurs with diarrhea.
It can also be determined:
- when measuring the pulse – its increased frequency;
- when measuring blood pressure – its decrease.
Instrumental methods of research are used to make sure that the symptoms of organs, systems of organs and tissues did not appear because of their somatic lesions, but as a result of an allergic reaction to alcohol. In order to narrow the range of instrumental methods, in some cases, consultation of related specialists is necessary. In general, in the diagnosis of alcohol allergy, research methods such as:
- survey radiography of the abdominal cavity;
- ultrasound examination of the abdomen (ultrasound);
- magnetic resonance imaging of the abdominal cavity (MRI);
- fibrogastroduodenoscopy (FGDS);
- duodenal sounding;
- electrocardiography (ECG);
- bronchoscopy; bronchography;
- spirometry and others.
From laboratory research methods in the diagnosis of alcohol allergies are involved:
- general blood test – an increase in the number of eosinophils indicates an allergic type of reaction. Since an inflammatory reaction of tissues occurs, a slight increase in the number of leukocytes (leukocytosis) and ESR can be observed;
- allergic tests – cutaneous, intradermal, subcutaneous. They are carried out with allergens, which are part of alcoholic beverages (wheat, yeast, and so on);
determination of allergen-specific immunoglobulins (classes E and G);
- histamine test – carried out with suspicion of a pseudo-allergic type of allergy to alcohol. In this case, a potential allergen is introduced into the duodenum, the reaction to it is analyzed.
- DIFFERENTIAL DIAGNOSTICS
Differential (distinctive) diagnosis of alcohol allergy is carried out, as a rule, with such diseases and pathological conditions as:
- food allergy – intolerance to certain types of products or their components;
- Allergic dermatitis – an inflammatory lesion of the skin caused by allergens;
- pathology of the digestive system;
- acute and chronic intoxication – infectious, food, drug and so on;
- neurocirculatory dystonia (it is based on reactions of a vegetative-vascular nature);
- congenital intolerance to alcohol.
The main complication of an allergy to alcohol is anaphylactoid reactions – a pronounced reaction of the body to alcohol in the form of a violation of its general condition.
- ALLERGY TREATMENT FOR ALCOHOL
Allergy treatment for alcohol is conservative. The basis of therapy is the following:
- a ban on the use of alcoholic beverages;
- diet food;
- drug therapy.
If you are allergic to alcohol, the ban applies to alcoholic beverages of any strength and their derivatives (cocktails, punches, mulled wine, etc.), as well as to some products that may contain alcohol – in particular, sweets (like “Drunk Cherry”).
The basis of dietary nutrition is the restriction of consumption:
- foods that contain large amounts of histamine and tyrosine;
- histamine-lab products are hard cheeses, sausages, sausages, sausages, brawn, smoked and pickled products, products with food coloring and preservatives.
Drug therapy is practiced with the ineffectiveness of the above treatment methods. Assigned:
- desensitizing drugs – they “neutralize” histamine;
– glucocorticosteroids – they are used with the ineffectiveness of antihistamines, in severe cases of an allergic reaction to alcohol, with the development of complications;
- general strengthening agents – in particular vitamins in the form of injectable preparations or pharmacy complexes for oral (by mouth) use.
Measures to prevent the occurrence of the described pathology are:
- avoiding the use of low-quality alcoholic beverages, if necessary – a complete rejection of them, as well as alcohol-containing products;
- diet food, which excludes the ingestion of allergens and histaminolibrators into the body;
- regular preventive examinations by a therapist and allergist.
The prognosis for an allergy to alcohol is different, but generally rather favorable. Timely detection of this pathological condition and adequate appointments help to quickly stop it. The forecast worsens when:
- late treatment at the clinic;
- repeated contact with the allergen;
- cross-type allergies.
It should be borne in mind that even after a successful stopping of an allergic reaction, it can reoccur when it comes back into contact with an allergen (alcohol).