Diet therapy for allergic diseases in adolescents

The article was written by leading allergist-immunologist, pediatrician Euromed Kids Artem Andreevich Batin

At the first visit to an allergist and a food-related allergic reaction is suspected, the patient is recommended a hypoallergenic diet .

The hypoallergenic diet developed by immunologist, academician Andrei Dmitrievich Ado has already become classic.

The Ado diet is a whole nutritional system that involves the exclusion of all potential allergens and histamine liberators .

IMPORTANT! Information from the article cannot be used for self-diagnosis and self-medication! Only a doctor can prescribe the necessary examinations, establish a diagnosis and draw up a treatment plan during a consultation!

After the patient’s health with an allergic reaction has normalized, the products are gradually returned to the diet, while carefully monitoring the reaction to each food product.

The goals of recommending a hypoallergenic diet are to eliminate all potential allergens until the acute condition resolves.

When to sound the alarm?

It is impossible not to notice the manifestations of nettle fever.
Redness and then blisters appear on the child's skin. Rashes appear in the folds of the skin, on the lips, and in places of close contact with clothing. The body itches a lot, hence another name for it - infant pruritus .

Often parents do not pay attention to this.

Moreover, the rash usually disappears after a few hours , but soon appears in a new place.

There is no need to panic, but you should see a doctor as soon as possible.

Who should I contact?

In children, the disease often manifests itself immediately in an acute form; it is necessary to urgently call a local doctor ; if it worsens severely, call an ambulance. Allergists, dermatologists, and nutritionists treat the causes of the disorder.

It is necessary to undergo many tests to identify parasites, infections, diseases of the liver, kidneys, and gastrointestinal tract. Identify foods that cause a painful reaction. Without determining the etymology of the rash, it is impossible to prescribe the correct treatment or choose a diet. How to choose nutrition for urticaria in a child?

For this:

• after the disappearance of acute manifestations, one product is introduced into the menu;
• in case of relapse, the identified allergen is excluded from use and a break is taken for a week;
• If the new dish does not cause negative reactions, add the following.

Compatibility must : when two neutral components come into contact, they can be activated. Then urticaria will appear again in children, the diet should be tightened.

Advantages and disadvantages

Diet features

A diet for urticaria in children, as in adults, is prescribed after the results of a provocative test.

To know what to feed a child or an adult with allergies and what not to eat, you need to familiarize yourself with the list of prohibited and permitted foods.

For acute urticaria

In this case, identifying the allergen will not be difficult. Symptoms of hives appear within a few hours after consuming a particular product. With acute urticaria, it is important to remember what new product was included in the diet the day before. The acute form can also occur with excessive consumption of one dish. If the child ate one chocolate candy, there will be no symptoms. But when more chocolate has been eaten than normal, signs of an allergy will appear within a few hours.

For chronic urticaria

The chronic form is often accompanied not only by a skin rash, but also by disruption of the gastrointestinal tract, gall bladder, and liver. In this case, dietary nutrition for urticaria in adults and children should be constant. Doctors prescribe table No. 5, which excludes not only allergens, but also limits the consumption of salt and fat. Following a diet will help not only eliminate symptoms, but also improve the functioning of the abdominal organs.

In the chronic form, a basic diet is prescribed. In the first days of illness, fasting is recommended, then foods with low allergenicity are introduced.

For children

Children are more likely to suffer from hives than adults. The first symptoms of the disease may appear in infancy, with the introduction of complementary foods. Any food can cause an allergy when first introduced, so parents should monitor the body’s reaction.

For urticaria, children are given low allergenic foods in small quantities. The kit is always prepared by a doctor. Children under three years of age are not recommended to include honey, chocolate, nuts, citrus fruits and other allergens in their diet.

Many parents are interested in whether it is possible to eat bananas for hives. The fruit is hypoallergenic, so it can be given to a child from 6 months as complementary food.

For pregnant and lactating women

If a woman is allergic to any product, it should not be included in her diet. With excessive consumption of allergens, the risk of developing the disease increases, not only in the woman, but also in the child. For nursing mothers, the doctor selects an appropriate diet that will protect the baby from possible negative reactions.

What you can eat if you have hives during breastfeeding should be decided by your pediatrician. If you are hypersensitive to food allergens, the baby's feeding period should be monitored and a food diary kept.

Principles of treatment of urticaria and angioedema

Urticaria and angioedema (angioedema) (AO) are widespread skin diseases that have a significant negative impact on the patient’s quality of life. They are usually easy to diagnose, but not always easy to treat due to varying severity, frequent resistance to antihistamines, and the presence of other diseases in the patient, which are the primary cause of the skin process. In addition, not all specialists are familiar with the leading guideline documents; many of them do not know the specifics of treatment of acute urticaria ((OK), lasting less than 6 weeks) and chronic urticaria ((CU), lasting more than 6 weeks) and are not always able to choose the right one therapeutic and/or diagnostic tactics for a particular patient.

The purpose of this review is to briefly describe the main methods of treatment of various types of urticaria in adult patients and older children and the drugs used, based on existing scientific evidence.

To optimize pharmacotherapy and select further treatment tactics, it is important to determine the type/form of urticaria (for example, physical/vibrational), its duration (acute, episodic or chronic). The features of such diagnostics are described in other publications [1, 22].

The goal of treatment is to achieve control of the disease and the associated improvement in the quality of life of patients, the ability to work or study, and also to minimize side effects mediated by the use of drugs. This is especially important when treating long-term forms of chronic urticaria. To assess disease control, you can take into account the severity of itching, AO, the size of blisters, their number and frequency of occurrence, night awakenings and the duration of remission of the disease.

Treatment aimed at causative and precipitating factors

First of all, the underlying disease (if identified) that causes urticaria is treated. It is necessary to do everything possible (carry out all the necessary diagnostic tests) to identify the cause and provoking factors of urticaria in case of its chronic course. After determining the latter, it is necessary to exclude contact with them, for example, do not take Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) if you are sensitive to them (many NSAIDs cause exacerbation of CU in 20-30% of patients, even with another cause) or angiotensin-converting enzyme inhibitors (ACEIs). ) with recurrent AO.

Elimination of provoking factors

Exclusion of provoking factors is an effective type of treatment and prevention if these factors are known or suspected (food product, drugs, physical stimulus, etc.).

Many experts recommend that all patients with urticaria avoid taking pseudoallergens, Aspirin and other NSAIDs, and ACE inhibitors as possible nonspecific triggers [2], although reliable evidence for this statement is lacking.

Patients with acute allergic urticaria should avoid contact with identified causally significant allergens, and with physical allergens, avoid exposure to a causative physical stimulus depending on the type of urticaria: sunlight, mechanical irritation, skin compression, vibration, water, cold, heat, overheating, physical loads.

In many cases, alcohol, stress and overheating increase the manifestations of CU (Table 1).

Diet

In patients with allergic IgE-related urticaria, it is important to exclude causative foods from the diet. On the other hand, allergies to food and food additives in chronic chronic disease are extremely rare, despite widespread misconception. Data on the need to prescribe a diet with a limitation of food additives (dyes, preservatives, flavor enhancers, aromas, etc.) [5–7] and natural salicylates (so-called pseudoallergens) to patients with Aspirin-sensitive CU are contradictory. In a prospective, open-label study that included 64 patients, 73% of patients with CU showed an improvement in the skin process when following a strict diet with the exclusion of pseudoallergens for 2 weeks, but confirmation of the reaction after a provocative test with individual pseudoallergens was recorded in only 19% of them [ 8].

Treatment of physical urticaria. Tolerance induction

In motivated patients with cold, solar, cholinergic and generalized thermal urticaria, desensitization (induction of tolerance) is possible. The procedure involves repeated exposure of the patient's skin to a stimulus, such as cold or heat, until it becomes refractory (i.e., does not respond to provocation) [9–11]. Exposure to the stimulus must be regular and of sufficient intensity, otherwise tolerance will disappear within a few days [1].

Treatment of autoimmune urticaria

It is believed that in about 50% of patients, CU has an autoimmune form, which is confirmed using laboratory methods and intradermal autologous serum test (IAT).

Currently, protocols are being developed to carry out desensitization in patients with autoimmune CC using injections of autologous serum or whole blood [12, 13]. The goal of this treatment is to induce tolerance to circulating histamine-releasing factors. In a Turkish study published in July 2011, the authors used injections of autologous serum, autologous plasma, and placebo in three parallel subgroups of patients with both TAC-positive (TAC+) and TAC-negative (TAC-) responses [14]. The effectiveness of treatment with autologous serum and plasma was almost equal to that in the placebo group (the difference was not statistically significant), despite this, in patients with TAC+ and TAC– there was a decrease in urticaria activity and an increase in quality of life indicators. Taking into account these data, the effectiveness of autohemotherapy in patients with CU needs further study.

Treatment of concomitant infections

The need for treatment of chronic foci of infection in urticaria, in particular Helicobacter pylori, is still under debate. There are studies (including Russian ones) confirming that eradication of H. pylori can lead to a significant improvement in the course of urticaria [15, 16], while in others, antibacterial treatment did not have any significant effect on the symptoms of CU [ 17, 18].

The role of this microorganism in the pathogenesis of CC and AO remains controversial. The frequency of infection in the general population is very high [19], so H. pylori is detected in 40–50% of patients with CU. Some experts recommend, even in the absence of scientific evidence of effectiveness, prescribing antibacterial treatment to patients with CU both for the eradication of H. pylori and for other subclinical infectious diseases (streptococcal, staphylococcal, yersiniosis, etc.), although, according to research data, such an approach does not always lead to improvement in urticaria symptoms.

Further randomized clinical trials (RCTs) are required to examine the effects of antibiotic therapy and H. pylori eradication on urticaria.

Treatment of acute urticaria

Acute spontaneous urticaria can be allergic or non-allergic. But the treatment in both cases is practically the same. In more than 90% of cases, the acute form of the disease resolves spontaneously [1].

Indications for hospitalization:

• severe forms of OK and AO in the larynx with a risk of asphyxia;
• all cases of anaphylactic reaction accompanied by urticaria;
• severe forms of exacerbation of OK, CC and AO, resistant to outpatient treatment.

Initial treatment measures include addressing the cause: stopping the use of the causative drug or food product, removing the insect sting, and prescribing antibiotics for a bacterial infection. Subsequently, symptomatic pharmacotherapy is carried out.

Despite long-term and widespread use, only a few RCTs have been published on the use of second-generation histamine H1 receptor blockers (H1-HBs) (first-choice drugs) and short courses of systemic glucocorticosteroids ((GCS), second-choice drugs) for CC [1] .

Initial symptomatic therapy includes the administration of non-sedating N1-BG with the possibility of increasing the daily dose in adult patients 4 times higher than that indicated in the instructions for the drug (possible side effects must be taken into account). In some cases, especially with limited urticaria, topical treatment is used - antipruritic and cooling lotions (for example, 1% and 2% water-based menthol) [1].

Second-line drugs include corticosteroids prescribed orally at 50 mg/day in a short course for 3 days [20] or 20 mg 2 times a day for 4 days [21].

In severe cases of urticaria (for example, when combined with AO or with a high risk of developing anaphylaxis), some experts recommend intravenous administration of corticosteroids (30–100 mg of prednisolone or 4–16 mg of dexamethasone or more) and sedative H1-BG, incl. and again [22].

In severe, progressive cases with the development of anaphylaxis and shock, therapy should be carried out in conjunction with parenteral administration of epinephrine.

Most cases of OC respond well to treatment with N1-GD and corticosteroids. However, symptoms may reappear after a few hours (in some patients, symptoms persist for up to 2 weeks or more). In these cases, patients should receive non-sedating second-generation N1-GDs in adequate doses (up to a 4-fold increase in adult patients) for the required time; such patients should be advised to have corticosteroids in tablets (for example, prednisolone) at home in case symptoms worsen.

The use of topical N1-BG should be avoided due to its limited effect and possible sensitizing potential.

In most cases, it is impossible to predict whether acute urticaria will become chronic. It is also unclear whether such a transition is influenced by the administration of adequate treatment or not.

Treatment of chronic urticaria

Unfortunately, the disease that causes the onset of CC is rarely detected, but if this can be done, then its treatment is carried out first. When the underlying disease is cured, there is a high probability of complete disappearance of urticaria symptoms. To a lesser extent, this applies to autoimmune urticaria associated with other autoimmune diseases, since, for example, even with complete control of autoimmune thyroiditis associated with hypothyroidism and autoimmune urticaria, an improvement in the course of the skin process is not always observed.

Key treatment features:

• treatment of the identified cause of urticaria (if possible);
• cessation/reduction of contact with provoking factors;
• explaining to the patient the features of the course, diagnosis and treatment of the disease (orally and in the form of notes);
• approach to relieve symptoms;
• trial administration of second generation N1-BG; increase the daily dose if necessary;
• use of second- and third-line drugs in patients with severe and treatment-resistant disease, including immunosuppressive and immunomodulatory drugs.

It is important to inform the patient with CU that:

• CC does not lead to progressive or irreversible tissue damage in all cases in the absence of an underlying disease that serves as its cause;
• the disease often stops spontaneously (approximately 50% of cases);
• food and allergies are almost never the cause of CC, so there is no need for extensive allergological examinations;
• It is necessary to have an first aid kit (especially for patients with recurrent laryngeal edema). The first aid kit should contain adrenaline/epinephrine (preferably in the form of an autoinjector), corticosteroids and antihistamines for parenteral administration, syringes and needles.

Another important direction of therapy is the use of drugs for symptomatic treatment in order to reduce the severity of skin rashes/itching/AO and prevent their reappearance.

Cooling lotions (eg, 1% water-based menthol cream, calamine lotion, and 10% crotamiton lotion) can be used as a topical treatment, especially in areas of severe itching. It must be borne in mind that alcohol-containing lotions, when applied to areas of damaged or eczematous skin, can exacerbate the exacerbation of the disease. Antihistamine creams and gels (eg, dimethindene) are widely used, but their pharmacological effectiveness is limited by poor skin absorption. Topical corticosteroids are practically not used in routine clinical practice for the treatment of chronic urticaria, but some studies have shown that when they are regularly applied to local areas of the skin, the severity of the urticarial response to pressure is reduced. This may be due to a decrease in the number of mast cells in these locations [23, 24].

According to the recommendations of the World Allergy Organization (WAO), in all cases of urticaria, treatment should begin with non-sedating second-generation antihistamines (drugs of first choice). Only if they are unavailable or ineffective in maximum doses, the use of sedative H1-BG is possible [25], which is limited by frequent side effects, in particular sedation and anticholinergic. In most patients, the use of second-generation antihistamines helps control the disease [26], however, adding first-generation H1-GD at night is logical and is allowed if the patient is bothered by severe night itching and associated insomnia.

Subsequently, depending on the response, treatment in adult patients is carried out according to the algorithm shown in Fig. The cost, safety and effectiveness of treatment are discussed in Table. 2.

It is important to remember that some patients with CU may not respond to standard doses of second-generation antihistamines. In this case, it is possible to increase the daily dose of a drug from this group by 2–4 times from that recommended in the manufacturer’s instructions. Both clinical experience and research data confirm that this approach (increasing the dose of non-sedating N1-GD) is associated with greater treatment efficacy and disease control in many (but not all) patients [29, 30].

If there is no effect from increasing the dose of H1-BG, you can add antileukotriene drugs or replace H1-BG with another one. If urticaria is ineffective or severe, alternative therapy with second or third line drugs, such as cyclosporine, a combination of H1- and H2-BG, dapsone or omalizumab, should be considered [25]. It is recommended to refrain from prescribing such treatment for up to 1–4 weeks, since the effect of taking antihistamines may be delayed [25].

The effectiveness of drugs may vary for each patient. It should also be taken into account that the drugs do not maintain a long-term effect after they are discontinued, therefore, for persistent urticaria, maintenance therapy is necessary. With long-term treatment, the development of tachyphylaxis is usually not observed, and in many patients with chronic idiopathic or autoimmune urticaria, symptomatic therapy leads to a significant positive response and control of the disease.

Further observation

In many cases, long-term use of drugs is necessary until remission of the disease occurs. For most patients with CU, 3–6 months of regular therapy is recommended [25]. In patients with a long history of urticaria and AO, treatment is carried out for 6–12 months with gradual withdrawal for several weeks. It was shown that patients with CU who took N1-BG continuously suffered from a less pronounced decrease in quality of life compared to those who used drugs occasionally [32].

Every 3–6 months or more often, it is necessary to examine and interview the patient to identify new symptoms (signs of autoimmune pathology, etc.), as well as to assess the severity of urticaria (it may change over time) and adjust therapy [25].

The average duration of CU is 3–5 years, although approximately half of patients experience spontaneous remission 0.5–1 year after onset. In approximately 40% of patients, CU that has existed for more than 6 months will recur over the next 10 years, and in 20% even over 20 years [31].

The goal of treatment for chronic disease is to minimize the manifestations of the disease against the background of optimally selected therapy until remission occurs.

Conclusion

Urticaria/AO is a heterogeneous group of diseases characterized by a variety of clinical manifestations and different mechanisms of development. Therefore, it is logical that a stepwise approach should be used to treat it, based on the form of urticaria, severity, pathogenesis and course characteristics.

As already mentioned, the key principle of therapy for both OC and CC in adult patients (and sometimes in children), which, unfortunately, is unknown to many Russian doctors, is the prescription of second generation antihistamines (drugs of choice) in a standard dose, and when their ineffectiveness - increase the daily dose up to 4 times from that specified in the instructions. This approach is approved and recommended by leading international and national communities and specialists, it is based on increasing the effect of H1-GD while maintaining relative safety (sedation, impaired cognitive and psychomotor functions and other side effects are usually absent even at high doses) compared to prescription GKS. It is important to emphasize here that from a legal point of view, the doctor does not have the right to deviate from the instructions for the use of a particular drug. To date, in all instructions for second generation antihistamines approved in Russia, there are no recommendations for increasing the dose. In addition, you should always weigh the possible benefits and risks of any type of treatment.

It must be remembered that antihistamines are indicated for almost all patients with urticaria, with the exception of some patients with isolated AO, in particular with hereditary AO. In addition, unless specifically indicated, it is advisable to avoid prescribing antihistamines and other systemic drugs in the first trimester of pregnancy, despite the fact that studies have not shown a teratogenic effect. The addition of leukotriene receptor blockers (montelukast, zafirlukast) to antihistamine therapy in adult patients may provide an additional effect when exacerbation of urticaria is associated with the intake of food pseudoallergens, aspirin, or the presence of functional autoantibodies.

Currently, additional research is required on existing drugs for the treatment of urticaria, especially urticaria, and the search for new highly effective drugs. It should be taken into account that the use of most second- and third-line drugs, in particular cyclosporine and omalizumab, is associated with high costs and/or a significant risk of severe side effects.

Literature

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P. V. Kolkhir, Candidate of Medical Sciences

Research Center GBOU VPO First Moscow State Medical University named after. I. M. Sechenova Ministry of Health and Social Development of Russia, Moscow

Contact information about the author for correspondence

Why is diet necessary?

The occurrence of the disease in 35% of cases is caused by: an unbalanced diet, incorrectly chosen complementary foods, and various foods.

What should a child eat if he has hives, what can he include in his diet? Drawing up an individual menu is designed to interrupt contact with a possible irritant. It is necessary to eliminate the pathology and support the weakened body of the little patient with special therapeutic nutrition.

Important ! Identification of unwanted products continues for a long time - a month or more. A food diary will help your doctor create an individual diet .

Quitting the diet

To avoid causing serious harm to your body, adhere to the following rules:

• exit the diet slowly, it will take 2-3 days;
• do not consume large quantities of sweets, as well as prohibited foods;
• watch your drinking regime, consume enough liquid;
• minimize contact with unfamiliar dishes;
• Avoid overeating.

Exiting the diet should be smooth; for 2-3 days, stick to the diet described above, gradually adding new foods. Don't eat too much; moderate food intake will avoid increasing the load on the gastrointestinal tract and liver.

What is possible

Depends on whether the cause of the disease is found. For the first day or two, it is better to fast and limit yourself to drinking plenty of fluids. If this is an allergy, the found product is excluded and then used in cooking:

• fermented milk products, preferably home-made;
• boiled or stewed vegetables;
• cereals, preferably limited to buckwheat, rice and corn grits, semolina is strictly prohibited (adults are allowed);
• boiled or stewed meat - chicken breast, turkey, rabbit, and rarely beef;
• some fruits, mostly green and yellow, most often green apples, pears, cherries, maybe bananas;
• drink clean water, unsweetened green tea, unsweetened jelly and decoctions of dried fruits.

An example menu in this case might look like this:

• Breakfast: a glass of kefir and a portion of corn porridge.
• Second breakfast: fruit.
• Dinner. Soup with meat and vegetables.
• Afternoon snack: not sweet jelly.
• Dinner: buckwheat porridge with steamed fish cutlets.

But the allergen may not be detected immediately. In this case, you will have to follow a more strict diet that excludes meat and fish products completely. In this case, the menu for the day is compiled as follows:

• Breakfast: cottage cheese, rice porridge and tea.
• Second breakfast: low-fat yogurt.
• Lunch: mashed potatoes (pre-soaked potatoes), white cabbage salad.
• Afternoon snack: tea with crackers.
• Dinner: baked zucchini.

With chronic urticaria, you will have to consider a few more points:

• you need vitamin B12, which can be obtained from poultry meat and whole grain cereals;
• it is important to get a lot of antioxidants, which contain blueberries, raspberries, green tea;
• you need zinc (potatoes and celery);
• increase the amount of omega-3 acid (flax seeds, sea fish and soy);
• reduce the amount of vegetable fats in food due to omega-6 acids.

But after identifying the allergenic factor, you can consume almost all products that are not on the prohibited list. Naturally, adhering to the principle of eating in small quantities and often.

Of course, an individual menu is used for infants, depending on age and the number of products introduced. But the main principles remain the same.

Fully or partially limited products

The diet for acute/chronic urticaria involves the complete exclusion of such products as fatty red meats, strong meat and fish broths, as well as first courses based on them, duck, goose, smoked meats, most sausages, whole milk, chicken eggs, fish, especially , “red” fish of all kinds.

Citrus fruits, chocolate, seafood (shrimp, mussels, squid), flour products and sweets, honey and honey products (propolis, bee jelly, wax), any salty foods, canned food, pickled vegetables, animal and cooking fats, salty and fatty are prohibited. cheeses, cream, sweet curds, sour cream.

All products containing easily digestible carbohydrates are excluded - sugar and products containing it, honey, jams, preserves, sweets, confectionery, ice cream. Semolina, rice and pasta, and soy are subject to restrictions.

Red and orange fruits/vegetables (tangerines, red apples, oranges, tomatoes, radishes, beets, radishes, carrots, strawberries, strawberries), nuts (especially peanuts and hazelnuts) are excluded from the diet; coffee; vinegar, all seasonings (mustard, ketchup, horseradish, mayonnaise), mushrooms, eggplant, pineapple, melon, butter dough.

The hypoallergenic menu should not include products containing food additives (dyes, preservatives), fruit tea, fruit/vegetable juices from prohibited berries, vegetables and fruits, sweet carbonated drinks and any alcohol-containing drinks.

Table of prohibited products

What to limit?

The list of prohibited foods is compiled individually; food for urticaria in children must be without:

• sweets, chocolate, honey;
• sausages, canned food, smoked meats;
• citrus fruits, exotic fruits, red apples, currants, cherries, raspberries, wild strawberries, strawberries;
• nuts, seeds, mushrooms;
• spices, seasonings, mayonnaise;
• seafood, caviar;
• anything that contains dyes, preservatives, thickeners, flavor enhancers, flavors, emulsifiers;
• no chips, instant noodles, palm oil-based products.

Reduce the consumption of salt, sugar, bread, butter. These ingredients should not be completely excluded from children's diets. In moderate doses, butter, sugar, and salt are necessary for a growing body.

The list of foods that you should avoid eating includes:

• citrus fruit;
• alcoholic drinks;
• nuts;
• fatty meat, poultry, smoked meats;
• chicken;
• honey;
• fish and any dishes made from it;
• butter dough;
• pineapples;
• melon;
• strawberries, strawberries;
• apricots, peaches;
• chocolate and other products containing cocoa (pastes, candies);
• cow's milk;
• coffee;
• eggs;
• mushrooms;
• mayonnaise, mustard, ketchup, vinegar, spices;
• radish, radish, horseradish.

Modern allergology suggests not giving up all foods (according to the Ado diet), but only those that definitely cause a reaction. a food diary will help you deal with this issue .

Recipes for children

Dietary dishes will seem tastier to your child if you show your imagination and serve them in beautiful dishes, decorate with herbs and pieces of fruits and vegetables.

We recommend using the following recipes.

Broccoli soup with peas and croutons

To prepare you need to take:

• 2 pcs. medium sized potatoes;
• 200 g broccoli;
• 100 g green peas;
• 20 g butter;
• 100 g of bread with bran;
• a little salt;
• 300 ml boiled water;
• dill greens.

Peel the potatoes, soak in water for 30 minutes, and then cut into small cubes. Add broccoli, disassembled into stalks and peas. Pour boiled water over the vegetables, add salt, put on fire and cook until soft. At the very end add butter.

From the finished soup, remove one broccoli stalk and a few peas. Use a blender to puree the remaining vegetables. Cut the bread into small pieces and dry in the oven.

Pour the soup into a plate, garnish with a piece of broccoli and peas. Sprinkle with chopped dill. Serve with croutons.

Vegetable cream soup

To prepare you need to take:

• 2 pcs. medium sized potatoes;
• 100 g zucchini;
• 100 g cauliflower;
• 30 g carrots;
• 50 ml sour cream;
• 300 ml vegetable broth;
• a little salt;
• parsley and dill.

Peel the potatoes, soak in water, cut into cubes. Peel the carrots and zucchini and grate on a coarse grater, disassemble the cauliflower into inflorescences. Place all the vegetables in a saucepan, add salt, add a little vegetable broth and simmer until tender.

Grind the cooked vegetables with a blender until a homogeneous mass is formed. Pour in the remaining broth and sour cream, stir thoroughly. When serving, sprinkle with parsley and dill.

Soup with turnips and apples

To prepare you need to take:

• 150 g turnips;
• 100 g green apple;
• 10 g butter;
• a little salt;
• 300 ml vegetable broth.

Remove the peel from the turnips, cut into small slices and steam. Peel the apple, remove the seeds and bake in the oven.

Rub the prepared turnips through a sieve, add the baked apple and salt. Dilute with vegetable broth to a puree consistency. When serving, place butter on a plate.

Millet porridge with pumpkin

To prepare you need to take:

• 100 g light pumpkin;
• 100 g millet;
• 10 g butter;
• 1 glass of boiled water;
• 1 teaspoon sugar.

Peel the pumpkin and grate it on a coarse grater, add a little water and simmer until soft. Rinse the cereal, add water, bring to a boil and cook over low heat for 15 minutes. Then add sugar and pumpkin and simmer for another 10 minutes. Place butter in a plate with porridge.

With a hypoallergenic diet, all dishes should be served warm, since food that is too hot or too cold can aggravate the disease.

Strict adherence to the prescribed diet will help the child get rid of the symptoms of urticaria and prevent their occurrence in the future.

What to feed?

What diet should children be prescribed for urticaria?

1. First courses : cereal, vegetable soups - lean or with low-fat broth.
2. The list of mandatory dishes includes rice, oatmeal, buckwheat, corn, pearl barley, and rolled oats porridge cooked in water. It is not recommended to cook semolina.
3. Meat is preferable to chicken, rabbit, and turkey.
4. Vegetables - broccoli, cauliflower, white cabbage, zucchini, squash, pumpkin, green beans, fresh green peas - are boiled, baked, stewed. To replenish vitamins, add parsley, dill, Chinese cabbage, various types of lettuce, and spinach. Potatoes are soaked for 8-10 hours before being cooked.
5. What can you eat from dairy products ? Bifidok, fermented baked milk, yogurt, kefir help normalize the functioning of the digestive system.
6. Bakery products include yeast-free bread, crackers, biscuits, crispbread.
7. Neutral fruits : green apples, yellow apples, pears, apricots, bananas.

Important ! When breastfeeding, the mother must adhere to a diet. What can a child on artificial nutrition eat if he has hives? You should not start complementary feeding until the symptoms of pruritus disappear.

If the baby is already receiving additional nutrition, or eats full meals 4-5 times a day, replace meat broth with vegetable broth , exclude fish, cottage cheese, yolk, juices, and for dinner replace “adult” food with breast milk or infant formula. Do not add new foods to the patient's diet .

Diet for urticaria

As mentioned above, both adults and children are susceptible to the appearance of this disease. The causes of urticaria are very different:

• genetic predisposition;
• disruption of the digestive system due to the consumption of “harmful” foods;
• hormonal disbalance;
• the presence of any infection in the body;
• the presence of parasites in the body;
• emotional overload.

Regarding the types of this disease , urticaria occurs:

• Allergic. Occurs when you come into contact with something that causes you to be allergic;
• Spicy. It may appear after an insect bite, taking medications or food allergens. Is in the form of blisters;
• Chronic. The disease lasts more than one and a half months. The causes may be caries, tonsillitis and liver dysfunction. In this case, an urgent therapeutic diet is necessary;
• Mechanical. A rash of characteristic red color appears on the skin. It may be accompanied by deterioration in health and severe headaches;
• Non-allergic. Occurs when the skin is exposed to heat or cold. That is, this disease can appear in summer or winter, when the skin comes into contact with snow, sun or ice. Requires urgent adherence to proper nutrition and diet during the above-mentioned periods;
• Demographic. In this case of the disease, an allergy to wool or various types of mechanical substances appears;
• Cholinergic urticaria occurs due to nervous tension. If you have such a disease, you should definitely resort to proper nutrition.

Before introducing you to the basic principles of a diet for urticaria, let's look at its most pronounced symptoms:

• the appearance of blisters and swelling on the skin;
• increased body temperature;
• increased frequency of headaches;
• joint pain;
• red rashes on the skin;
• severe itching.

You should immediately call an ambulance if symptoms of urticaria appear , such as:

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• swelling of the larynx and tongue;
• drop in blood pressure;
• labored breathing;
• pain in the abdominal area;
• semi-fainting state.

Basic nutrition rules for adults

A diet for urticaria necessarily requires proper nutrition and no contact with allergens.

In order to get rid of any disease using a therapeutic diet, you should strictly adhere to it. The basic principles of the diet for urticaria are as follows:

• give up alcohol and alcohol-containing products, as they contribute to the exacerbation of this allergic disease;
• you should drink two liters of purified still water per day;
• eat often, in small portions;
• try not to overeat, as this will lead to an immediate deterioration of the condition;
• products are best prepared at home;
• dishes are allowed steamed, stewed and boiled.

The diet for urticaria lasts from three weeks to two months. If necessary, it can be extended.

What can and cannot be eaten by children with hives?

Let's start with the pleasant things. The diet for urticaria allows the following foods in its menu:

• vegetarian soups;
• boiled beef, turkey and rabbit;
• yogurt, cottage cheese, curdled milk, milk;
• whole grain bread, bran;
• all types of fruits, in addition to strawberries and citrus fruits;
• pasta;
• buckwheat, oatmeal, pearl barley and millet porridge;
• rice;
• dried fruit compote;
• herbal, green and black tea;
• vegetable fats;
• cucumbers, cabbage, zucchini.

The following products are allowed in moderation while following a therapeutic diet:

• carrot;
• beet;
• tomatoes;
• sour cream;
• butter.

The list of prohibited foods for the diet for urticaria for children and adults is as follows:

• chocolate;
• smoked meats;
• eggs;
• nuts;
• fried food;
• nutritional supplements;
• coffee, cocoa;
• strong tea;
• carbonated drinks;
• mushrooms;
• canned foods;
• baking;
• honey;
• fatty meat broths;
• sausage, frankfurters;
• fish;
• seafood;
• red berries and fruits: (cherries, cherries, raspberries, pomegranates, watermelon).

Reviews and results

A hypoallergenic diet, according to reviews from most patients, minimizes the frequency of exacerbations of food allergies and the severity of clinical manifestations.

• “...I have suffered from food problems since childhood. Since I don’t know exactly what you can and can’t eat, and what product I’m allergic to, I try to stick to a hypoallergenic diet and periodically take Enterosgel”;
• “... A diet combined with antihistamines helps a lot. At the first reaction, I take treatment, start with an adsorbent and go on a diet.”

Water balance

It is recommended to drink purified or still mineral water an hour before meals 4 times a day.

We figured out what children can eat if they have hives, but what they shouldn’t drink is:

• freshly squeezed undiluted juices;
• nectars;
• strong black tea;
• strong green tea;
• cocoa;
• soda of all types;
• coffee.

We recommend weak tea without fruit or herbal additives. You can sweeten your tea with fructose. Black tea is preferred, but if no allergen is identified, green tea is brewed.

Fruit drinks and compotes are cooked following the basic rules - cook only from neutral fruits.

Important ! Bananas do not cause allergies even in infants. Their presence in the diet normalizes the intestinal microflora , promotes the rapid absorption of nutrients, the accumulation of calcium in the body, and the production of serotonin.

When a child has urticaria, the diet should contain banana (if there is no individual intolerance).

What you definitely shouldn’t do with hypoallergenic diets:

1. Limit your diet without confirming a reaction to a particular product
2. Ignore keeping a food diary
3. Avoid certain foods due to their color, etc.*
4. Try to follow so-called rotation diets, when the list of foods consumed changes every few days. With this approach, it will not be possible to reliably track reactions; the risk of false positive conclusions is high.

*For example, the red color of a fruit or berry does not always mean a high ability to cause allergies. The most characteristic is the fact that green tomatoes can cause an allergic reaction just like red ones.

The best solution would be to coordinate each step in expanding your diet with your attending allergist .

Allowed products for urticaria

Here's what all categories of patients can eat for urticaria - both adults and children:

• light-colored vegetables (except for sweet peppers) - onions, potatoes and cucumbers, squash, any cabbage (except orange varieties), lettuce, greens and peas.
• light berries and fruits - apple and pear fruits, white cherries, light currants;
• low-fat poultry and meat;
• any porridge, with the exception of semolina;
• hard pasta;
• quality whole grain bread;
• olive and sunflower oils;
• kefir and curd products;
• weakly brewed tea.

Sugar can be replaced with plant-based alternatives like stevia.

Your doctor should give precise instructions on what you can eat if you have an allergy-urticaria and what you can’t.

From the above components you should make dietary dishes, steamed, stewed or boiled. As a last resort - in the oven. The maximum proportion should be vegetable soups in non-meat broth, salads with unrefined oil dressing, as well as stewed vegetable mixtures. In second place are porridge and cooked meat.

Approximate menu for the week

Diet for urticaria is an important issue for a child. It is necessary to completely eliminate foods that may cause allergies. The diet must contain hypoallergenic or neutral products.

We present to your attention a weekly menu, what a child can eat with hives.

Monday

Breakfast : corn porridge, kefir.

Lunch : banana.

Lunch : chicken soup, oatmeal cutlets, unsweetened tea with a bagel.

Afternoon snack : rice pudding, tea.

Dinner : buckwheat porridge with fish balls, tea, crispbread.

Tuesday

Breakfast : rice porridge, tea with biscuits.

Lunch : mashed green apple.

Lunch : vegetable broth, fresh cabbage salad, boiled chicken, prune compote.

Afternoon snack : pumpkin curd, tea.

Dinner : baked potatoes with steamed sole, tea with homemade oatmeal cookies.

Wednesday

Breakfast : corn porridge, green tea with crackers.

Lunch : yogurt, green apple.

Lunch : pumpkin soup, turkey cutlets, green salad, tea.

Afternoon snack : baked green apples.

Dinner : pasta with apple sauce with steamed meatballs, green tea.

Thursday

Breakfast : oatmeal porridge, tea, biscuits.

Lunch : baked yellow or green apple

Lunch : fresh cabbage soup, vegetable stew with chicken, tea.

Afternoon snack : unsweetened tea, bread.

Dinner : mashed potatoes with meatballs, unsweetened tea

Friday

Breakfast : pearl barley porridge, tea.

Lunch : acidophilus.

Lunch : cucumber salad, cauliflower soup with rolled oats, tea.

Afternoon snack : cottage cheese casserole, apple compote.

Dinner : stewed spinach, chicken in sour cream, tea

Saturday

Breakfast : zucchini casserole, green tea with dried bread.

Lunch : yellow cherry or green apple.

Lunch : vegetable broth with rice balls, fruit juice or tea.

Afternoon snack : Kefir jelly (Mix kefir with sugar, natural yogurt, gelatin, refrigerate until frozen).

Dinner : baked cod with green beans, jelly or tea.

Sunday

Breakfast : buckwheat porridge with water, mild cheese, green tea.

Lunch : cottage cheese with grated apple.

Lunch : chicken soup with broccoli and zucchini, unsweetened tea.

Afternoon snack : acidophilus.

Dinner : buckwheat casserole with chicken, compote or tea.

Products contraindicated for urticaria

If urticaria is of the allergic type, food that is not tolerated by the body is initially removed. This is verified by laboratory testing or an experimental menu.

The diet for urticaria contains a list of foods recommended for exclusion in all forms of pathology:

• salt;
• animal oil;
• sour cream products and cream (both fat and low fat);
• semolina;
• alcoholic drinks;
• caffeinated products;
• smoked, spicy and fried;
• sausage and offal;
• mushrooms;
• eggs;
• baked goods and sweets;
• honey products and nuts;
• some vegetables (sweet peppers, tomatoes, celery);
• a number of fruits and berries (citruses, pineapple, grapes and strawberries, peaches with nectarines and apricots, raspberries, dark currants, watermelon, kiwi and oriental persimmons).

These products should be treated with particular caution when creating a diet for acute urticaria.

It is also recommended to exclude foods with a high histamine content:

• cheese products;
• fish and shellfish;
• fermented milk (especially yogurt);
• buttermilk;
• chocolate products;
• products with synthetic dyes;
• red meat.

In cases of stress-related urticaria, it is recommended to avoid foods that stimulate the nervous system - caffeine-containing foods, sweets, too salty foods, alcohol, seasonings and spices.

Find out more

Complications of urticaria

It is important to know what hives look like and to be able to provide first aid correctly.
This will help prevent the development of severe complications that can lead to death. Often urticaria is accompanied by Quincke's edema, which is also called angioedema. Its development in the larynx area is especially dangerous, as it can compress the trachea and impair breathing.

Another serious complication is anaphylactic shock. This is a life-threatening immediate allergic reaction that occurs when the human body is hypersensitive to a particular allergen. Usually develops upon repeated contact with the allergen and requires immediate medical attention.

Recipes for kids

It is worth noting that the diet for urticaria in infants is individual. It is worth limiting salt and sugar. Replace sugar with fructose.

Cream soup

Ingredients:

• 2 chopped leeks;
• 3 large potatoes, pre-soaked and peeled in cold water;
• 2 tablespoons olive oil, a little salt.

Heat the oil in a saucepan, add the chopped white part of the leek and diced potatoes. Simmer for 5 minutes.

Add 0.5 liters of water and cook for about 15 minutes. In a blender, or using a masher, bring the soup to the consistency of puree. When serving, add butter and herbs.

Vegetable cream soup

Ingredients:

• potatoes - 2 pcs;
• pumpkin - 40g;
• squash - 40g;
• cauliflower - 40g;
• hypoallergenic milk formula, salt.

Boil the potatoes together with cabbage, disassembled into inflorescences.

Scald the pumpkin and squash with boiling water and simmer. Boiled and stewed vegetables, stir. Dilute the milk mixture with vegetable broth and add puree.

Apple soup with turnips

Ingredients:

• turnip - 80g;
• egg yolk - 1 pc;
• flour - 1 tsp;
• apple - 1 piece;
• butter, salt - to taste.

Peel the turnips and cut into large pieces, boil and grind until smooth.

Beat the yolk with flour, add to the broth in a thin stream, bring to a boil, add turnip puree, grated small green or yellow apple, butter, salt.

Rice porridge with apple

Ingredients:

• rice - 2 tbsp. l;
• water - 1 glass;
• small apple - 1 piece;
• salt - to taste.

Rinse the rice. Pour water, peeled diced or julienned apples, and cook over low heat for half an hour. Add salt.

Pumpkin millet porridge

Ingredients:

• millet - 2 tbsp. l;
• water - 1 glass;
• pumpkin - 200g;
• salt - to taste.

Boil the cereal. Scald the pumpkin and grate it on a very fine grater. Peel the apple and cut into small strips. Add vegetables to the prepared porridge, add salt and butter.

Spaghetti with cheese sauce

Prepare cheese sauce.

From two tablespoons of cream and a tablespoon of finely grated unsalted cheese.

Add salt.

Heat in a water bath until a homogeneous mass is obtained.

Season the cooked spaghetti.

Rabbit casserole

Ingredients:

• rabbit fillet - 70 g;
• potatoes - 4 pcs;
• onion - 1 pc.

Boil the rabbit meat and grind in a meat grinder. Fry the onion in olive oil, mix with meat, add salt. Boil the potatoes and crush them. Place some of the puree into a greased form, place the minced meat on top of it, and cover with the remaining potatoes. Pour in low-fat sour cream or cream. Bake in the oven for about 20 minutes.

Chicken cutlets

Ingredients:

• white chicken meat - 150g;
• small onion - 1 piece;
• a slice of stale white bread;
• 1 egg.

Soak the loaf in milk. Make minced meat, bread, eggs, and onions. Add salt and form small cutlets. Bake for half an hour on a baking sheet with water at 220°.

Oat cookies

Ingredients:

• oatmeal - 2 cups;
• kefir or sour cream - 3 tbsp. spoons;
• egg - 1 pc (if you can’t, you can do without it);
• butter - 100g;
• sugar - 60 g;
• flour - ½ cup; a few grains of soda.

Grind the oatmeal and melt the butter. Mix. Finally, add soda, salt, and raisins as desired. Grease a baking sheet with oil and spoon out the dough.

Healthy recipes

A hypoallergenic diet for urticaria is not such a sad thing if you approach the process with imagination. Newly diagnosed allergy sufferers and their parents are faced with the problem of what to cook. We have selected recipes for delicious first and second courses with which you can start cooking safely.

We present only some recipes for the menu for urticaria in adults and children. It will be great if you share your recipes in the comments.

Soups

Soups are necessary for normal digestion and regular bowel movements. This is an effective prevention of constipation.

Beef broth with vegetables and rice

1. Prepare broth from lean beef.
2. Separate the meat into portions.
3. Add potatoes and rice and boil.
4. Chop the onion, curly cabbage, parsley, dill and add at the end of cooking.
5. For a child, the soup is filtered, ground in a blender, again poured with broth and boiled.

Potato soup

1. Sauté chopped onion in olive oil.
2. Add finely chopped potatoes there and simmer again.
3. Pour in a small amount of boiling water and simmer until done.
4. Drain in a colander.
5. Puree the vegetables in a blender.
6. Pour in broth.
7. Add parsley to taste.

Noodle soup with vegetables

1. Stew carrots, parsley root, and onions in a small amount of water.
2. Drain the water and chop the vegetables in a blender.
3. Return the broth to the vegetables, add more water (up to 0.5 l).
4. Add diced potatoes and boil until tender.
5. Add noodles, bring to a boil and turn off.
6. Add a piece of butter to the finished soup or add vegetable oil.
7. Before serving, sprinkle a bowl of soup with herbs.

Main courses, hearty sweets

The second courses are rich in vitamins and are very filling. These are food “energy drinks”.

Cheese sauce for pasta

1. Melt butter, 100 g.
2. Add cream 10%, 200 g.
3. Add 200 g of finely grated cheese.
4. Melt everything, stir, serve with pasta.

Apple sauce for pasta and cereals

1. Peel 2 apples and cut into pieces.
2. Simmer in a small amount of water until tender.
3. Mash with a masher to puree.
4. Add sugar, 1 tbsp. l.
5. Add cinnamon, 0.5 tsp.
6. Simmer again for 3-5 minutes.

Vegetable casserole

1. Chop the potatoes and onions into circles.
2. Place potatoes in layers on a greased baking sheet, then onions.
3. Cook cauliflower in salted boiling water.
4. Disassemble the cabbage into inflorescences and place in a third layer.
5. Bake until done.
6. You can sprinkle the dish with grated cheese, pour cream and bake in the oven for 5 minutes. It turns out super delicious!

Cottage cheese casserole

1. Mix cottage cheese, 200 g and low-fat sour cream, 200 g.
2. Add sugar, 0.5 tbsp. l. and rice flour, 100 g.
3. Stir in soda, 0.5 tsp, slaked with vinegar.
4. Line a baking tray with baking paper and pour out the mixture.
5. Bake for 40 minutes.