Food-Dependent Exercise-Induced Anaphylaxis, or FDEIA, is a very rare type of allergic reaction that affects teens and adolescents more than children. The opposite is true of food allergies, which effect more children than any other age group. A person with FDEIA has the extreme allergic reaction called anaphylaxis only after consuming an allergen and then exercising immediately after eating. Neither the food nor the exercise alone causes the reaction. Although rare, this allergy is serious and life-threatening and should be taken seriously.
Anaphylaxis is a serious, but not uncommon, reaction to an allergen. Many children, and even some adults, experienced the scary symptoms of swelling in the face, tongue and throat, constricted airways, difficulty breathing and others that come with anaphylaxis. This reaction can be caused by any food allergen, and if not treated quickly it can be fatal. A dose from an epinephrine injector followed by emergency medical care is the appropriate treatment.
Although we often think of it as a reaction to food allergens, some people also experience anaphylaxis after exercising. EIA is a rare condition, but the symptoms are every bit as serious as those seen in people reacting to food allergens. Unlike those with food allergy-induced anaphylaxis, someone with EIA may recover from the scary symptoms by stopping the physical activity that triggered it. This isn’t always the case and sometimes epinephrine and emergency care are needed. Any kind of exercise may trigger the reaction, but more vigorous activities like running or jogging are most often implicated.
Food-Dependent Exercise-Induced Anaphylaxis
Even rarer than EIA is a subset of the condition that combines food allergies and EIA. If you have this condition you will likely never experience anaphylaxis from just exercise or from exposure to an allergen only. The reaction occurs when you consume the particular allergen that affects you and then exercise. Any food allergen could be a trigger, but the most common culprits are wheat, tomatoes, shellfish, peanuts and corn. Other triggers noted in case studies include soy, peas, rice, beans, fruits, seeds and milk. Case studies have also shown that there are variations to FDEIA. Some individuals experience anaphylaxis after eating anything followed by exercise, while another experienced EIA after inhaling mold spores from contaminated food.
According to limited research done on Food-Dependent Exercise-Induced Anaphylaxis, one possible answer to why the combination of food allergen and exercise causes anaphylaxis is related to how physical activity affects digestion. Exercise slows the excretion of gastric acid in the stomach, which in turn slows the rate of digestion. In this way exercise may allow the food allergen to stay intact in the digestive system longer, giving it more time to be absorbed into the blood stream and to have an effect on the immune system and cause a reaction.
Living With FDEIA
As with other food allergies, Food-Dependent Exercise-Induced Anaphylaxis is most effectively treated with prevention. For instance, if you know you have FDEIA triggered by wheat, you can avoid physical activity for a few hours after you eat anything with wheat in it. Of course, this is easier said than done, especially if you don’t know that you have the condition.
This is an easy condition to overlook, as a teen may be able to eat wheat, for instance, or exercise, without having a reaction. It can be challenging to make the connection between the two and to realize that the combination of the food and exercise is what causes anaphylaxis. If your child ever has such a reaction after exercise, try to identify what he or she ate before the activity. Your doctor or a specialist can help you try to figure it out, but unfortunately you may never realize there is an issue until your child experiences anaphylaxis.
Once you do know that your child has FDEIA, practice prevention, but also be prepared with epinephrine injectors. Make sure you have them available everywhere your child spends time and that all adults responsible for him know how to use them. Treating Food-Dependent Exercise-Induced Anaphylaxis is possible, but prevention is better.