How to Treat a Seafood Allergy

Patient

Q: I have a severe allergy to shellfish - eating a tiny bite of something that was cooked with shellfish has sent me to the ER. My only reaction is constant vomiting. I literally can't move an inch without throwing up, and can't hold down a sip of water. It will last about a day when it happens. I don't swell up or have trouble breathing or anything like that, just vomiting and slight diarrhea. I'm going to be going to Asia soon and was wondering if an epi pen would stop this reaction if it occurred, or if there were other alternatives?

Doctor

A:   Adrenaline administered intramuscularly in the form of an Epi pen is generally reserved for severe anaphylactic or anaphylatoid reactions, which include symptoms of swelling tongue and lips, wheeze, difficulty breathing and acute bronchospasm. Even though you obviously have a food allergy to shellfish, I would not advocate the use of an Epi pen, without prior consultation with an immunologist. Seafood allergies are usually treated with an exclusion diet and vigilant avoidance of foods that may be contaminated with shellfish or fish ingredients and/or oils. The use of anti-histamines may help your symptoms but referral to an immunologist may also be appropriate in your case.

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