Contents
What is angioedema?
Angioedema (also called Quincke’s edema or angioneurotic edema) is a swelling that occurs quickly in the deep layers of the skin:
- Dermis
- Subcutaneous tissue
- Mucous
- Submucosa
It resembles urticaria (hives), but this only develops in the upper part of the dermis.
About half of patients have both urticaria and angioedema.
Due to the risk of suffocation, a rapid increase in angioedema is considered a medical emergency.
If the angioedema is the result of an allergic reaction, then the patient is injected with epinephrine (adrenaline).
The doctor may prescribe the following remedies:
- Antihistamines
- Corticosteroids in tablet form.
Fluid accumulation (edema) can be severe and affect almost all areas of the body, especially:
- Hands
- Feet
- Genitalia
- Arms
- Legs
- Face.
Fascial angioedema affects the face, especially the eyelids and lips.
Types of angioedema – Classification
There are four main types of angioedema:
Hereditary angioedema – the patient has an inherited abnormal gene. It is very rare for urticaria to occur along with this type of angioedema.
This is the rarest species.
Blood levels of the C1 esterase inhibitor (C1-INH protein) are lowered.
The C1-INH protein plays a key role in regulating our immune system.
With this type of angioedema, symptoms develop gradually and appear within the age of 20.
In women, it can be aggravated by:
- Pregnancy
- Contraceptive pill.
Acquired angioedema
Acute allergic angioedema – is the most common type and affects people with an alimentary allergy.
It can also be caused by:
- insect bites,
- Contact with latex.
With laryngeal angioedema, the neck and epiglottis may swell. This makes it difficult for the patient to breathe.
If angioedema affects the mucous membrane, severe intestinal swelling is also possible, which can lead to intestinal obstruction.
There may also be a sudden drop in blood pressure.
A severe allergic reaction like this is called anaphylaxis.
This type of angioedema is not chronic (long-term) because the person can usually very quickly identify the food or substance that caused this allergic reaction and will therefore avoid it.
In general, children and adolescents are more likely to be affected.
Drug-indicated non-allergic angioedema – some medications can cause swelling in the deep layers of the skin peripherally, for example, angiotensin conversion enzyme inhibitors (ACE inhibitors), which are used in the treatment of high blood pressure (for example, Delix® – ramipril).
Symptoms may persist for a few months after the patient stops taking it.
Less commonly, this type of angioedema occurs due to:
- Bupropion,
- serotonergic antidepressants SSRIs,
- selective anti-inflammatory drugs of the COX-2 group,
- non-steroidal anti-inflammatory drugs,
- statins,
- Proton pump inhibitors.
Idiopathic angioedema – idiopathic means that the exact cause is unknown.
Idiopathic angioedema is:
- chronic
- recurrent.
Causes of angioedema
Angioedema may be caused by an allergic reaction. In this reaction, histamine and other chemical substances are released into the bloodstream.
The body releases histamine when the immune system recognizes a foreign substance called an allergen.
In most cases, however, no cause is found.
Possible causes of angioedema:
- Animal hair
- Contact with water, sun, cold or heat
- Food (e.g. seafood, fish, nuts, eggs and milk)
- Insect
- Medications such as antibiotics (penicillin and sulfonamides), anti-inflammatory drugs (NSAIDs), and arterial hypertension medications (ACE inhibitors)
- Pollen
- Infection
- Anxiety or stress
- Caffeine
- tight clothing
- Alcohol
Causes also include:
- Problem of the thyroid gland (hyperthyroidism, hypothyroidism, thyroiditis )
- Liver disorder
- Iron deficiency
Urticaria and angioedema can also occur after infection or after other conditions, including autoimmune diseases such as:
Symptoms of angioedema
The main symptom is a sudden swelling under the surface of the skin.
The swelling usually occurs in the area of the eyes and lips.
They can also be found in the throat, ears, hands and feet.
Swelling of the skin (or blister) may be diffuse or along a line.
Rashes may also appear on the surface of the skin.
The rash is painful and may itch (cause itching).
This is called urticaria.
If the swelling of angioedema is deep-seated, it can be painful.
Other possible symptoms include:
- Abdominal cramps
- Breathing difficulties
- Mouth and eye swelling
- Swelling of the conjunctiva (chemosis)
Diagnosis of angioedema
Tests and examinations
The doctor examines the skin and asks the patient if he has been in contact with irritants.
If the neck is affected, a physical examination may reveal unusual sounds when breathing (stridor).
The doctor may order blood tests or allergy tests
The doctor can help identify the foods that cause the allergic reaction:
- by evaluating the patient’s detailed description of nutrition;
- by taking skin tests for allergies;
- by evaluating the changes in symptoms after gradual omission of foods in the diet; the doctor checks the reactions as these foods are gradually reintroduced into the diet.
For example, Graves’ disease can lead to eyelid edema. Therefore, this disease should be considered as a differential diagnosis.
Therapy of angioedema
In case of mild symptoms, no therapy is required.
Moderate or severe symptoms should be treated.
Breathing difficulties are a medical emergency.
People with angioedema should:
- avoid known allergens or triggers that cause the symptoms;
- avoid medications, herbal products or supplements that are not prescribed by a doctor;
- attach cold compresses, they can bring relief from pain.
Medications
Medications for the treatment of angioedema are:
- antihistamines (for example, Zyrtec or Reactins);
- cortisone-based drugs (Betnesol);
- injections with epinephrine or epinephrine (people who have already had serious symptoms may carry spray material with them);
- drugs for inhalation, which are used to open the airways;
- Ranitidine (Zantic).
If the person has difficulty breathing, a doctor must be consulted immediately.
If the throat swells, a dangerous narrowing of the airways can occur.
Diet and nutrition for congenital or acquired angioedema
Some foods can cause angioedema in people who have an allergic reaction.
One should avoid foods or supplements that cause the symptoms.
Here are the foods that often cause an acute occurrence:
- Seafood
- Bouillon cube (because of the sodium glutamate)
- Nuts and almonds
- Eggs
- Chocolate
- Milk
- Fruits
- Citrus fruits
Some people may develop a reaction to:
- Sulfites – found as antioxidants or preservatives in many foods and beverages;
- Tartrazine (dye made from sulfur-containing granules and crystals) – People who are allergic to aspirin or other anti-inflammatories are more likely to have a tartrazine allergy.
In case of intestinal symptoms such as abdominal pain, vomiting, diarrhea or loss of appetite, a diet that avoids the most common triggering factors is recommended, even if there is no specific food allergy.
Natural diets
It is not easy to change the diet, but the food we eat can cause almost all diseases, especially the chronic ones.
Many people have changed their eating habits because they found that the drugs could not cure their illnesses.
A natural diet and lifestyle have shown excellent results in patients with angioedema.
According to my patients and acquaintances, the following diets are the most effective:
- Blood type diet
- Vegan diet with at least 50% raw food content
- Stone Age diet (Paleo diet)
These types of natural treatment do not allow you to take:
- Medicines
- Food supplements.
The diet must consist of natural products, without:
- Processing
- Transformation
- Preservation.
The correct food combinations must be observed, because if different foods are taken together in one meal, digestion becomes much slower.
The consequences are: intestinal fermentation and putrefaction, with accumulation of toxins:
- in the intestines,
- in the blood.
Lack of exercise should be avoided, because physical activity and sweat detoxify the body.
Supplements
Supplements can help treat the symptoms:
Vitamin C can help lower histamine levels, although there is insufficient evidence to do so.
If diarrhea develops, the dose should be reduced.
Vitamin C supplements may interfere with other medications, including:
- Chemotherapy
- Estrogens
- Coumadin and others.
Natural remedies for congenital or acquired angioedema
Taking herbs is a “classical” approach to strengthening the body and treating the disease.
Herbs can trigger side effects and interact with other herbs, supplements, or medications.
For these reasons, herbs should be taken with caution and under the supervision of a doctor.
Golden sealwort (Hydrastis canadensis) has been used for gastrointestinal ailments such as:
- stomach pain,
- Diarrhoea
- loss of appetite,
- severe allergic reactions.
Some health professionals recommend golden sealwort for people with food allergies to prevent or reduce allergic reactions.
Golden sealwort interacts with various medications, including:
- cyclosporine,
- Blood thinners.
It can also lower sugar levels in the blood. Before taking gold sealwort, one should consult the doctor if one is taking any other medicines or has diabetes.
Licorice root (Glycyrrhiza glabra) has always been used to reduce inflammation in allergic reactions.
It can support the health of the immune system.
However, one should not consume licorice if the following diseases are present:
- high blood pressure (arterial hypertension), erectile dysfunction, edema or heart failure;
- hormone-sensitive tumors such as those on the breast, prostate, ovary or uterus;
- Diabetes;
- Kidney disease;
- Liver.
Licorice reacts with various drugs. So, to be on the safe side, one should consult the doctor before taking licorice along with other medications.
Chamomile (Matricaria recutita) has always been used in the treatment of urticaria, although there is no scientific evidence of its effectiveness in this regard.
Chamomile can enhance the effect of other sedatives.
It also interacts with other medications. People who are allergic to ragweed should not consume chamomile.
Prognosis and possible complications of congenital or acquired angioedema
If the angioedema affects the throat, the person’s airways can become blocked and this could be dangerous.
In rare cases, angioedema and anaphylaxis may develop.
These symptoms need to be treated immediately to keep the airways clear and blood pressure and heart function stable.
- Urticaria or hives and itching in children
- Acute pulmonary edema
- Urticaria or hives: treatment and diet
