What is angioedema?

The meaning of angioedema (also known as Quincke’s edema or angioneurotic edema) is a swelling that occurs rapidly in the deep layers of the skin:

  • Dermis,
  • Subcutaneous tissue,
  • Mucous membranes,
  • Submucosa.

It is similar to urticaria , but the latter occurs only in the upper part of the dermis. 
Almost half of the patients have both urticaria and angioedema.

Due to the risk of suffocation, a rapid progression of angioedema is considered a medical emergency. 
When angioedema is the consequence of an allergic reaction, epinephrine(adrenaline) is injected into the patient. 
Your doctor may prescribe:

  • Antihistamines medications,
  • Corticoids in tablet form.

The accumulation of fluid (edema) can be severe and can affect any part of the body, especially:

  • Hands,
  • Foot,
  • Genitals,
  • Arms,
  • Legs,
  • Face.

Facial angioedema affects the face, especially the eyelids and lips.


Types of Angioedema – Classification

There are four main types of angioedema:

Hereditary angioedema – the patient inherited an abnormal gene. 
It is very rare that urticaria occurs along with this type of angioedema. 
This is the weirdest kind. 
Blood levels of C1-esterase inhibitor (C1-INH protein) inhibitors are low. 
The C1-INH protein plays a key role in regulating our immune system. 
In this type of angioedema the symptoms develop gradually and occur until the first 20 years. 
In women, they may worsen due to:

  • Pregnancy,
  • Birth control pills.


Acquired angioedema

Acute allergic angioedema – the most common type and affects people with a food allergy. 
It can also be caused by:

In the case of  angioedema in the pharynx, the throat and glottis may swell; therefore, it is difficult for the patient to breathe. 
If angioedema affects the mucous membranes , it is possible to have an even severe bowel swelling, which can cause an intestinal blockage . 
There may also be a sudden drop in blood pressure. 
A severe allergic reaction like this is known as anaphylaxis . 
This type of angioedema is not chronic (for a long time) because the individual soon identifies the food or substance that caused the allergic reaction and then tries to avoid it. 
It usually affects children and young people more.

Drug-induced angioedema – non-allergic.  Some medicines can cause deep swelling of the skin layers at the peripheral level, for example angiotensin converting enzyme inhibitors ( ACEIs ) that are used to treat hypertension (eg, Triatec ® -Ramipril). 
Symptoms may remain for a few months after the patient stops taking the medication. 
Less commonly, this type of angioedema can be caused by:

  • Bupropiona,
  • Serotonergic antidepressants,
  • Anti-inflammatory drugs COX 2 selective inhibitors,
  • Drugs Non – steroidal anti-inflammatory ,
  • Statins,
  • Inhibitors of the proton pump.

Angioedema caused by medication is rare.


Idiopathic idiopathic angioedema means that we do not know the specific cause.

Idiopathic angioedema is:

  • Chronic,
  • Recurrent.


Causes of Angioedema

Angioedema can be caused by an allergic reaction . During the reaction, histamine and other chemicals are released into the bloodstream. 
The body releases histamine when the immune system detects a foreign substance, called an allergen. 
In most cases, the cause of angioedema is not found.

Causes of angioedema can be:

  1. Animal hair;
  2. Exposure to water, sun, cold or heat
  3. Food (eg, clams, fish, nuts, eggs and milk)
  4. Insect bites
  5.  Medications such as antibiotics (penicillin and sulfonamides), non-steroidal anti-inflammatory drugs (NSAIDs), and blood pressure medications (ACE inhibitors)
  6. Pollen.
  7. An infection ,
  8. Anxiety ,
  9. Stress ,
  10. Hot,
  11. Caffeine,
  12. Wear tight clothing,
  13. Alcohol .

The cause can also be:

Urticaria and angioedema may also occur after an infection or other illnesses, including an autoimmune disease such as:


Symptoms of angioedema

The main symptom is sudden swelling under the surface of the skin. 
The swelling usually occurs around the eyes and lips. 
It can also be found in the throat, ears, hands and feet. 
The swelling of the skin (or blisters) can be spread or formed along a line.

Rashes may also develop on the surface of the skin. 
The rash is painful and can be itchy ( itching ). 
This is known as hives. 
If the swelling caused by angioedema is deep, it can be painful.

Other symptoms may include:


Diagnosis of angioedema

Tests and tests
The doctor examines the skin and asks the patient if they have been exposed to irritants. 
If the throat is affected, a physical examination may reveal abnormal (stridor) sound when breathing. 
The doctor may perform blood tests or allergy tests.

Your doctor can help you identify foods that cause allergic reactions:

1. Assessing detailed information on patient feeding; 
2. Doing skin examination for allergies; 
3. Observing the changes in symptoms when excluding foods from the diet one at a time. 
The doctor controls the reactions when slowly reintroducing food one at a time.

For example, Basedow-Graves disease can cause eyelid edema, so it is necessary to consider this disease in the differential diagnosis.


Treatment for angioedema

For mild symptoms a treatment may not be necessary. 
Moderate or severe symptoms should be treated. 
Difficulty breathing is a medical emergency. 
People with angioedema should:

1. Avoid known allergens or triggers that cause the symptoms; 
2. Avoid medications, herbs or supplements that are not prescribed by a doctor; 
3. Cold compresses can relieve pain.

Medications used to treat angioedema include:

1. Antihistamines, for example Diphenhydramine (Benadryl); 
2. Cortisone medicines, for example Betamethasone (Celestone); 
3. Injections of epinephrine or adrenaline (people who have had severe symptoms may always have the syringe with them); 
4. Inhalation medicines that help open the airways; 
5. Ranitidine (Antak).

If the person has difficulty breathing, seek medical attention immediately. 
If the throat swells, a dangerous obstruction of the airways may occur.


Diet and feeding for hereditary or acquired angioedema

Some foods can cause angioedema in people who are allergic. 
It is necessary to eliminate any food or food additives that trigger the symptoms. 
Here are foods that cause exacerbation more often:

1. Fruits of the sea 
2. Ready-made lyophilized broths (because of sodium glutamate) 
3. Fruits in shells (nuts, almonds, peanuts) 
4. Eggs 
5. Chocolate 
6. Milk 
7. Wild 
fruits 8. Citrus fruits.

Some people may have a reaction in response to: 
1. Sulfites – used as antioxidants or preservatives in many foods and beverages; 
2. Tartrazine (dye composed of granules and yellow crystals containing sulfur) – those who are allergic to aspirin or other NSAIDs are more likely to have an allergy to tartrazine.

In case of intestinal symptoms like belly pain , vomiting , diarrhea or loss of appetite, it is recommended to try a diet that eliminates the most frequent triggers, even if the person does not suffer from a specific food allergy.


Natural diets

The change of diet is not easy, but the food that the person eats can cause almost all diseases, especially the chronic ones. 
So many people are changing their diet because they have seen that their medications can not resolve their illnesses. 
A natural diet and lifestyle have given excellent results for patients with angioedema. 
The following diets are the most effective based on the experience of my patients and acquaintances:

  • Blood Type Diet,
  • Vegan diet with at least 50% raw food,
  • Dieta Paleo.

These types of natural therapy do not allow the ingestion of:

  • Medicines,
  • Supplements

The food should be composed of natural products and not:

  • Processed,
  • Transformed
  • Preserved

The right food combinations should be respected because when a person eats different foods in the same meal, the digestion gets much slower. 
The consequences are: fermentation and intestinal putrefaction; thus, toxins accumulate:

  • No intestine,
  • In the blood.

Lifestyle should not be sedentary because physical activities and sweat help to detoxify the body.


Supplements for angioedema

Supplements can help treat the symptoms:

The Vitamin C may help reduce histamine levels, though not sufficient evidence. 
Reduce the dose in case of  diarrhea .

Vitamin C supplements may interact with other medicines, including:

  • Chemotherapy drugs,
  • Estrogen,
  • Coumadin and others.


Natural Remedies for Hereditary or Acquired Angioedema

Taking herbs is a “classic” approach to strengthening the body and treating the disease. 
Herbs can cause side effects and can interact with other herbs, supplements or medications. 
For these reasons, one should take the herbs carefully under the supervision of a physician.

The Goldenseal  (Hydrastis canadensis) was used for gastrointestinal symptoms such as:

Some health care professionals may recommend hydraste (yellow root) for people with food allergies in order to prevent or reduce allergic reactions.

The hydrates interact with various medications, including:

  • Cyclosporine,
  • Anticoagulants

It can also lower blood sugar levels. Consult your doctor before taking the hydraste if you take any other medicine or if you have diabetes .

Licorice root  (Glycyrrhiza glabra) has traditionally been used to reduce inflammation in case of allergic reaction. 
It can improve the health of the immune system.

Do not eat licorice if you have:

Licorice interacts with various medications; so to be sure, be sure to consult your doctor before taking licorice along with other medications.

Chamomile (Matricaria recutita) has been used traditionally to treat hives, although there is no scientific evidence that it works. 
Chamomile may increase the effects of other sedatives. 
It also interacts with other medications. People with allergy to ragweed should not take chamomile.


Prognosis and possible complications of hereditary or acquired angioedema

If angioedema affects the throat, the person’s airway may become blocked and this can be dangerous. 
In rare cases, angioedema and anaphylaxis may develop. 
These symptoms should be treated immediately to maintain breathing, blood pressure and cardiac function.