If people with asthma and a history of allergies that have been going on for many years, as well as those who are often exposed to "sensitive stomach" prejudices, develop shortness of breath during meals, a rash on their face, or sudden abdominal cramps and subsequent diarrhea attacks, they may have accidentally been exposed to one of the triggers contained in the food. It is necessary to think. But figuring out which trigger it is can be difficult. If so, we should consider the possibility of sulfite sensitivity
WHAT IS SULFITE SENSITIVITY?
Food additives are used to increase the shelf life of foods and prevent them from spoiling. Food additives are added to foods to increase their durability or to give them the desired taste, consistency or color. Additives added to food products are labeled either with their own names or with the ̎E ̎ code given to them by European countries. Food preservatives (E-codes 200 - 299) placed in foods are included on the labels. The number of food preservatives and food additives is increasing day by day, one of them is sulfite compounds.
Sulphites contained in food preservatives can naturally be found in some fruits and vegetables or can be added to some foods as food additives. Although rare, some people (according to the FDA, approximately 1 in 100 people in the USA) are sensitive to these compounds.
Sulphites are sometimes used as preservatives in beverages, foods, and sometimes medicines. Reactions due to sulfites may occur with symptoms of food intolerance or may increase asthma symptoms due to underlying asthma. Apart from this, it can sometimes cause allergic rhinitis (hay fever)-like reactions, sometimes skin complaints such as urticaria (hives) and contact dermatitis, and in very rare cases, it can cause life-threatening reactions such as anaphylaxis (serious allergic reactions).
Containing sulfites. The most common complaint when foods are taken is the appearance of wheezing symptoms in asthmatic patients or the appearance of asthma symptoms in people who have not had asthma complaints before.
WHAT IS SULFITE?
Sulphite, when used as food additives, sodium or potassium bisulfite. , sod He defines it with names such as yum or potassium sulphide and sulfur dioxide. Sulfites, which have been used for many years, are mostly used to preserve the flavor and color of foods, prevent the proliferation of bacteria, reduce spoilage, prevent fresh foods from becoming discolored, stained or brown, as well as to help preserve medicines and extend shelf life.
Sulfites, which help preserve food and medicines, then release the active ingredient sulfur dioxide, and it has been observed that this resulting compound can cause narrowing of the bronchi in the lungs.
Occupational exposure to sulfur dioxide (SO2) is more common in cooling, disinfecting with steam. This may be the case in businesses such as mining, sugar refining, wool whitening and paper manufacturing. Exposure to sulfur dioxide (SO2) causes irritation to the eye and nasal mucosa in workers in these and similar lines of work. It has been observed that it causes serious problems in the airways, lung parenchyma tissue and vascular system in case of contact with high concentrations.
Sulfur dioxide (SO2) gas has been shown to have irritating properties in many studies. There are studies showing that sulfur dioxide gas in the airways changes the acid pH in the bronchi, stimulating the cholinergic reflex and causing a reflex contraction. The rapid onset of symptoms with the ingestion of liquid foods such as fruit juices, beer or wine indicates that sulfur dioxide (SO2) gas is released during the swallowing process.
In some people with asthma who react to sulfites, sulfite is the enzyme that helps break down sulfur dioxide. There is a partial deficiency of oxidase. A lack of this enzyme appears to cause damage because sulfur dioxide elimination is slow.
Sulphites have a useful role in helping preserve many foods and beverages. In most countries, adding sulfites to some foods, such as beer and wine, is allowed.
Below are the foods where we are most frequently exposed to sulfites.
In Beverages Liquor, Some fruit juices and instant tea contain sulfites. Sulfites are used in beer making and to prevent wine from turning into vinegar. used for k; Many wines have the phrase "contains sulfites" on the label.
Beverages such as beer and wine contain natural sulfites, but some manufacturers add sulfites to control fermentation. Among wines, red wines do not contain more sulfites than white wine; Both white and red wines contain sulfites. Many sweet white wines contain more preservatives than red because sweet wines contain more sugar. Sulfites prevent sugar fermentation. Therefore, sulfite sensitivity should be taken into consideration in patients who have complaints after drinking beer or wine.
Other liquids are included in foods and commercial products with a long shelf life, such as lemon juice, vinegar, grape juice.
Ready-to-consume foods mashed potatoes and foods containing mashed potatoes, canned fruits or vegetables, syrups and fruit sauces, salad dressing or fruit sauces, cherries, pickled cucumbers, maple syrup, jam, biscuits, bread. or cake or pizza dough.
Dried fruits, especially dried apricots and sometimes raisins, contain sulfites.
Sometimes sulfites are added to restaurant salads and fruit salads to preserve their color.
>It can be added to meat and meat products, especially sausages and processed foods.
Sulphites occur naturally in some foods, which pose an additional challenge to sensitive individuals. Peanuts, eggs, black tea, vinegar and other fermented foods naturally contain sulfites. Strawberries, blackberries, plums, coconuts and other fruits also contain varying amounts of natural sulfites. The sulfite in these foods may be in small amounts, but if eaten too much, it may cause complaints.
WHAT ARE THE SYMPTOMS OF SULFITE SENSITIVITY?
The symptoms that occur due to sulfite sensitivity are thought of as allergy, but sulfite sensitivity is different from allergy. In food allergies, IgE antibodies develop against proteins in foods and then an allergic reaction develops through these antibodies, whereas sulfite usually causes non-IgE-mediated reactions. Chemically, it is a salt of sulfuric acid, and the sulfur dioxide (SO2) gas formed is known to cause asthma complaints. Sulfite sensitivity in patients with asthma The risk of developing � is higher.
Very rarely, some people have been found to have a positive skin test to sulfite, which indicates a true (IgE-mediated) allergy.
Symptoms of sulfite sensitivity usually appear 15 to 30 minutes after eating. It begins and asthma-like symptoms such as shortness of breath and wheezing, urticarial rashes such as skin redness, facial swelling, or complaints related to the digestive system are observed.
Complaints such as wheezing, chest tightness and cough are the most common symptoms after sulfite ingestion. and is estimated to affect 5 to 10% of people with asthma. These complaints are more likely to occur in patients with inadequate asthma control. Sulfite sensitivity has been found to occur more frequently in patients with steroid-dependent asthma. However, adverse reactions to sulfites may also occur in people with no previous history of asthma.
Anaphylaxis due to sulfites has been described, but is very rare. Symptoms include whole body flushing, increased heart rhythm, wheezing, hives, dizziness, stomach upset and diarrhea, loss of consciousness, and difficulty swallowing. People with such complaints should carry an adrenaline injector with them.
Other complaints related to sulfites include nausea, indigestion, abdominal pain, diarrhea, constipation and vomiting, while skin rash or redness, itching and swelling are seen in the digestive system. or may cause urticaria. In studies on the frequency of skin reactions to sulfites, it has been reported that these additives increase skin sensitivity when used at a rate of 1-5%. Unwanted skin reactions have been reported after exposure to sulfite substances, especially when using cosmetics such as cosmetic creams used for the face, hair dyes and bronzing lotion.
HOW IS SULFITE SENSITIVITY DIAGNOSED?
After contact with products containing sulfites. Sometimes there are symptoms that we cannot understand, but they can be revealed if we pay attention. It has been noted that sulfites not only increase asthma complaints, cause urticarial rash and stomach complaints, but also may cause anaphylactic shock. It needs to be kept in mind and diagnosed.
There is no reliable test for diagnosing sulfite sensitivity and therefore the skin prick test has no place. Since the majority of sulfite-related reactions do not develop through IgE, skin prick tests are not used to make a definitive diagnosis.
Patch tests can be performed in patients with contact dermatitis-like complaints due to contact with sulfite. Skin reactions caused by products containing sulfites may be observed.
Oral provocation tests can be used to diagnose sulfite sensitivity, but it is recommended that these tests be performed by allergists as they may cause anaphylactic shock complaints.
Among the tests performed on blood. Screening tests such as specific IgE are not used to show sulfite sensitivity, but sulfite sensitivity can be detected with basophil activation tests performed on blood. Basophil activation tests can be helpful in diagnosing patients who are evaluated by allergists and are considered to be sulfite sensitive, and sulfite-related reactions can be clarified by evaluating them together with other tests.
HOW IS THE TREATMENT OF SULFITE SENSITIVITY?
When sulfite sensitivity is diagnosed, it is extremely important to stay away from foods containing sulfite. Since processed products may contain high amounts of sulfite, it is necessary to be careful and not use such products if it is written on the labels.
There is no proven treatment such as desensitization or immunotherapy to reduce the severity of sulfite sensitivity.
Sulphite. For relatively mild asthma symptoms, such as mild wheezing that occurs with the consumption of foods containing food, patients should carry with them symptom-relieving medications used in asthma. Those who have more serious reactions due to sulfites should receive training on the use of adrenaline autoinjectors used in the treatment of anaphylaxis and carry them with them.
AS A CONCLUSION
Sulphites are sometimes found in drinks, foods. It is used to prevent spoilage and sometimes as a preservative in medications.
Symptoms arising from sulfite sensitivity make one think of allergy, but sulfite sensitivity is different from allergy.
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