Most people with LPR require medical therapy with  drugs that reduce the amount of acid produced by the stomach. A class of drugs  known as the proton pump inhibitors are the most effective, and includes omeprazole which is a non-prescription medication, and the prescription medications Nexium, Aciphex, Protonix and Prevacid.  Unlike classic acid reflux, LPR requires medication twice daily to turn off acid production for a full twenty-four hours. Medical treatment must be continued  indefinitely, unless lifestyle changes have a major impact on symptoms. Even with medical therapy, improvement is sometimes not seen for three to six months. Some patients require multiple medications including motility agents to control symptoms. Refractory cases can be caused by a esophageal hiatus hernia, in which the valve between the stomach and esophagus leaks because it has slid above the diaphragm  into the chest. In these instances, endoscopic surgery or ablation of the lower esophageal sphincter can control reflux without medication.

Food Allergy refers to a specific type of syndrome caused by certain foods that is mediated by  allergy causing antibodies. Many adverse reactions to foods not caused by allergy are due to inability to digest certain components like lactose or gluten, the presence of toxins due to improper handling, or bacterial  contamination. The first step in treatment requires precise diagnosis. This is quickly accomplished by scratch testing the skin with fresh food extracts. Once the offending foods are identified, the mainstay of treatment is avoidance. The Food Allergy and Anaphylaxis Network is an Excellent source of information about  hidden sources of the foods that may be causing your allergies. It also offers alternative recipes for cooking without eggs, milk, wheat, soy and peanuts. For allergic reactions causing throat swelling, hives or respiratory difficulty, one should always carry an epinephrine syringe for emergency treatment  if food  is accidentally ingested. An Epi-pen should only be used for life-threatening allergic reactions. These are reactions that cause swelling of the throat and block the airway, and can be accompanied by wheezing, shortness of breath, low blood pressure and collapse.   Allergen immunotherapy is dangerous and ineffective for food allergy. New treatment on the horizon includes a medication that removes the food-allergy causing antibodies from the body, but this is still in the early clinical trial stage. IgG antibodies to food are of uncertain significance. Most authorities feel these antibodies are not pathogenic.

Stinging Insect Allergy requires treatment when it causes symptoms of hives, lip or tongue swelling, circulatory collapse, throat swelling or shortness of breath. A Large amount of swelling at the site of a sting is not a risk factor for the development of a generalized allergic reaction with a subsequent sting. A Large local reaction to a sting is caused by the destructive effects of venom on normal tissues. Venom contains enzymes that break down tissue, similar to the way your stomah breaks down meat and other foodstuffs. In adults, hives after a sting indicates there is  risk of a systemic or generalized allergic reaction to future stings. In children however, hives alone is not associated with higher risk of a more serious reaction with the next sting. Desensitization is very effective for allergy to venomous insects. Almost all people successfully completing a course of desensitization are all protected from life threatening reactions.  Desensitization is accomplished is a manner similar to environmental allergens. In general, increasing amounts of venom are injected until the equivalent of two sting can be tolerated without a reaction. Rush protocols that decrease the time between shots are used during the months when there is a higher probability of a sting and to achieve protection sooner. Those at high risk can be desensitized in several weeks using certain protocols.

Allergic Contact Dermatitis (ACD) is a skin reaction to substances that are normally harmless to most people. The eyelids, face, neck and hands are the  most common areas involved, primarily because they are most frequently in contact with foreign substances. ACD can become chronic if the offending substance is not identified. It is common not to be able to  determine the cause of the rash because it usually does not appear  until a week after contact. By then, then contactant may be forgotten.  Fortunately, patch testing can find the allergy causing substance. Complicating identification of offending substances are labeling laws that require listing only ingredients comprising more that one per cent of the product. Finding the these low-level exposures may require vigilance. Consequently,  all personal care products should be screened for the potential to cause allergy as they may unknowingly be part of the problem. Treatment of ACD is the same as atopic dermatitis.  For specific substances and how to avoid them, click here.