Food Allergy

Food Elimination in the Management of Refractory Chronic Rhinosinusitis: A Pilot Study

BACKGROUND

Chronic rhinosinusitis (CRS) is one of the most commonly reported chronic diseases. Refractory CRS represents a subgroup of patients who continue to be symptomatic even after adequate medical and surgical therapy. These patients started to form a significant portion of patients with CRS. Food elimination as a therapeutic method to control symptoms of different chronic diseases, such as eosinophilic esophagitis, asthma, and atopic dermatitis, has been described in the literature with variable success rates.

OBJECTIVES

To evaluate the effectiveness of food elimination therapy as adjuvant treatment in refractory patients having CRS with positive food sensitization.

DESIGN

Prospective open-label study.

SETTING

Tertiary academic center.

METHODS

Consecutive adult patients with refractory nonobstructive CRS (patients who had persistent sinonasal symptoms despite endoscopic sinus surgery and patent sinuses ostia with adequate medical treatment) with positive food sensitization were included. Subjects were asked to eliminate the sensitized food from their diet. Clinical outcome was assessed using the Lund-Kennedy symptom and Lund-Kennedy endoscopic appearance scores.

RESULTS

Twenty-two patients were initially enrolled in the study. Six patients were excluded; 4 were lost to follow-up, and 2 did not eliminate the causal food for the required period. The average age of the patients was 36 years old. There were 10 female and 6 male patients. Nasal discharge and facial pressure were the most common presenting symptoms. Shellfish, egg, and meat mix were the most common eliminated foods. There was a significant difference in the patients' Lund-Kennedy symptom and Lund-Kennedy endoscopic appearance scores at 6 and 12 weeks after food elimination therapy.

CONCLUSIONS

Food elimination in refractory CRS is an effective adjuvant treatment and should be considered in the treatment algorithm of patients with persistent symptoms after successfully performed sinus surgery.

Food allergy and food intolerance knowledge of foodservice workers in Hungarian schools

To provide food for children with food allergy or food intolerances represents an increasingly important role in school catering services. The number of children with food intolerances is growing continuously; therefore, it is necessary to improve the knowledge of foodservice workers, who are responsible for food provision in school catering units in relation with food intolerances, food allergies. The main goal of our research is to assess and analyze the knowledge of food service workers and food handlers on food intolerances and to determine those factors, which may influence their knowledge. Our research was conducted by using paper and pencil questionnaires. The mean of test results was 89,16% while deviation was 12,26%. There were no correlations between the test results and respondents”™ education level, age group and the number of years working in food catering sector, and only partial correlation was detected with the job of the respondents. Based on the answers the food handling techniques of diet foods represented the poorest results. Our findings proved that the knowledge and food handling practice of food handlers regarding food intolerances and the preparation of diet meals should be improved.