please help me interpret these allergy test results

[brightonwoman]

My son just had the skin prick allergy testing done. I know it can be flawed, but he has some issues (encopresis) and the doctor thought a food allergy might be part of the problem.

Problem is, I don't understand the allergy results well enough to understand what they truly mean.
Each thing he was tested on is rated for 'grade' 'wheel' and 'flare'--I realize this is rating the size/height of the bump where the thing was injected, but I don't have a sense of what the numbers mean.
For reference, the page says that 0= no reaction, 1= equivocal, 2= mild reaction, 3= moderate reaction, and 4-5=severe reaction. I *think* that is in reference to the 'grade' but I don't know!! Help!!
His positive control rated grade 3, wheel 5mm, and flare 10mm. So, does that mean that a reaction with smaller numbers is too small to worry over? All his reactions have a grade of 1-2, and a wheel of 4 at most, As I'm understanding it, those are mild reactions...but if he consumes the food daily then even a mild allergy could cause severe problems, is that correct?

He had reactions to wheat, egg, soy, and pork. I feel like the soy and pork aren't an issue because we already avoid those, and his grade was only 1-2, so I don't think he consumes enough to create the problems we're seeing.
The wheat is harder but I'm starting to go GF myself so I can take him off wheat too--if it's going to be worth it (it was rated grade 2 and wheel 4mm, flare 0). He'll fight it like crazy because he loves breads. Going egg-free would be tough too, as we use a lot of eggs (also rated grade 2, wheel 4mm). So I guess what I'm trying to understand here is whether these are reactions are serious enough to invest in the fight of eliminating them with him. He is a food sneaker (whole other issues there) so this could really be hard.

Thank you for whatever help you can give me. I am brand new to food allergies, I've never had this done before, and I'm feeling pretty overwhelmed!

[sbgrace]

So the allergist told you he was positive to wehat, egg, soy, and pork--is that right?

There is a 50% false positive rate for allergy testing of foods. So negative results are more accurate than positive. If there is question (say the child is eating the food without reaction or the positive is mild for example) the allergist should do follow up testing. This might be a blood test (immunocap RAST) or the gold standard for allergy testing is a food challenge.

If you have reason to believe he's not allergic I would want to food challenge personally. If he's actually allergic (mild or not) you avoid the food. So whether he's allergic is important to determine.

Soy is sometimes a trace contamination issue. He may or may not be avoiding based on your eating habits, supplements, etc.

For the egg and wheat you need to figure out if he's actually allergic. If he is avoiding is certainly worth it. Are you seeing reactions though? I'm not sure what precipitated the testing in general or those foods specifically?

Egg and wheat can certainly be avoided but there is no reason to do that if he's not allergic. Your wheel size doesn't predict strength of response or allergy reactions so forget that. If he was positive (your allergist should have told you that) you need to figure out if they were false positives essentially.

[mamafish9]

I know very little about allergy tests, but lots about constipation. If you give a little more information about that (is he just withholding at this point, how frequently does he poop, are the poops soft or hard), and what you've tried, the mamas here may be able to help with that (eliminating allergic foods is a good start, but as you figure those out, there are other things to try as well).

[DevaMajka]

Originally Posted by brightonwoman

So I guess what I'm trying to understand here is whether these are reactions are serious enough to invest in the fight of eliminating them with him.

I'm not experienced with this, but I'd imagine that ANY positive would be worth cutting out of his diet. I think that the reaction on the test is not always accurately indicative of the severity of the reaction IRL.

If you are worried about making too drastic of a change, you could try taking out one first. That would prolong it, though, so you'd have to weigh whether you want to get it over with quickly or not. Also bear in mind that you might see a major improvement in just a few days, so the whole thing might not take very long if you do it all at once, kwim?

How old is your ds? Is he old enough to understand a little bit if you explain it to him? Could you buy some rice bread, or perhaps get him some special treats that he doesn't usually have, to make up for the loss of the wheat and eggs?

[brightonwoman]

DS is 10, so he's absolutely old enough to understand...at least when we have a conversation about it. However he has some other issues with maturity/social responsiveness/applying knowledge to real life (he's currently in counseling and occupational therapy for all this). In other words, even though he knows that we always have food in the house, or that we need to eat dinner before treats, or that ___ is bad for him, he will sneak food out of the kitchen and eat it on the sly, or stash things in his room/school bag. He has very little impulse control, and doesn't take into consideration the things that he knows before he acts.
SO, we could talk about it all day, but for the present at least if he's actually going to be free of any given allergen, it's going to have to be me and dad making it happen, because DS won't (or can't, I don't know...so many issues going on with him...)

I didn't know there was that high a false positive for allergies. I agree that elimination makes sense, and since I'm in the midst of trying to go GF myself (I have my own new diagnosis...whole other story), so I can take him off wheat with me because I'm more or less taking the family off wheat...I think I can keep it up for everybody for a couple of weeks (they're not going to all stay GF with me), but hopefully that would be enough to see whether there's a difference or not.
The eggs though, WAY overwhelming.

In regard to the encopresis--basically he poops his pants almost every day. The official explanation of encopresis is that they withold their poop (probably initially because of constipation or painful pooping, but then out of habit and it becomes unconscious). Over time, since they never release the poo voluntarily, it backs up, the bowel becomes distended, extreme constipation ensues, and then there is slippage...in other words, the colon fills up so much that it overflows and they poop without warning (and, in DS's case, without his being aware that he's doing it). The standard course of treatment is to increase fiber or use laxatives to get things moving, and establish a routine of regularly sitting on the toilet so that there's a chance to go. Most kids are over it within a few months or a year.
In our case, in spite of daily fiber and a toileting routine for the 18m since diagnosis, DS continues to poop his pants almost every day, sometimes multiple times a day. (Did I mention he is 10? I believe there are psychological issues compounding all of this physical stuff BUT if there's an allergy here that's part of the puzzle then I'll go for it because clearly he needs all the help he can get.)
ANYWAY, we went to see the doctor about the encopresis...he did a physical examination to ensure that there's not a sensory issue, and then suggested that a food allergy might be affecting DS's regularity and thus his control...so we did the allergy testing. I have not seen anything that I would have thought to blame on a food allergy, but if he is indeed allergic then who knows, any number of his 'normal' behaviors might be allergy related. We've never gone down this road before.

In regard to his actual poops--when he'll stay on the toilet long enough to go there--he'll go once a day and usually make one massive huge log. (DH and I have actually joked that DS may be the one male in the world who can understand what it feels like to give birth.) Anyway, they are very formed, so I'm presuming that they are pretty firm...and astoundingly foul smelling too. His accidents are usually small, but he may have several in a day (even if he's gone in the toilet that day). They also smell very strong.

[brightonwoman]

oh, and I'm looking into healing allergies too (for both me and DS)--in both cases our tests indicate mild allergies, and I was talking with a friend today who does energy work and she was telling me about a seminair she'd been to talking about emotional basis for food allergies, and it really resonated for me...there are DEFINITELY things in DS's past that could have caused him to have very negative reactions to whatever was in his environment at the time, so I'm going to pursue that...but in the meantime, of course, he should be off anything that he's reacting to unless/until we can heal it.

[mamafish9]

Three ideas for the pooping, and some of the impulse & social pieces you describe as well.

The first is magnesium. I'd be supplementing at least 300mg/day (unless that much gives him diarrhea), more if it seems to be helping. Use any form except mag oxide (doesn't absorb well) - I like mag glycinate best, many use mag citrate as well. Ideally split into two doses. I do one in the morning 30 min before food, one in the evening. Give away from dairy or other calcium as well.

If he is mag deficient, you'll likely notice changes within 3-4 days. Mag deficiency is common, and can affect a huge realm of behaviors - pooping and impulse control are both classic.

The second is GABA. It's a calming neurotransmitter, but it also helps cause the muscle contractions in the gut that cause pooping. It also impacts social responsiveness type issues (my son is autistic, in case you wonder where I get all this random info from ). It's been hugely helpful in getting my son on a regular poop schedule.

What you'd be looking for is pooping at least once a day, probably more often, with more normal smells (the size & smell suggest that he's probably backed up quite a few days, even if he's pooping regularly).

Longer term, especially if the foul smell doesn't resolve, I'd look at digestive enzymes and pancreatic support. Being in Alaska, the first of those to consider would be vitamin D...

[brightonwoman]

thank you for the tip on the magnesium--that is something we can start immediately (and he will take pills, even where he'll fight the fiber or the diet changes).
We all take cod liver oil already, the vitamin D is definitely a concern here.