Specialty: Allergy and Immunology
Hospital Affiliation: Vassar Brothers Medical Center
The practice areas of allergy and immunology attracted David Resnick, MD, FAAAAI not only for their complexity, but for the gratification he derives from “taking someone who’s having difficulty breathing, and in a short amount of time, with proper education and medication, help them to breathe again.” Resnick was formerly director of Allergy and Immunology at the New York-Presbyterian Hospital of Columbia University, where, in 2006, he created the Food Allergy Center, using skin-prick and food-patch testing to evaluate a wide range of allergies.
You’re an expert in an allergic/immune condition called eosinophilic esophagitis, in which large numbers of white blood cells are found in the tissue of the esophagus. How did this condition end up on your radar?
When I was director of Allergy and Immunology at New York-Presbyterian Hospital, we used to see one case every year. But starting in 2000, there was a tremendous increase to about three to four cases per month. The younger the patient, the more the condition is linked to food. There are six main foods that can cause sensitivities: milk, eggs, wheat, soy, nuts, and fish. Eosinophilic esophagitis can be treated with steroids and proton pump inhibitors (PPIs), but I prefer to determine what the trigger is and treat with a diet that eliminates foods that ‘fuel the fire.’
Food sensitivities are a hot topic these days. What are some of the less obvious ways that food allergies manifest themselves?
The most common symptoms of food allergies include developing hives all over your body, difficulty breathing, a swollen tongue, coughing, and sneezing. Food sensitivities, however, play roles in other conditions, which have more atypical symptoms. For example, migraines can be triggered by chocolate, MSG, and alcohol. The skin condition rosacea is triggered by spicy foods, hot liquids, or alcohol. Celiac disease is caused by a sensitivity to gluten (the protein found in wheat, rye, and barley), which can cause abdominal pain.
Talk about the relationship between childhood allergies and exposure to bisphenol A (BPA), a chemical found in many plastic products.
Studies have found that children exposed to BPA had an elevated risk of allergies and asthma. So, I’d say it’s probably wiser to stay away from plastic bottles containing this chemical. In my house, we try not to use plastic; we try to use glass.
What are some ways to help prevent kids from developing allergies?
The most recent science indicates that the earlier you introduce a food, the less likely you will become allergic to it. So now we are introducing peanut powder to children at 4 to 11 years old. If there are peanut allergies in the family, we’ll give the child a scratch test first. If negative, we’ll give the peanut product to them. Some studies show that probiotics may help prevent eczema and food allergies, while other studies show no great benefit. I say introduce probiotics, because it can’t hurt — it can only help.