Objective test for food sensitivity in asthmatic children: Increased bronchial reactivity after cola drinks

Abstract

The overall importance of food sensitivity in childhood asthma is unknown. Several substances such as nuts, eggs, milk, chocolate, and fish as well as food additives such as sulphur dioxide, benzoate, and tartrazine cause wheezing in asthmatic subjects. When the reaction is severe and immediate, diagnosis is not a problem. Sometimes, however, the symptoms are mild, intermittent, or delayed, and a proportion of subjects with a history of such wheezing do not respond to an oral challenge test. The authors designed the present study to compare airway sensitivity to inhaled histamine before and after an oral challenge to see whether a change in the degree of airway hyperreactivity might account for the alleged symptoms of cough and wheeze. Ten asthmatic children with a history of cough and wheeze after drinking a cola drink performed histamine inhalation tests before and 30 minutes after a drink of Pepsi-Cola, soda water, and water on three separate study days. There was no significant change in baseline peak expiratory flow after any of the three drinks. Sensitivity to histamine was increased after the cola drink (p < 0.005) but was not significantly different after soda water or water. The detection of change in sensitivity to histamine appears to be a simple and effective method of testing for food sensitivity in asthma.