Atopy and Children: What is Going On?
by Peter Gigante
Peter Gigante was the presenter for the February/March 2011 Traditional Chinese Medicine seminar entitled “Eczema, Asthma and Allergy in Children – An Integrated Approach.”
In this discussion I reflect on some of my observations and understandings about the rising prevalence of atopic disease in children. In over 20 years of treating children with Chinese Medicine, I have paid close attention to special features of child physiology, development and pathological processes. I have suspected that the incidence and reported incidence of allergies are typically linked to certain common factors, and it is these I would like to discuss here.
In this age of technology in the modern world, we spend more time in physically passive pursuits, eating more processed foods, consuming more manufactured medicinals, exposed to more radiation sources for more hours of the day, wearing more synthetic fabrics, and exposed to less sunlight and natural environmental conditions such as wind and rain, heat and cold.
We are reproducing later in life than ever before, and raising children according to modern, or traditional, or ethnic and cultural values from allover the world, more separated than ever from our smaller, scattered extended families and the fewer available family elders, further away from ancestral homelands. Children are often cared for in more structured and controlled routines with less free imaginative play and a lot more disinfected objects, surfaces and materials. They are exposed however to more gratuitous violence, intense multi-sensory stimulation and hyper arousal earlier in life than ever before, and consuming more meats, refined carbohydrates, stimulant and chemical food additives and products and much less whole food fibre and nutrition than good health demands.
External factors such as sunlight, fresh air, physical activity and diet playa direct role in the development and maintenance of healthy children with strong immune systems. Love and affection, sense of safety and routine, imaginative play and challenging activities motivate and enrich their global development. In the world l just described child's health is exposed to significant challenges in all these areas.
Inherited predisposition and genetic susceptibility are activated once these challenges reach a pathological threshold, and the result may well be the rise of atopy and allergic disease in children. Regardless of the degree, Chinese Medicine dictates that we incorporate aetiology (shen yin) and other important factors (yin shi, yin di, yin ren) in proper determination of treatment, and that we understand in a holistic sense the pathogenesis and physiological status of the patient in order to combine a thorough understanding of the disease factors with a multi-dimensional appreciation of the patient.
Allergy occurs as an abnormal immune response to substances that do not normally produce a reaction, when the normal response is inhibited or has not developed well and when food and fluids are not properly transformed, infiltrating the blood, polluting the clear fluids and blocking the passages.
Much atopic pathology of children arises from blocked yang due to injured yin and/or food and phlegm blockage. If the blood and fluids cannot soothe, moisturise and nourish the skin and mucous membranes of the spleen and lung then dryness, heat, hypersensitivity and damage occur. If the fluids cannot drain and the blood cleanse, waste, phlegm accumulation and toxin cannot be removed. In addition, if damp-warmth factors are retained (lingering pathogenic factors), the child is constantly restless and irritable and attention is extremely poor, the lips or cheeks are red and the lymph nodes, throat or sinuses are swollen. Lingering pathogens are a primary cause of behavioural disorders, and skin sensitivity and allergy are common.
In paediatric practice children frequently present with idiopathic functional disorders of the digestive system, and the same child may experience pain, distension, diarrhoea, vomiting, poor appetite or irregular intake of food and fluids, dietary allergies, food intolerance, and special preferences and aversions at different times.
In Australia, these problems typically arise from dietary imbalance, excessive intake of cold, hard to digest, or contaminated food and drink, frequent use of antibiotics or analgesics, and fright and anxiety. They are also often associated with family history.
The combinations of yin deficiency, phlegm, accumulation, toxins and heat frequently lead to Gan Ji syndromes. Ji stagnation is a chronic gastrointestinal disease caused by the retention of food or milk in the middle jiao, with no desire for foods, abdominal distention, and irregular stools.
Gan is a type of insubstantial dry phlegm, resulting from drying of fluids due to disturbed spleen and stomach function with associated heat. Although the usual pathogenesis is food accumulation, gan may also be concentrated in specific locations or affect particular zangfu and ultimately affects the sensitivity, receptivity and metabolic efficiency of the lung and spleen. Modern lifestyle, pharmaceuticals, compromised diet, environmental toxins, and lingering pathogenic factors from incomplete, suppressive or inadequate therapeutics predispose children to gan diseases.
Eczema, or atopic dermatitis, is a chronic fluctuation disease frequently associated with respiratory allergy which may occur at any age, although for many children it will begin before one year of age. 3 to 5% of infants suffer from atopic eczema where it is slightly more common in males (however by adulthood is more common in females). Over 50% of patients will develop asthma and allergic rhinitis (hayfever), which may only significantly emerge as the period of atopic dermatitis subsides.