Hereditary angioedema (HAE) is a rare genetic disorder that causes repeated and unpredictable episodes of swelling in the skin and upper respiratory and gastrointestinal tracts. The episodes come and go, but if they affect the throat, one’s airways can get blocked, leading to life-threatening complications. People are born with the condition as it is passed on from the parents to the child. Here are a few common triggers of HAE.

Food triggers for HAE attacks
The following foods can lead to an HAE attack, characterized by rapid swelling in different areas of the body:

1. Tree nuts
Tree nuts like almonds, cashews, and walnuts are excellent snacks that help keep one full for longer. However, experts recommend those with HAE to avoid these nuts as they can trigger the condition.

2. Food additives
Food additives used for flavor are a potential trigger of HAE attacks. People with the disorder should reach for meals with fresh ingredients and avoid anything that has additives.

3. Shellfish
Shellfish are known triggers for those with food allergies. The food can also cause an allergic episode of HAE, so patients should avoid it.

4. Spinach
Spinach or arugula is a green leafy vegetable known for its health benefits. However, those with HAE are advised to avoid dishes that use spinach.

These foods are harmful to HAE patients mainly because they may contain high levels of histamines, which can trigger an attack. People with this hereditary disorder are sensitive to histamines. Some other foods and beverages that may have high antihistamine levels are citrus fruits, fermented foods, processed meats, alcohol, aged cheese, vinegar, and tomato ketchup. Patients are also advised to avoid canned fish, dairy products, bananas, bread, kiwi, and salads.

HAE is not an allergic reaction but a condition caused by a genetic defect. However, patients may be allergic or intolerant to certain foods, resulting in a sudden HAE attack. Not everyone may have an episode if they eat these foods.

Other triggers for HAE attacks
The other factors that can increase the risk of HAE attacks are:

1. Deficiency of C1 inhibitor
C1 inhibitor is a protein in our blood plasma that controls inflammation. A defect in this protein or a lack of it can cause uncontrollable inflammation and lead to HAE.

2. Underlying diseases
Diseases like lymphoma can disrupt C1 inhibitor production, leading to HAE and HAE attacks. When HAE occurs due to other underlying diseases, it is called acquired HAE.

3. Use of ACE inhibitors
ACE inhibitors are medications used to treat hypertension, coronary heart disease, diabetes, certain chronic kidney disease, heart attack, and heart failure. HAE can occur as a side effect of long-term use of ACE inhibitors.

Other non-food triggers of HAE attacks include a sudden change in weather, insect bites, stress, infections, and dental or other medical procedures. During an attack, patients could experience unexpected and unpredictable episodes of swelling in the face, throat, airways, skin, and extremities. One could also experience swelling in the abdomen and have symptoms like nausea and vomiting. The episodes could be mild and disappear independently or be acute, requiring hospitalization. The symptoms and the severity of the episodes vary from one person to another.