Nothing ruins a night out like a trip to the ER. Certain foods can trigger symptom episodes in systemic mastocytosis (SM). The resulting allergic reaction can lead to flushing, hives, itchy rashes, stomach pain and bloating, nausea, vomiting, diarrhea and even anaphylaxis. All this makes making dining out with SM challenging — but planning ahead and clearly communicating your needs can make eating out a fun experience again.
What is SM?
Systemic mastocytosis (SM) is a rare hematological disease characterized by mast cells that are overactive and accumulate in different parts of the body such as the bone marrow, liver, spleen, gastrointestinal tract and lymph nodes.
Know your food triggers
In SM, symptoms and symptom triggers can vary from person to person. So can the sensitivity of specific triggers, as well as the severity and duration of a symptom episode.
A dietitian can help you identify the foods mostly likely to trigger an allergic reaction. Possible SM food triggers may include high-histamine foods, such as:
- Aged cheeses
- Tomatoes
- Spinach
- Smoked meat products
- Chocolate
- Nuts
- Shellfish
- Eggs
- Processed foods
- Pineapple
- Strawberries
- Bananas
- Dried fruits
- Citrus
- Tea
- Beans
- Hard alcohol, especially aged liquors
- Beer
- Wine, especially red wines
Before taking the risk of dining out, take the time to better understand your dietary constraints in a safe environment. Spend time cooking at home, testing different ingredients and assessing their impact on your SM. You should track your triggers and symptoms in a symptom journal to uncover patterns and learn what to avoid.
Once you understand which foods act as symptom triggers, you can expand your dining options and accept invites to dine at the homes of family and friends. Share your dietary restrictions with your hosts and express the importance of knowing all the ingredients of each dish. A spice or a marinade with hidden ingredients can make all the difference to your experience.
Navigating restaurants with systemic mastocytosis
Navigating a restaurant menu after an SM diagnosis might feel like walking into a minefield — but it doesn’t have to. Anticipation and communication are key to dining out when you have SM.
Do your research: Choose a restaurant with a menu that offers several meal options which correspond with your dietary needs.
Call ahead: Call the restaurant to check that the online menu is still current and explain your dietary restrictions. Ask about possible cross-contamination in the kitchen (shared oils etc).
Give clear guidance on your dietary restrictions on arrival: Allergies are quite common these days, but that doesn’t mean they are always taken seriously. Restaurant staff may not understand the significance of your allergy if you don’t clearly communicate the possible outcomes, such as anaphylaxis.
Order with caution: Avoid marinades, sauces and seasoning. Double check the ingredients in your order, and don’t be afraid to ask your waiter to check with the kitchen.
Be prepared for the unexpected: Be sure you have your two doses of epinephrine with you and your emergency medical kit of antihistamines in case things don’t go as planned.
You won’t always be able to control every detail of your restaurant experience, but a structured approach will limit risk and allow you to explore dining away from home.
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