How Angioedema Is Treated

There are medical treatments that can suppress angioedema. Most of the time, if an allergen (a substance that triggers an allergy) is identified, it is recommended that you avoid it.

Once you have an established diagnosis of angioedema, your treatment depends on the cause. You might need to take regular treatment with steroids if your symptoms are not the result of an avoidable allergy. If you do have an allergy, you might need to carry injectable epinephrine with you because emergencies may progress quickly before you can get medical attention.

Sometimes the condition is hereditary, and in many cases, the trigger is not identified.

Home Remedies and Lifestyle

There are a number of effective lifestyle adjustments that you can make if you experience angioedema. Some of the lifestyle modifications are helpful in preventing a reaction if you have a known allergen, and some can help you become more comfortable if you have had a reaction.

Identify Triggers

If you have had recurrent episodes, especially if they are mild, it may be challenging to identify the cause of your angioedema. Thinking about the different foods, drinks, and materials you may have been in contact with can help you determine what may have caused your reaction.

Sometimes an allergy test can help in identifying the substance that is causing your reaction.

Avoid Food Triggers

Once you identify the trigger, you can take action to avoid exposure by reading the ingredients of pre-prepared food and even avoiding foods if you cannot figure out how they were prepared.

Medication Awareness

Be sure to tell your healthcare provider if you experience angioedema in response to a medication. Angiotensin-converting enzyme (ACE) Inhibitors are among the medications that commonly cause episodes of angioedema. These medications are used for treatment of heart problems such as high blood pressure and heart failure.

Maintaining Comfort During Episodes of Angioedema

Some people use ice packs for comfort during episodes of angioedema, especially if the swelling is very localized or if there is associated pain or burning. 

If you have swelling throughout your body, you might consider a cold bath as a way to relieve the discomfort. Be sure not to spend more than a few minutes in cold water.

Over-the-Counter Therapies

If you have recurrent angioedema that does not advance to become severe, you might respond well to over-the-counter medications. If one of these medications has worked for you in the past, it is a good idea to have it handy in case your symptoms recur.

Oral Antihistamines

Antihistamines such as diphenhydramine (Benadryl), hydroxyzine (Visatril), and cetirizine (Zyrtec) are often helpful in managing and preventing episodes of angioedema. They work by blocking histamine, which can cause some episodes of angioedema.

These medications are taken orally and you should only use them if your healthcare provider has already evaluated your signs and symptoms and has told you that this is a good option.

If you experience side effects such as sleepiness or drowsiness, ask your doctor if you should switch to another antihistamine that you can tolerate. In general, non-sedating antihistamines like cetirizine are preferred over sedating versions like diphenhydramine and hydroxyzine.

Prescriptions

You might need prescription medications if you have recurrent angioedema or if your symptoms are severe. 

Antihistamines

Your doctor may prescribe prescription-strength antihistamines such as cyproheptadine (Periactin), and desloratadine (Clarinex).

Intravenous (IV) Steroids

Your medical team may consider giving you IV instead of oral steroids, particularly if you cannot swallow or if you need a faster effect than what is expected with oral steroids.

Epinephrine

Epinephrine is a powerful medication that suppresses the immune system more quickly than steroids and antihistamines. It is used as an injection when you have a severe, sudden reaction and when you are prone to respiratory difficulties or heart involvement.

Specialist-Driven Procedures

In general, you should not need surgery or special procedures for treatment of angioedema. However, there are rare circumstances in which you could need special procedures if your breathing is affected.

Tracheostomy

If your tongue or throat becomes extremely swollen, you might need to have a lifesaving procedure called a tracheostomy. This is a procedure in which a hole is placed in the neck and windpipe and a tube is placed in the hole so that air can get to your lungs. This hole will be surgically repaired after you recover. 

Mechanical Ventilation

If you experience respiratory difficulties or respiratory arrest, you may need mechanical ventilation that provides the pressure needed to move air in and out of your lungs as you recover.

Respiratory involvement is a different problem from airway obstruction, which is caused by physical swelling of the tongue or throat. Severe respiratory difficulties are the consequence of the inflammatory effect of angioedema on the lungs and bronchi.

Complementary Medicine

You might come across advice to use complementary treatments for angioedema, but it is important for you to know that they are not effective. and they can be be unsafe.

Vitamins

Vitamins have been recommended for the prevention and treatment of angioedema, with little solid evidence.

Oatmeal

Soothing treatments applied to the skin, such as oatmeal, are sometimes recommended for the rash and itchiness of angioedema. In general, soothing your skin does not diminish the hyperactive immune activity of angioedema.

Milk Baths

As with oatmeal, there is no specific evidence that milk baths actually relieve the inflammation of angioedema.