Allergies
Over 60 million people in the United States suffer from chronic or seasonal allergies accounting for nearly 28 million days of missed school or work each year.
Allergies, by definition, are abnormal responses by the body’s immune system to normally harmless substances, also known as allergens. Some of the most common allergens affecting the ear, nose, and throat are pollen, dust, mold, and animal dander.
When the body is exposed to an allergen, it releases a variety of chemicals, including histamine, which is the precipitating cause of the allergic reaction.
Allergy symptoms can be mild or severe, and in some cases, can lead to a life-threatening reaction.
COLD vs. ALLERGIES
Is it a cold or allergies? The similarities in symptoms can lead to confusion about which condition is the underlying issue. It’s easy to mistake one for the other. The main difference between them is the speed of initial onset and the duration of symptoms.
ALLERGIC OUTCOMES
The term “allergy” can refer to a wide range of allergic reactions that can occur in all parts of the body – some of them life-threatening. Allergic reactions can manifest themselves in many ways, including:
Anaphylaxis
Anaphylaxis is a sudden, severe, potentially life-threatening allergic reaction that can affect the entire body. Almost any substance can trigger anaphylactic shock, but the most common offending agents are foods, drugs, latex, and insect stings.
Asthma
Asthma is a chronic, inflammatory lung disease characterized by recurrent breathing problems usually triggered by allergens. Keep in mind, not all asthma is triggered by allergies, and not all allergies develop into asthma.
Conjunctivitis
An allergic response to airborne allergens can also develop in the eyes. The eyes may become red, swollen, may itch, burn, or even hurt, and become watery.
Dermatitis
Allergic contact dermatitis can be caused by almost anything that meets the skin. Allergic reactions of the skin can produce rashes, hives, and atopic dermatitis, also known as eczema. Some of the known irritants of the skin include poison oak, poison, ivy, nickel, latex, dyes, preservatives, cosmetics, medications, and fragrances.
Food Allergy
An allergic reaction to certain foods, known as food allergy, may manifest as an upset stomach, loose stools, vomiting, skin rash, and breathing problems. Allergic reactions to food can appear, in some people, whether the food is ingested or whether food particles are inhaled. The most common food allergens are milk, eggs, wheat, peanuts, shellfish, soy, tree nuts, and fish.
Hay Fever
Allergic rhinitis, also known as hay fever, is the term used for allergic reactions in the nose and sinuses. Allergic rhinitis is caused by exposure to airborne allergens and is classified into two categories – seasonal and perennial. The seasonal allergies usually involve tree, grass, and weed pollens. The perennial allergies usually involve dust mites, molds, and pet dander.
COMMON ALLERGY SYMPTOMS
Many people are familiar with the standard allergy symptoms such as itchy, watery eyes, or sneezing, but allergies can affect your mood and other parts of the body including the skin, eyes, lungs, gastrointestinal system, inner ears, and sinuses resulting in a wide range of potential symptoms, including:
– Absentmindedness
– Anaphylaxis
– Asthma
– Burning Eyes
– Constipation
– Coughing
– Dark circles under or around eyes
– Dermatitis
– Depression
– Diarrhea
– Distraction, difficulty with concentration
– Dizziness
– Eczema
– Embarrassment
– Fatigue
– Flushing
– Headaches
– Heart Palpitations
– Hives
– Impaired sense of smell
– Irritability/Behavioral problems
– Itchy skin
– Joint aches
– Muscle pain
– Nausea
– Post-nasal drip
– Rapid pulse
– Rash
– Rhinorrhea (runny nose)
– Ringing, popping, or fullness of the ears
– Shortness of breath
– Sleep difficulties
– Sneezing
– Swallowing difficulties
– Swelling
– Tingling nose
– Vertigo
– Vomiting
– Watery, itchy, crusty, or red eyes
– Wheezing
ALLERGY TESTING
Once it’s determined that you are a candidate for allergy testing, an allergy specialist will conduct appropriate testing to determine exactly what it is you are allergic to and to what sensitivity to be able to develop a treatment plan tailored to your individual needs.
Skin Testing
Skin testing for allergic disorders has been used successfully for more than 100 years and is considered the gold standard for determining a patient’s susceptibility to a wide range of allergens. These tests are not very invasive, and, for most allergens, they tend to produce quick results.
There are two types of skin tests:
- Prick / Scratch test: This is the most common test type. A tiny drop of a possible allergen is pricked or scratched into the skin (also called a percutaneous test.) Testing is normally administered on the inner forearm. Each allergen introduced to your skin will react differently, if at all. The test is highly accurate and has been compared to the feeling of a fingernail scratch.
- Intradermal test: This test shows whether someone is allergic to things that won’t react to testing on the skin’s surface. A small amount of the potential allergen is injected just below the skin in the upper outer arm using a thin needle. Some mild discomfort is possible for a short period.
Some medicines can interfere with skin testing, so you should let your allergist know about any medications you’re taking.
Blood Testing
Some patients are unable to tolerate skin testing due to chronic skin conditions or other contributing circumstances. In these cases, allergy blood testing may be recommended to determine the presence of environmental or food allergies.
A small blood sample from the patient is examined to measure allergen-specific antibodies. The human body makes antibodies when triggered by an allergen. An increased number of these antibodies can indicate the presence of allergies.
WHY A SPECIALIST IS NEEDED
While testing may seem simple, it must be carried out by trained practitioners with an understanding of the variables and risks of the testing procedure. The skill of the tester can also affect the accuracy of the results.
The most common symptoms during testing are itching and swelling of the skin, but in rare cases, a more serious reaction can occur, so testing should always be done by
trained specialists who have first reviewed a patient’s medical history and performed a physical exam to determine that allergy skin testing is both appropriate and safe to perform.
TREATMENT OPTIONS
Avoidance Therapy
Once it has been determined what allergens you are allergic to a plan can be created to avoid these allergens in your environment if at all possible.
Pharmacology
There are many pharmaceutical products available to treat the allergic reaction such as antihistamines, nasal sprays and more depending on your symptoms.
Allergy Shots (Immunotherapy)
Allergen immunotherapy, also known as allergy shots, is a form of long-term treatment that decreases symptoms for many people with allergic rhinitis, allergic asthma, conjunctivitis (eye allergy) or stinging insect allergy.
Allergy shots decrease sensitivity to certain allergens and often lead to lasting and potentially permanent relief of allergy symptoms even after treatment is stopped.
Immunotherapy is not a treatment for food-related allergies.
The frequency of shots is determined on a case-by-case basis but is typically 1-3 times per week.
Allergy Drops (Sublingual Therapy / SLIT)
A variation of immunotherapy that delivers an allergen solution under the tongue rather than by injection. Like allergy shots, your reactions to allergens can reduce and subside with consistent treatment.