Understanding and Treating Allergies
No barefoot walks in the yard? No romps with the new puppy? No peanut butter? No flowers? “No” can seem to be the only answer for those who suffer from allergic reactions. But enjoyable activities and everyday items don’t always have to be off limits. With a clear diagnosis and the appropriate treatment, having an allergy doesn’t have to mean always saying“no.”
By Pamela Boaz
Allergies, defined
Over 50 million Americans suffer from some kind of allergy, making it the sixth leading cause of chronic disease in the country. An allergy occurs when the immune system reacts abnormally to a substance—also called an allergen—that generally speaking is not harmful, such as pet dander or flower pollen.
The body’s immune system when working properly produces antibodies that protect against invading viruses or bacteria that can make you sick. However when people have allergies, their immune systems have identified a normally non-harmful substance as harmful.
What are allergens?
Anything from pollen to medications and even foods can be allergens. Insect bites from mosquitoes or bees; foods, particularly shellfish and peanuts; and, most commonly, animal dander, mold, and dust are frequently responsible for allergic reactions.
During an allergic reaction, an allergen binds to allergic antibodies made by the immune system. These cells then release chemicals like histamine and leukotrienes into the blood stream. These chemicals are responsible for allergy symptoms, such as inflammation of the skin, sinuses, airways, or digestive system.
Understanding the symptoms
Allergic reactions are generally considered to be the least serious form of immune system dysfunction, and, therefore, are classed as a Type I hypersensitivities. However, this does in no way mean that allergies aren’t often severe—depending on the symptoms, allergic reactions can even be life-threatening. Symptoms of Type I hypersensitivities range from mild irritations to sensitivities so severe that if untreated, can lead to death. Allergy symptoms usually depend upon the part of the body touched by the allergen.
A stuffy nose, an itchy nose or throat, excess mucus, coughing, and wheezing are symptoms caused by allergens that have been breathed in.
Itchy, watery, red and swollen eyes are caused by allergens that touch the eyes.
Food allergens cause intestinal reactions such as nausea, vomiting, abdominal pain, cramping, or
diarrhea.
Blisters, itching, skin rash or peeling can occur when an allergen touches the skin.
Drug allergies may affect the entire body and cause a variety of symptoms.
Anaphylaxis, the most severe of all allergic reactions, occurs when allergens cause the entire body to have an allergic reaction. Symptoms include itching and hives all over, wheezing and shortness of breath, hoarseness or tightness in the throat, and tingling in the extremities or on the scalp. Anaphylaxis can progress rapidly, so it is crucial to call 9-1-1 immediately.
Who is most at risk?
While anyone can develop an allergy, the risk is usually higher for someone with a family member who has asthma or allergies—particularly if both parents have allergies. Children are more likely to develop allergies than adults; however, some children outgrow allergies, and some adults who have never had an allergy can develop one. Having asthma also increases the risk of developing an allergy, and someone who has one type of allergic condition is more likely to be allergic to something else.
What allergy tests are available?
Various types of allergy tests administered by your health care provider can help to identify and help you eliminate triggers. They can also determine if other issues may be causing your symptoms. Skin testing, the most common way to detect allergies, can be done through three different methods.
Prick Test: In the prick test, a small amount of the suspected allergen is placed on the skin. The area of skin around the allergen is then pricked in order to move the substance under the skin. Any reaction—such as swelling or redness—indicates an allergic reaction.
Patch: Another way to identify an allergen involves putting a patch on the skin for 48 hours. This is followed by an examination of the area by a health care provider.
Skin Injection Test (Intradermal): Intradermal testing is used to determine an allergic reaction to one specific allergen. In this test, a small amount of the suspected allergen is injected into the skin and then the patient is watched for a reaction.
A doctor may also use a blood test to diagnose certain allergies. Sometimes called the radioallergosorbent test (RAST), the blood test measures the amount of allergy-causing antibodies in your bloodstream. A sample is sent to a lab, where it can be tested for evidence of sensitivity to possible allergens.
What treatments are available?
Once an allergy has been identified, a treatment plan can be determined. For food and drug allergies, the best way to reduce symptoms is to avoid the allergen. For other types of allergies, several different types of medication are available to help patients prevent or manage symptoms.
Antihistamines, either over-the-counter or prescription, are available as capsules or pills, as well as in eye drops, injections, liquids or nasal sprays.
Corticosteroids, which treat inflammation, come in eye drops, nasal sprays, lung inhalers, and creams or ointments.
Decongestant nasal sprays can be effective for relieving a stuffy nose, but should only be used short-term to avoid a “rebounding” effect. A pill form is an option for longer treatment periods.
Immunotherapy, or allergy shots, may be recommended if avoiding the allergen is difficult or if the patient’s symptoms are hard to control.
Emergency epinephrine. If you have a severe allergy, your doctor may give you an emergency epinephrine shot (EpiPen) to carry with you at all times.
Hope for Allergy Sufferers
The American Academy of Allergy, Asthma & Immunology says that if the right precautions are taken, there is no reason why even the worst allergy sufferers have to tolerate allergy symptoms. Additionally, promising avenues of research continue, particularly in the field of immunotherapy. One hope is that injections could render people nonallergic, instead of the years of immunotherapy now often required.
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