Allergy

How An Allergist Diagnoses Allergies

If you have never been diagnosed with allergies but think you might have them or aren't sure what causes your allergy symptoms, see an allergist.

When you visit, the doctor will:

• Take a medical history. You will be asked about your health, your symptoms and whether members of your family have asthma or allergies such as hay fever, hives or skin rashes like eczema.
• Ask you about your symptoms. The doctor will want to know when symptoms occur, how often they happen and what seems to bring them on. The allergist will also ask about your work, home and eating habits to see if these can provide clues to help pinpoint your allergy.
• Do a physical exam.
• Conduct allergy tests.

Tests can be done for common allergens such as plant pollens, molds, dust mites, animal dander, insect stings and various foods such as peanuts, eggs, wheat, shellfish and milk. Testing also is available for some medicines, such as penicillin. There are two types of skin tests:

• The prick test pricks the surface of the skin with a tiny amount of the allergen. The test is done on your back or the inside of your arms with several allergens tested at once. If you're allergic, redness and swelling appear at the site of the prick.
• The intradermal test injects the allergen with a very fine needle under the first few layers of the skin. This type of skin test may be used when the result of a prick test is not clear.

Allergy Blood Tests

Skin tests are more sensitive than blood tests, but a blood test to help diagnose allergies if:

• You're taking a medicine that could interfere with allergy test results.
• You have very sensitive skin or a serious skin condition.
• You had a previous reaction to an allergen that suggested you were very sensitive and should avoid more exposure.

After drawing blood, the sample is sent to a lab to look for the antibodies of specific allergens that show if you have allergies. It takes a few days to receive blood test results.

Types of Allergy Medications

When you cannot avoid allergens, there are many medicines that can help control allergy symptoms. Decongestants and antihistamines are the most common allergy medications. They help to reduce a stuffy nose, runny nose, sneezing and itching. Other medications work by preventing the release of the chemicals that cause allergic reactions. Corticosteroids are effective in treating inflammation in your nose.

We will work with you to determine which medicines are best for you and how often and how much of them you should take—while eliminating or minimizing any side effects.

Allergy Shots (Allergy Immunotherapy)

Immunotherapy is a preventive treatment for allergic reactions to substances such as grass pollens, house dust mites and bee venom. Immunotherapy involves giving gradually increasing doses of the substance, or allergen, to which the person is allergic. The incremental increases of the allergen cause the immune system to become less sensitive to the substance, probably by causing production of a "blocking" antibody, which reduces the symptoms of allergy when the substances is encountered in the future. Immunotherapy also reduces the inflammation that characterizes rhinitis and asthma.

Before starting treatment, the physician and patient identify trigger factors for allergic symptoms. Skin or sometimes blood tests are performed to confirm the specific allergens to which the person has antibodies. Immunotherapy is usually recommended only if the person seems to be selectively sensitive to several allergens.

How allergy immunotherapy is done

Allergy shots have been used since 1911. In the past century, there has been considerable improvement in the effectiveness of this treatment, which decreases a patient’s sensitivity (allergy) to a number of allergens, such as cat or ragweed. The treatment is a method for increasing the allergic patient's natural resistance (tolerance) to the things that are triggering the allergic reactions.

This treatment involves injections of small amounts of purified "extracts" of the substances that are causing allergic reactions. For example, the extracts may be derived from pollens, mold spores, animal dander, dust mites or insect venom. The U.S. Food and Drug Administration approve them for this use, and over the years they have been improved considerably.

Allergy shots stimulate the immune system to fight allergies safely, effectively and naturally. Beginning with small doses and increasing them gradually on a weekly or biweekly basis, the therapy continues until a maintenance level is achieved. Then, a maintenance dose is injected every few weeks.

Immunity does not occur immediately, but some patients do begin to feel better quickly. Most patients are continued on monthly injections for 3 to 5 years once they reach the maintenance dose. In some patients, immunity is maintained and treatment can be stopped after several years. For others, treatment may be needed for longer periods of time. Generally the benefits of allergy shots can last for many years, or even a lifetime.

With the immune system restored to good health, few or no medications may be needed. Work or school days are no longer missed. The burden of allergies is lifted, and allergies become something you just don't think about any more. Candidates for allergy shots include most children and adults. Pregnant patients can continue treatment that was started prior to pregnancy.

Allergy shots are always given under medical supervision and medications are available to handle any serious reaction. Although rare, serious reactions can occur from allergy shots because the treatment involves the substances to which the patient is known to be allergic.

Adverse reactions can occur from allergy shots because treatment involves the injection of substances to which the patient is sensitized. The most common adverse reaction is an immediate red, itching bump at the injection site. In some cases, a similar delayed reaction can occur six to twenty-four hours later. Rare, more severe reactions include generalized itching, chest tightness/wheezing, or dizziness due to a drop in blood pressure. Deaths have been reported from allergy shots at a rate of approximately one in three million injections. This is why allergy shots are given under supervision where medical staff and medications are available to handle serious reactions. As allergists, we feel that the benefits far outweigh the extremely small risk of a serious reaction. It is safe for both children and adults, and even pregnant patients may continue treatment started prior to pregnancy.


Immunotherapy for asthma

Immunotherapy is effective in the treatment of allergic asthma. Allergy shots can help relieve the allergic reactions that trigger asthma episodes, thereby enhancing pulmonary function and decreasing the need for asthma medications.

When Should I See an Allergist?

Asthma and other allergic diseases are two of the most common health problems. Approximately 50 million Americans have asthma, hay fever or other allergy-related conditions.

Some allergy problems - such as a mild case of hay fever - may not need any treatment. Sometimes allergies can be controlled with the occasional use of an over-the-counter medication. However, sometimes allergies can interfere with day-to-day activities or decrease the quality of life. Allergies can even be life threatening.

An allergist treats asthma and allergies

An allergist is a physician who specializes in the diagnosis and treatment of asthma and other allergic diseases. The allergist is specially trained to identify the factors that trigger asthma or allergies. Allergists help people treat or prevent their allergy problems. After earning a medical degree, the allergist completes a three-year residency-training program in either internal medicine or pediatrics. Next the allergist completes two or three more years of study in the field of allergy and immunology. Afterwards, passing a rigorous examination allows the phsycian to become board certified in allergy and immunology. Rest assured both physicians here are board certified in allergy and immunology.

What is an allergy?

One of the marvels of the human body is that it can defend itself against harmful invaders such as viruses or bacteria. But sometimes the defenses are too aggressive and harmless substances such as dust, molds or pollen are mistakenly identified as dangerous. The immune system then rallies its defenses, which include several chemicals to attack and destroy the supposed enemy. In the process, some unpleasant and, in extreme cases, life-threatening symptoms may be experienced in the allergy-prone individual.

The cause of allergic reactions

There are hundreds of ordinary substances that can trigger allergic reactions. Among the most common are plant pollens, molds, household dust (dust mites), cockroaches, pets, industrial chemicals, foods, medicines, feathers and insect stings. These triggers are called "allergens."

Who develops asthma or allergies?

Asthma and allergies can affect anyone, regardless of age, gender, race or socioeconomic factors. While it's true that asthma and allergies are more common in children, they can occur for the first time at any age. Sometimes allergy symptoms start in childhood, disappear for many years and then start up again during adult life.

Although the exact genetic factors are not yet understood, there is a hereditary tendency to asthma and allergies. In susceptible people, factors such as hormones, stress, smoke, perfume or other environmental irritants also may play a role.

Types of allergy problems

An allergic reaction may occur anywhere in the body but usually appears in the nose, eyes, lungs, lining of the stomach, sinuses, throat and skin. These are places where special immune system cells are stationed to fight off invaders that are inhaled, swallowed or come in contact with the skin.

Allergic Rhinitis (Hay Fever)

Allergic rhinitis is a general term used to describe the allergic reactions that take place in the nose. Symptoms may include sneezing, congestion, runny nose, and itching of the nose, the eyes and/or the roof of the mouth. When this problem is triggered by pollens or outdoor molds, during the Spring, Summer or Fall, the condition is often called "hay fever." When the problem is year-round, it might be caused by exposure to house dust mites, household pets, indoor molds or allergens at school or in the workplace.

Asthma

Asthma symptoms occur when airway muscle spasms block the flow of air to the lungs and/or the linings of the bronchial tubes become inflamed. Excess mucus may clog the airways. An asthma attack is characterized by labored or restricted breathing, a tight feeling in the chest, coughing and/or wheezing. Sometimes a chronic cough is the only symptom. Asthma trouble can cause only mild discomfort or it can cause life-threatening attacks in which breathing stops altogether.

Contact Dermatitis/Skin Allergies

Contact dermatitis, eczema and hives are skin conditions that can be caused by allergens and other irritants. Often the reaction may take hours or days to develop, as in the case of poison ivy. The most common allergic causes of rashes are medicines, insect stings, foods, animals and chemicals used at home or work. Allergies may be aggravated by emotional stress.

Anaphylaxis

Anaphylaxis is a rare, potentially fatal allergic reaction that affects many parts of the body at the same time. The trigger may be an insect sting, a food (such as peanuts) or a medication. Symptoms may include:

• vomiting or diarrhea
• a dangerous drop in blood pressure
• redness of the skin and/or hives
• difficulty breathing
• swelling of the throat and/or tongue
• loss of consciousness.

Frequently these symptoms start without warning and get worse rapidly. At the first sign of an anaphylactic reaction, the affected person must go immediately to the closest Emergency Room or call 911.

When to see an allergist

Often, the symptoms of asthma or allergies develop gradually over time.

Allergy sufferers may become used to frequent symptoms such as sneezing, nasal congestion or wheezing. With proper management, these symptoms usually can be prevented or controlled with major improvement in quality of life.

Effectively controlling asthma and allergies requires planning, skill and patience. The allergist, with his or her specialized training can develop a treatment plan for your individual condition. The goal will be to enable you to lead a life that is as normal and symptom-free as possible.

A visit to our office might include:

Allergy testing. The allergist will usually perform tests to determine what allergens are involved.

Prevention education. The most effective approach to treating asthma or allergies is to avoid the factors that trigger the condition in the first place. Even when it is not possible to completely avoid allergens, an allergist can help you decrease exposure to allergens.

Medication prescriptions. A number of new and effective medications are available to treat both asthma and allergies.

Immunotherapy (Allergy Shots). In this treatment, patients are given injections every week or two of some or all of the allergens that cause their allergy problems. Gradually the injections get stronger and stronger. In most cases, the allergy problems get less and less over time.

You should come in for an evaluation if:

• Your allergies are causing symptoms such as chronic sinus infections, nasal congestion or difficulty breathing.
• You experience hay fever or other allergy symptoms several months out of the year.
• Antihistamines and over-the-counter medications do not control your allergy symptoms or create unacceptable side effects, such as drowsiness.
• Your asthma or allergies are interfering with your ability to carry on day-to-day activities.
• Your asthma or allergies decrease the quality of your life
• You are experiencing warning signs of serious asthma such as:
• You sometimes have to struggle to catch your breath.
• You often wheeze or cough, especially at night or after exercise.
• You are frequently short of breath or feel tightness in your chest.
• You have previously been diagnosed with asthma, and you have frequent asthma attacks even though you are taking asthma medication.