Forty-five million Americans suffer from a recurring problem called allergy. Allergic rhinitis was once known as hay fever because workers would sneeze and develop nasal and sinus congestion when they worked around hay in the fields. Hay fever, asthma, and eczema are the most common symptoms of an allergic reaction.
Allergy symptoms appear when the body's immune system begins to respond to a substance as though it were a dangerous invader (called an antigen or allergen). It does this by sending specific defenders called antibodies to the entry site. The battle between allergen and antibody results in a release of chemical mediators, such as histamine, into the bloodstream. Those chemical mediators cause changes in the body, which produce the symptoms that we feel.
Symptoms that may be caused by allergy are itching eyes, sneezing, nasal stuffiness, nasal congestion and drainage, and sometimes headache. Some people experience hearing changes, scratchy sore throats, hoarseness, and cough. Other less common symptoms include balance disturbances, swelling in face or throat tissues, skin irritations, and even respiratory problems and asthma.
Some allergy sufferers experience symptoms all year (perennial). Others find certain seasons bring on attacks (seasonal). Hay fever is caused by pollens. The most significant cause of hay fever in the United States is ragweed. It begins pollinating in late August and continues until the first frost. Late springtime pollens come from the grasses, i.e., timothy, orchard, red top, sweet vernal, Bermuda, Johnson, and some bluegrasses. Early springtime hay fever is most often caused by pollens of trees such as elm, maple, birch, poplar, beech, ash, oak, walnut, sycamore, cypress, hickory, pecan, cottonwood, and alder. Colorful or fragrant flowering plants rarely cause allergy because their pollens are too heavy to be airborne.
Certain allergens are always present. These include house dust, household pet danders, foods, wool, various chemicals used around the house, and more. Symptoms from these are frequently worse in the winter when the house is closed up. Mold spores cause at least as many allergy problems as pollens, grow outdoors and indoors, and are present all year long. Dead leaves and farm areas are common sources for outdoor molds. Indoor plants, old books, bathrooms, and damp areas are common sources of indoor mold growth. Molds are also common in foods, such as cheese and fermented beverages.
Foods can also be allergenic. Food allergies usually do not develop the first time the food is eaten. Rather, it is the repeated consumption of a particular food that may lead to allergy. In fact, people with food allergies often crave the very foods to which they are allergic. During early childhood allergies to milk, eggs, wheat, soy, peanuts, and fish are very common. Fortunately many children outgrow these allergies by 3 or 4 years of age. Because children with allergic parents are at higher risk for developing allergies mothers should try and avoid highly allergenic foods while pregnant or breastfeeding. By avoiding foods like eggs, milk, and peanuts she may be able to avoid sensitizing her baby. The best treatment for food allergy is avoidance, however immunotherapy can sometimes be used.
Allergy symptom control is most successful when multiple management approaches are used simultaneously. Minimizing exposure to allergens, managing symptoms with medications, and desensitization with allergy shots are all methods that can be useful in controlling allergic symptoms.
Medications properly used can be very helpful. Over the counter drugs can be beneficial, but some cause drowsiness. Sometimes prescription medications offer the best chance for good control. When medicines do not provide enough relief, immunotherapy is the next line of therapy.
Immunotherapy, or allergy shots, provide the only treatment method that can offer lasting relief or cure from allergies. Before beginning a series of such shots, allergy testing must be performed. This testing helps identify the allergens that are causing symptoms and helps determine a safe starting point for immunotherapy dosing. Over 80% of patients treated with immunotherapy will show significant improvement or be cured of their allergy symptoms.
Although allergic rhinitis is usually not life threatening, its symptoms account for numerous missed days of work and school. They also can impact social activity and family life. In the U.S. over 3.5 billion dollars are spent annually on allergy medications, office visits, and absenteeism in schools and offices.
As otolaryngologists we have been managing allergy for over 70 years. Here at KUMED Otolaryngology we are uniquely equipped to provide the careful and in depth evaluation that allergy patients need and deserve.