Allergies

Allergies reflect a hyper-responsive state of the body’s immune system to a trigger. Most often they occur when common everyday substances induce a reaction from a person’s immune system. The body’s defense systems go into overdrive and produce a large amount of antibodies, notably one called Immunoglobulin E, when coming into contact with a substance that would otherwise not cause symptoms in other people. The symptoms will depend on how that substance came into contact with the body, be it through the air, as is the case with pollen, through the skin like with latex, or through the mouth like with peanuts. The type and severity of allergies can vary widely.  Some may lead to a simple itchy rash, while others can lead to a life threatening condition called anaphylaxis. Seasonal allergies are the most common type of allergy.  There may be a family history of seasonal allergy and most people experience their first symptoms while they are young. Seasonal allergies tend to be a lifelong condition but the severity of the symptoms can change with time and with each attack.

What Are Seasonal Allergies?

Seasonal allergies are sometimes called hay fever.  They may cause of collection of symptoms including:

• Stuffy nose, runny nose, and sneezing
• Watery, red or itchy eyes
• Itchy or sore throat and troublesome cough
• Itchy or inflamed ears
• Waking up at night because of the itchiness or difficulty breathing

They are called seasonal allergies because they only occur at certain times of the year. These types of allergies can be caused by pollen from trees, grasses, or weeds, or from mold spores that grow in enclosed damp areas. There are people who suffer the symptoms of seasonal allergies all year long and in these cases, the allergy is more likely to be caused by other irritants such like insects such as dust mites or pet dander.

How Are Seasonal Allergies Diagnosed?

A doctor will suspect seasonal allergies based on the patient’s symptom history. They may need to undergo a physical examination to exclude other conditions of the ear, nose and throat. Most patients with allergies are easily treated by their Family Doctor or primary care giver, while difficult to treat cases may be referred to an Allergist Immunologist.

An allergy skin test will confirm the diagnosis and identify which substance the patient is allergic to. This involves putting a small amount of the substance on the patient‘s skin and then making a tiny prick so that the substance goes underneath the skin. Once the substance has gotten past the skin barrier, the doctor will watch to see if the body mounts an allergic response to it. The test is positive if the substance induces the formation of red bumps on the skin.

There is a blood test called radioallergosorbent test (RAST) that can also be performed. This tests the level of a certain antibody in the blood. It is used less commonly than the skin test.

Relieving The Symptoms Of Seasonal Allergies

Although most seasonal allergies cannot be cured, there are multiple ways to relieve the symptoms.  The type of medication should be discussed with the doctor. These include:

• Nasal rinses – A sterile salt solution is used to clean out the nose and get rid of any substance inside causing the allergy. The solution may be administered by spray form or using a device called a neti pot which has a long nozzle.
• Steroid nasal sprays – The commonest steroid used is triamcinolone. These may be available over the counter without a prescription. Steroids, while very effective, take a longer time to start working. They are normally given together with a decongestant so that the patient feels immediate relief while waiting for the steroid to start acting.  Steroid sprays are most effective in providing longer term relief from allergies that cause stuffy noses that make it difficult to breathe or in cases where the patient complains of mucus dripping down the back of their throat.
• Antihistamines – These come in tablet or syrup form. Care should be taken when driving or working as certain brands may make the patient drowsy. This type of medication helps to relieve the itchiness coming from the nose, eyes, ears or throat.
• Decongestants – These are available as sprays and drops or tablets. People with certain health problems, such as high blood pressure, should not take oral decongestants. They are instilled into the nose to clear it and allow for better breathing. However, they cannot be prescribed in patients with high blood pressure. The nasal sprays only be used for a maximum of 3 days; otherwise they cause a rebound effect that actually makes the nose more congested.
• Allergy injections – These are given on a weekly or monthly basis before the allergy starts. They contain a small amount of the substance the person is allergic to. Many patients report good results with these but it may take months before any effect is seen.
• Allergy tablets – These work for a specific type of allergy (similar to allergy injections) and are normally only prescribed after the allergy test has been performed. The pills dissolve under the tongue and need to be taken everyday.

Talk with your doctor or nurse about the benefits and downsides of the different treatments. The right treatment for you will depend a lot on your symptoms and other health problems. It is also important to talk with your doctor or nurse about when and how to use your medicines.

Preventing Seasonal Allergies

• A patient can find out which medications can be used to prevent the allergies from starting in the first place. They can then be taken one or two weeks before the seasonal allergy normally starts.
• Staying indoors more often to avoid contact with pollen during that specific time of the year.
• Wearing a dust mask if they do need to be outdoors.
• Keeping car and house windows closed and using an air conditioner instead.
• Taking a shower before sleeping to rinse off any pollen from the hair and skin.
• Use a vacuum and room air purifier with a high-energy particulate air (HEPA) filter at home.
• Fix any leaks around the home or office that may lead to damp conditions and encourage the growth of mold.

Pregnancy And Seasonal Allergy

A doctor can give advice about which medications can be taken during pregnancy. Seasonal allergy symptoms can get worse, get better, or stay the same in pregnant women.

Important Note

Patients who are at risk of severe allergy attacks (anaphylaxis) should carry an epinephrine shot (epipen) with them at all times.