When Should You Consult An Allergist?
Approximately 50 million Americans have asthma, hay fever or other allergy related conditions.
You can spot them from across the room – tissue in hand, sneezing, sniffling, blowing their nose, tearing, and rubbing their eyes. This is a common presentation for millions of children and adults who suffer from the misery of allergies. If fortunate, these symptoms are but a minor inconvenience, but if severe, they can significantly affect one’s quality of life.
Allergies involving the nose (rhinitis) and eyes (conjunctivitis) are almost always caused by contact of an offending “allergen” to the mucous membrane lining of the nose or eyes. Constant exposure for the allergic individual can cause daily symptoms, resulting in what your physician would diagnose as persistent, chronic, or perennial allergic rhinitis. Common allergens responsible for these chronic symptoms may include house dust mites, mold spores, indoor pets, cockroach allergen, or feathers.
Symptoms of allergic rhinitis can also be acute or intermittent, presenting only when one is exposed to a relevant allergen. One of the most common presentations of allergies is seasonal allergic rhinitis or “hay fever”. As its name implies, symptoms will present during the pollen seasons, most typically in the spring during the tree and grass pollinating times, and in the fall when ragweed and other weed pollens are present.
You may want to consider a visit to an allergist if the following symptoms are present on a daily basis or seasonally:
• Itchy, swollen, red, tearing eyes
• Itching of the nose, ears, eyes, or throat
• Runny nose
• Nasal congestion
• Persistent post-nasal drip
Allergic rhinitis is actually one of the easiest diagnoses for your physician to make. If the medical history suggests allergic rhinitis, an allergist will likely perform allergy testing in order to confirm the diagnosis, identify the offending allergen(s), and ascertain the severity of the allergy. The preferable testing method by most allergists is skin testing. This method allows the testing of multiple allergens simultaneously, with the results being immediately available. Alternatively, similar results can be obtained through a blood test called RAST or ImmunoCap.
Once the relevant allergens have been identified, an allergist will recommend a comprehensive treatment plan. This plan may include one or all of the following:
• Environmental control – minimizing exposure to allergens that you are sensitive to
• Pharmacotherapy – medicines including antihistamines, steroid nasal sprays, and other non-steroidal blockers of inflammation
• Immunotherapy or desensitization – extracts of allergens (pollens, dust, molds, etc.) are introduced into the body to induce an immunologic response, resulting in the eventual reduction or elimination of the allergic reaction. Historically, this form of treatment was available only by injection. Recent advances now allow the desensitization process to be given, in selected patients, by taking drops under the tongue, a process called sublingual immunotherapy (SLIT).
The most severe allergic reaction is called anaphylaxis. The most common causes of anaphylaxis include the ingestion of a highly allergenic food, such as peanuts, tree nuts, and shell-fish, or a medicine. The sting of a yellow jacket, wasp, hornet, or honeybee, or the bite of a fire ant can also result in a severe allergic reaction in a susceptible individual.
The symptoms of anaphylaxis vary from person to person. For some, they may be mild and include only generalized itching and urticarial (hives). In more severe reactions, however, they can include involvement of the respiratory, circulatory, and digestive systems, and can be fatal if not treated quickly and aggressively by the administration of epinephrine. Epinephrine can be self-injected with the use of an EpiPen or AuviQ.
Symptoms of full blown anaphylaxis may include:
• Difficulty breathing
• Hives or swelling
• Tightness of the throat
• Hoarse voice
• Abdominal pain
• Low blood pressure
• Cardiac arrest
Those who have had anaphylaxis or are at risk for anaphylaxis should be evaluated by a board certified allergist for confirmation, identification of the allergen(s), and education regarding prevention, recognition, and self-treatment of anaphylaxis.
There are many preventative measures allergy sufferers can take to protect themselves from potentially dangerous allergic reactions. Education is the best medicine. And, consider consulting an allergist for the most complete and up-to-date treatments available.
Allergists are also asthma specialists. Allergists are often consulted by primary care physicians to help manage difficult to control asthma symptoms in children and adults. Tools such as pulmonary function studies are used extensively by allergists to monitor lung functions and one’s response to therapy. In addition, an allergist will take a detailed history to try to discern asthma triggers and create a treatment plan based on what is causing or exacerbating the asthma symptoms.
At least half of all asthma patients have a significant allergic component which needs to be identified and treated. An allergist will perform the necessary tests and will design a treatment plan based on one’s allergies and sensitivities.
The allergist is a critical player in a team approach to wellness. Working in strong collaboration with the primary care physician, the patient, and family, one can maximize the likelihood of good health and excellent control of allergy and asthma symptoms.