Allergy & Asthma Care

Does the great outdoors make you feel… not so great? Do you have to turn down invitations from friends who have cats? Are tissues a major monthly expense? Do you never leave home without your epiPen? If any of this sounds like you, you’re not alone. More than 50 million Americans suffer from allergies, the 6th leading cause of chronic illness in the U.S.

While children seem to be especially susceptible to allergies and asthma, these conditions can affect anyone. They can also appear at any age — adult-onset allergies may develop due to exposure to new allergens or changes in the immune system. On the other hand, some lucky people find that they outgrow their childhood allergies in their twenties and thirties.

Causes of Allergies and Asthma

Allergies and allergic asthma occur when the body misidentifies harmless substances such as pollen, dust, or pet dander as dangerous. We refer to things that cause an allergic reaction as allergens. The immune system responds to the presence of allergens by producing antibodies to remove them from the body and releasing a chemical called histamine. This causes inflammation and an allergic reaction, which can range from mild to potentially life-threatening.

In the case of asthma, allergies are not the only trigger. Depression, stress, respiratory infections, and the flu can all trigger asthma attacks in susceptible people. If your asthma is not due to allergies, your doctor will likely refer you to a pulmonologist.

When to See a Doctor

It’s always best to have your symptoms evaluated by a doctor. Allergy and immunology specialists receive extensive training in identifying the triggers for an allergic response and developing a plan for treatment and prevention.

Some types of environmental allergies are mild and require little or no treatment. Other allergies can be treated with occasional over-the-counter medications or managed with ongoing prescription medications. But some allergies can significantly impact your quality of your life. As anyone who carries an epi-pen knows, the body’s response to food allergies can even be life-threatening.

Common Allergy Problems

• Hay Fever: Hay fever, or allergic rhinitis, is a type of allergic reaction based in the nose. Symptoms include congestion, runny nose, sneezing, and an itchy nose and/or eyes.
• Skin Allergies: Skin allergies include contact dermatitis, atopic dermatitis, and hives. These types of reactions are most often caused by chemicals, animals, foods, medications, or insect bites and may take hours or days to develop symptoms.
• Asthma: Asthma can be described as difficulty breathing, coughing, wheezing, and/or a tightness in the chest. Muscle spasms may block airflow to the lungs and the lining of the bronchial tubes can become inflamed. Asthma symptoms can be mild but can become life-threatening if breathing stops altogether.
• Food Allergies: Food allergies are caused by the immune system reacting to the proteins in certain foods. Symptoms may include swelling of the tongue, mouth, or face, difficulty breathing, low blood pressure, vomiting, diarrhea, hives, itchy rash, and anaphylaxis. The most common food allergies are reactions to milk and milk products, tree nuts, peanuts, soy products, fish, shellfish, eggs, and wheat (gluten).
• Anaphylaxis: Anaphylaxis is a rare, potentially fatal allergic reaction that causes many systems of the body to malfunction at the same time. Symptoms include swelling of the throat, mouth, or tongue; difficulty breathing; hives; a sudden drop in blood pressure, and loss of consciousness.

Treating Allergies

Preventing exposure to allergens goes a long way towards reducing allergy attacks. Get rid of anything in your home that has caused allergic reactions in the past. Reduce your exposure to airborne allergens by washing out your nose with a saline rinse or Netipot. As frustrating as it is to stay indoors on a beautiful day, do pay attention to the pollen count. If you can’t resist going out, wear a mask when the pollen count is high.

Many people resist taking medicine for their allergies. Unfortunately, this can lead to sinusitis and ear infections. You’ll be more comfortable if you take your medicine. Signs that you may need a prescription medication include:

• Experiencing symptoms several months out of the year
• Chronic stuffy nose, breathing, problems, and sinus infections
• Symptoms that interfere with daily activities
• Symptoms that don’t respond to over-the-counter (OTC) medications

There are a variety of medications to treat allergies. The prescription medication is usually just a more concentrated and potent version of the OTC.

• Nasal corticosteroids are nasal sprays that reduce the swelling, itching, runniness, as breathing difficulties associated with nasal allergies.
• Antihistamines block histamine, the chemical your immune system releases when it is triggered by an allergen. Histamine causes allergic inflammation. Antihistamines can calm sneezing, itching, runny nose, and hives.
• Mast cell stabilizers are prescription drugs that block the release of histamine in your body. Available as eye drops and nose sprays, mast cell stabilizers help with itchy, watery eyes or an itchy, runny nose.
• Decongestants reduce stuffiness by shrinking swollen membranes in the nose. However, these sprays should be used with caution. They can have a rebound effect if you use them more than three days and make nasal swelling and stuffiness even worse.
• Corticosteroid creams and ointments limit the spread of rashes and relieve itchiness. If you are using an over-the-counter corticosteroid cream for a week and your rash does not go away, see your doctor.
• Oral corticosteroids are occasionally prescribed for severe allergic reactions. These medicines can cause serious side effects and your doctor will monitor you carefully while you are on them.
• Epinephrine is an emergency prescription medication delivered through an epiPen. It is used for life-threatening anaphylaxis and must be given within minutes of the first signs of a reaction. People with severe allergies should always keep an epiPen with them.

Oral immunotherapy, an alternative to medication, is a desensitization treatment for food allergies. Under the supervision of a healthcare practitioner, you are given tiny doses of the food you're allergic to, either to swallow or place under your tongue. The idea is to gradually increase the dose as the body becomes used to the allergen.

If you or someone else are experiencing anaphylaxis, call 911 or go to your nearest emergency room immediately.