Allergies: Nothing to Sneeze At

by Eileen McCormick

AllergiesA condition that can adversely affect up to 50 million Americans is, to use an old clich窠”nothing to sneeze at.” Yet, sneezing, coughing, and a runny nose are frequent manifestations of various allergic diseases that trouble one in five individuals in the United States.

What Is an Allergy?

In simplest terms, it is a specific immunologic reaction to a normally harmless substance that is of no concern to most people. Allergic individuals, however, are frequently sensitive to more than one substance, and sometimes their too-aggressive defense systems launch a host of complex chemical weapons to attack and destroy harmless substances that are misread as “the enemy” (e.g., bacteria; viruses). In that process, some unpleasant (even life-threatening) symptoms may be experienced by an allergy-prone individual.

What Causes Allergic Reactions?

Although hundreds of ordinary substances can trigger such reactions, the most common include plant pollens, molds, household dust (dust mites), animal dander, industrial chemicals, certain foods (e.g., shrimp; peanuts), medicines, feathers, and insect stings. Such triggers are called “allergens” and, although allergic reactions may occur anywhere in the body, they usually appear in the skin, eyes, lining of the stomach, nose, sinuses, throat, and lungs; in other words, in places where special immune system cells are stationed to fight off invaders that are inhaled, swallowed, or come in contact with the skin.

Who Is Likely to Develop Allergies or Asthma?

Actually, anyone can be affected, regardless of age, gender, race, or socioeconomic factors. Although they are more common in children, asthma and allergies can initially occur at any age — or can recur in individuals after years of remission. A genetic component is reported in both allergies and asthma, and such factors as hormones, stress, smoke, perfume, or other environmental irritants are also implicated in susceptible individuals.

Can Allergies Be Cured?

There is no cure for allergies, but an allergist (a physician trained and qualified to specialize in the diagnosis and treatment of asthma and allergies) can tailor an effective treatment plan to allow the patient as normal and symptom-free a life as possible. Based on a complete medical history of the patient, the allergist may employ some of the following methods to achieve the best treatment goal:
Allergy testing: Skin tests that measure the level of IgE antibody in a patient are reportedly the most sensitive and least costly way to identify allergies. (A few individuals who suffer widespread eczematous conditions or take medications that interfere with skin testing may require a more costly radioallergosorbent blood test [RAST].)
Prevention: For both allergies and asthma, the most effective prevention is the avoidance of the factors that trigger the condition in the first place — in other words, creation of an allergen-free environment insofar as possible. See the box below for suggestions on allergy prevention.
Medications: Effective medications that can be prescribed by a physician include antihistamines and topical nasal steroids — used either alone or in combination. (Effective antihistamines and decongestants are also available over the counter.) Cromolyn sodium for allergic rhinitis is a nasal spray that helps some people prevent allergic reactions from starting. Used as directed, it has few side effects and offers significant help to some allergy patients. As with all drug therapy, however, allergy/asthma patients should not initiate or stop medication(s) without consulting their doctor.
Immunotherapy (allergy shots): With this treatment, patients are injected over time with gradually increasing doses of the substances to which they are allergic. These subcutaneous injections reduce the amount of IgE antibodies in the blood and cause the body to make a protective antibody called IgG. Within 12 months of starting immunotherapy, about 85% of allergic rhinitis patients have a significant reduction in their hay fever symptoms and in their need for medication. After 3 years of immunotherapy, some allergy patients can safely consider discontinuing the shots.
Emergency Situations: Certain people can have serious, life-threatening allergic reactions to certain foods, insect stings or airborne substances. Patients who are susceptible to these “anaphylactic” reactions can have their physician prescribe such products as Ana-Kit or EpiPen, which contain epinephrine that the patient injects into the thigh.

Allergy Prevention Tips

The following suggestions compiled by the Task Force on Allergic Disorders can help patients reduce allergen exposure and, consequently, allergic symptoms:

  • Avoid household cleaning products that trigger allergic symptoms.
  • Avoid substances and fumes that irritate airways, including cigarette and cigar smoke.
  • Reduce allergens in the home with careful and frequent cleaning, by covering mattresses and pillows with special covers, and by frequent washing of bedding with very hot water to kill dust mites.
  • Keep the indoor humidity at less than 50% to reduce mold.
  • Forego ownership of cats or dogs. (Cat dander and saliva are particularly troublesome for persons with allergies and can remain in a house for months after the animal is removed.)
  • People with food and latex allergies should be aware of their offending allergens (i.e., they should learn to read ingredient labels on food products, wear latex-free gloves, and alert medical professionals to ensure use of latex substitutes at physicians’ offices, clinics, etc.).
  • Allergic individuals should exercise regularly, but avoid activity near fields full of grasses and weeds that contain allergens (pollens, dust, molds, etc.). Wind-pollinated bushes and oak, elm, pecan, and maple trees are notorious allergens.
  • After working in the garden, allergic individuals should remove their clothes immediately, shower, and rinse their nostrils with a salt-water rinse.

© August 1999, Pharmacy Times