- Inflammation of the nasal passages resulting in sneezing, itching, congestion, runny nose and drainage in the throat.
- Increased incidence with personal or family history of asthma, eczema or allergies.
- Allergic rhinitis is the nasal reaction to allergens.
- Some allergens are year round (dust and pets) and some are seasonal (pollens and mold).
- These allergens can also affect the eyes, throat and ears.
- Contributes to other diseases (Asthma, Sinusitis, Recurrent ear infections, Headache, Chronic cough, Throat clearing usually due to post-nasal drip, Fatigue, etc.) and affects quality of life.
- Allergists help identify allergens, customize treatment and administer allergy injections.
- Symptoms similar to allergic rhinitis but with no known allergic cause.
- Triggers are weather changes and irritants (Smoke, Dust, Strong odors,Fragrances, Hair spray, etc.).
- Allergist help rule out allergy as a cause and customize treatment options.
RECURRENT EAR INFECTIONS
- Allergies can contribute to recurrent ear infections and Eustachian tube dysfunction.
- Controlling nasal symptoms can decrease ear infections and allow for better function of the Eustachian tube.
- Although Ear, Nose & Throat specialists may still be needed, treatment of allergies may reduce the need for surgical intervention.
- Allergists help identify allergens and customize treatment to improve symptoms which can possibly prevent the need for surgical intervention.
- Inflammation of the lining of the sinuses and nose.
- Acute sinusitis is typically caused by viral infections but can also be caused by bacterial and fungal infections.
- Symptoms include: nasal congestion and blockage, thick yellow-green discharge from the nose, pain in the teeth and face, fever, fatigue, cough, difficulty or inability to smell, ear pressure or fullness, headache and bad breath.
- Sometimes allergies contribute to recurrent acute and chronic sinusitis.
- Allergies cause chronic inflammation which can increase the risk for sinusitis when left untreated.
- If allergies are well controlled, sinus infections may decrease without any other intervention, including surgery.
- Allergists help to identify allergens and customize treatment which can decrease the need for recurrent antibiotic treatment as well as possibly preventing any surgical intervention.
- Warning signs of immunodeficiency include:
- Eight or more new ear infections in a year.
- Two or more serious sinus infections in a year.
- Two or more months on antibiotics with little effect.
- Two or more pneumonias within a year.
- Failure of infant to gain weight or grow normally.
- Recurrent, deep skin or organ abscesses.
- Persistent thrush in the mouth or elsewhere on skin after age one.
- Need for IV antibiotics to clear infections.
- Two or more deep-seated infections.
- A family history of primary immunodeficiency.
- Most common immunodeficiency is IgA deficiency which occurs in 1 out of 500 people.
- Although most primary immunodeficiency is present from birth, combined variable immunodeficiency can occur later in life causing recurrent infections in the adult population.
- Allergists customize treatment after using specialized laboratory testing to diagnose immunodeficiency.
- Lung disease caused by narrowing of airways in the lungs which can be partially or completely reversible.
- Asthma causes excessive mucus production and inflammation in the airways which can be reversible if treated early.
- Symptoms include Coughing, Wheezing, Chest Congestion/Tightness and Shortness of Breath.
- Asthma triggers are numerous but include allergens, viral infections, irritants such as smoke exposure, and weather.
- Controlling asthma involves identifying and avoiding triggers as much as possible.
- A family history of asthma increases the risk of developing asthma.
- Asthma can be either intermittent or persistent. Sometimes, chronic cough can be the sole manifestation of asthma.
- Most patients with asthma should be able to participate in all activities and function normally with proper management.
- Asthma medications include both controller medications and rescue medications.
- Allergists help identify triggers, perform pulmonary function and skin testing, customize treatment plan (medications and asthma action plan development) and monitor progress.
- Cough can be acute (lasting for a few days) or chronic (lasting for weeks).
- Chronic cough can be caused by a variety of conditions. The most common cause in children is from asthma while the most common cause for adults is from Post-nasal drip syndrome (allergens and irritants), Gastroesophageal
reflux disease (GERD), Habit and ACE inhibitors (blood pressure medications).
- Chronic cough can interfere with daily activities, sleep and bladder control in females.
- There is a need for specific causes to be identified in order to eliminate and treat chronic cough.
- Allergists help identify causes to facilitate treatment options or initiate further investigations.
- Inflammatory skin condition with dry patches that causes skin to itch and flake.
- There are allergic and non-allergic forms of eczema.
- Chronic eczema can affect quality of life due to the intensity of the itching and sleep interference.
- Uncontrolled eczema can lead to skin infection including Methicillinresistant Staphylococcus Aureus (MRSA).
- If eczema begins in early childhood, it typically improves with age though can persist for many years.
- When eczema begins in adulthood, it may be more chronic (long-lasting).
- Eczema results in an itch-scratch cycle that continues and worsens. Antihistamines can be helpful to break this cycle.
- Allergists help identify triggers including environmental and food allergens that may be contributing to uncontrolled eczema. Allergists can prescribe medications and teach proper skin hydration techniques to control eczema.
- Inflammation of the skin caused by contact with a substance containing an allergen or irritant such as plants (poison ivy and poison oak), cosmetics, metals and fragrances.
- Allergists help identify causes by taking detailed history and performing patch testing.
- Hives are raised, red welts of various sizes that are typically itchy.
- In some instances, hives are associated with swelling. (Angioedema).
- Hives can be acute (lasting for a few hours or days) or chronic (lasting for six weeks or longer).
- Acute hives are commonly caused by an overreaction to foods, drugs, insect stings or infections. Most cases of Chronic hives, the cause cannot be found (Idiopathic Urticaria).
- Finding the cause, avoiding the trigger and early treatment is recommended.
- Although many times a specific cause is not identified, safe effective treatment options are available.
- Allergists help identify causes by taking detailed history, ordering special laboratory tests and customizing treatment plan.
- A condition that causes swelling of tissue under the skin.
- Can be life threatening if it involves the airway.
- A common cause of angioedema is an allergic reaction to foods, medication, contact allergen, insect sting or exercise.
- There is also a condition known as hereditary angioedema that causes recurrent angioedema.
- Allergists help identify causes, customize treatment plan and manage symptoms.
- An immune system response to food resulting in an allergic reaction that can involve skin, gastrointestinal, respiratory and cardiovascular systems.
- Most commonly caused by milk, egg, wheat, soy, peanuts, tree nuts, fish and shellfish.
- Any type of food can potentially cause an allergic reaction.
- Reactions can range from very mild hives to a life-threatening reaction (Anaphylaxis) involving the respiratory or cardiovascular system.
- Identifying and avoiding the foods that cause reactions is of paramount importance.
- Identification is by history with confirmatory skin testing or blood testing with interpretation by an allergist.
- Clinical trials for oral food desensitization are underway
- Some patients may require oral food challenges to confirm safety of food reintroduction.
- Allergists help identify the offending food or foods, educate about avoidance, train the patient on when and how to use epinephrine auto-injector and educate family and schools about the patient’s specific food allergies.
- Condition in which eosinophils build up in the esophagus resulting in inflammation and tissue damage.
- Although the definite cause has not been established, food allergies may play a role in this inflammation and disease.
- Symptoms include food sticking, trouble swallowing, heartburn, feeding problems in young children, nausea and vomiting.
- Diagnosis is confirmed by performing an endoscopy with biopsy revealing elevated eosinophils in the esophagus.
- Allergists help identify the possible role of food allergies in patients diagnosed with Eosinophilic Esophagitis and work with a gastroenterologist in managing the disease.
INSECT STING HYPERSENSITIVITY
- An adverse allergic reaction to the venom of stinging insects including honey bee, hornets, yellow jackets, wasps and fire ants.
- Insect stings can cause severe life threatening reactions and are difficult to avoid.
- Symptoms that are life threatening include shortness of breath, chest tightness, wheezing, flushing, hypotension (dizziness and/or lightheadedness), vomiting and nausea.
- Children less than 16 years of age, with only skin reactions (hives) are not at a higher risk of developing severe reactions so testing or treatment may not be required.
- Adults with skin reactions (hives) have an increased risk of further lifethreatening reactions and should be tested and treated.
- Although having and using an epinephrine auto-injector is important, patients need to be tested and treated in order to prevent any further reactions.
- The standard of care is venom immunotherapy, commonly known as allergy shots.
- Venom immunotherapy decreases the likelihood of an allergic reaction from re-stings by 95-99%.
- Allergists help identify venom hypersensitivity and administer venom immunotherapy.
- An adverse allergic reaction to a medication.
- There are two major types of drug reactions: Immediate and Delayed.
- Immediate reactions include hives, flushing, swelling, throat tightness, wheezing, shortness of breath, nausea, vomiting, feeling light-headed and other symptoms.
- Immediate reactions can be life-threatening.
- Delayed reactions are typically less serious and result in a rash that can occur days after taking a medication.
- Delayed reactions are generally not life-threatening.
- Allergists help identify drug allergies through skin testing, blood testing and oral challenges so that patients may continue to use medication safely.
ALLERGY SKIN TESTING
- Utilizes manufactured extracts and fresh foods containing common allergens to identify allergies.
- Involves a mild prick or scratch on the skin that does not cause bleeding or pain for the patient.
- A positive result will cause a bump and redness (similar to a mosquito bite) and usually develops within 15 minutes.
- Testing is typically done on the arm or back.
- Sometimes additional intradermal testing (injection of a tiny amount of extract just under the skin) may be needed.
- Skin testing is available for many foods and environmental allergens and is typically less costly, quicker and more reliable than blood testing.
- Allergists perform and interpret skin testing in the office to help diagnosis and manage allergic conditions.
- Injections that are given to reduce sensitivity to allergens (also known as Allergy Immunotherapy or Desensitization).
- Available for pollens (grasses, trees and weeds), cat, dog, dust mite, molds and stinging insects (honey bee, hornets, wasps, yellow jacket and fire ant).
- The goal is to improve quality of life by controlling allergy symptoms while decreasing medication usage.
- Usually administered for a minimum of 3-5 years with a range from weekly to monthly injections.
- Improves control of asthma in patients with allergen-induced asthma.
- Cannot be used to treat allergies related to food, latex or medications.
- Allergists help determine if allergy shots are appropriate for a patient, create customized allergy extracts for each patient, administer allergy shots, treat any adverse reactions and monitor efficacy of allergy immunotherapy.