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Approximately one out of six Americans has one or more significant allergies, and suffers one or more of a huge and varied array of symptoms that can be vexing to diagnose. Consequently, many allergy disorders go undiagnosed and untreated.
While the physiological mechanizations of allergies are so deeply complex that modern day medicine is still unlocking its secrets, we do have a basic - and ever broadening - understanding of its workings, which enhances our methods of treatment. The following is a basic explanation that will increase your understanding of allergic reactions and the treatment of its symptoms.
An allergic reaction can occur almost anywhere in your body. The symptoms of the reaction often occur at the site of the reaction. Hence, the sneezing and stuffy nose of allergic rhinitis; the stomach cramps of food allergy; and the itching rash of poison ivy.
At other times, however, the symptoms may occur in a separate part of the body. Food allergies and sensitivities are known to cause migraine headaches, and can trigger asthma. Allergic reactions to insect stings can cause hives, dizziness, and other symptoms. And any type of severe allergic reaction can cause systemic symptoms that can be life threatening.
Stated most simply, "allergy" is an individual's sensitivity to a foreign substance that is usually harmless. This substance, called an allergen or antigen, is introduced to your immune system by a number of different routes; either by ingestion, inhalation, injection, or simply by touch.
An infection can increase an individual's likelihood of developing an allergy, as can stressful emotional factors. Allergy is the most personalized of diseases, and can occur at any point in an individual's lifetime. Once an allergic individual's immune system has identified an antigen, it sets into work producing antibodies to defend itself. Normal individuals produce Immunoglobin G to ward off invaders. It does not cause an allergic reaction. Allergic individuals also produce Immunoglobin G... but - in addition - they produce Immunoglobin E, an antibody with a "memory" for a specific substance.
When a substance - oak pollen, for instance - is introduced into the system, the Immunoglobin E antibodies specific for oak pollen combine with the pollen to form an "antigen-antibody complex." The IgE antibody is bound to the surface of mast cells, which then release histamine.
Histamine, and related substances, cause allergic symptoms to occur. This is a vastly simplified explanation of an allergic reaction. There are many chemicals that become part of the allergy chain.
Diagnosing allergies is, at times, easy, and at other times, all but impossible. A patient's history, and a physical examination, may suggest certain allergies, which can usually be verified by a skin test. Other allergies - notably food allergies - are sometimes diagnosed by blood testing. Still others may require more extensive diagnostic efforts.
Skin tests are performed by injecting a small amount of an allergen just under the skin. This test is no more painful than a mosquito bite, and will usually give an indication within twenty minutes of application. Skin testing is the most accurate type of diagnosis for most allergies.
Blood testing requires sending a small sample of blood to an outside laboratory, and is more expensive - and generally less accurate - than skin testing. It may help to uncover food allergies, however, and is sometimes considered a useful diagnostic tool.
Food allergies can be difficult to pinpoint. Sometimes the only way to accurately diagnose a food allergy is by process of elimination - to withhold a certain food substance from the diet for a period of time to observe whether symptoms abate.
Of primary concern is successfully treating the allergy, once it is detected. In principle, the best way to treat an allergy is to remove the cause. Sometimes this is a practical solution, and sometimes it is not. If the allergy is caused by a pet, down pillow, wool sweater, or certain food, removal of the allergen will eliminate the symptoms.
We may not wish to remove certain allergy-provokers, and others may be impossible to eliminate from one's environment. In Rochester, house dust mites, tree and grass pollens, and molds are most common. Limiting exposure will - at best - reduce symptoms. Sometimes there is no better option than immunotherapy to reduce or eliminate the misery of hay fever and other manifestations of allergies.
Immunotherapy - also known as "hyposensitization" and "allergy shots" - is helpful in most cases. Measured amounts of the identified allergen are actually introduced into the patient's system over a period of time through a series of weekly injections. Through carefully measured doses, enough of the allergen is injected to build immunity, but not enough to cause an unfavorable reaction to occur. Doses increase gradually, until a "maintenance" level is reached. Immunotherapy is not a quick fix. It may take months - or even longer - for sensitivity to decrease appreciably. In the meantime, there are medicines that provide symptomatic relief. Antihistamines, decongestants, bronchiodilators, cortisone, and other drugs are prescribed as appropriate.
Allergies are hereditary, though the tendency to become allergic may skip a generation, and go from grandparent to child. While in most individuals allergies first appear in the childhood years, they can wait until later stages of life. If you are experiencing unexplained symptoms and suspect allergies, call our office for an initial consultation.
The information provided in this Web site is not intended to replace consultation with your physician.
Entire contents © 2016 Ulrich O. Ringwald, M.D. Reproduction in whole or in part without
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