Allergies

Spring and summer bring forth wonderful feelings of renewal, freshness, and sunshine especially after a long hard winter. But for people who suffer from allergies, the arrival of warm weather can be a miserable time of the year.

According to the Asthma and Allergy Foundation of America, nearly 50 million people in the U.S. suffer from allergies with over 80% developing symptoms before the age of 20. Around the globe, an estimated 300 million people have asthma, and an estimated 1 billion people experience an allergy, intolerance, or sensitivity. That is roughly one in every seven people.

Allergies occur when the immune system reacts to a foreign substance such as pollen in the air or pet dander. When a person has allergies, the immune system makes antibodies that identify a particular allergen as being harmful — even if it isn’t — which causes the body to react by way of inflaming the skin, sinus, airways, or even digestive systems.

Types of Allergies

The most common types of allergies are environmental and food related. Environmental allergies can be seasonal or year around. Seasonal allergies are most often triggered by pollen or mold spores.

Ragweed pollen is the most common pollen causing the most severe and longest seasonal allergies and asthma in North America. The ragweed pollen season is typically from the middle of August to October. Mold spores are most prevalent in the summer months and tend to recede with the first hard frost. In addition, grass and tree pollen can cause severe allergy symptoms each spring, usually from March through June. Other allergens like dust mites and pet can be present year round.

Over the past several decades, climate change is causing longer warm seasons resulting in more pollen exposure. As temperatures rise globally, the season for allergies begins earlier and ends later. So allergy sufferers not only get sicker, they also tend to suffer longer. Allergenic weeds are also on the rise due to increased carbon emissions.

Global warming is just one of several contributing factors to an increase in allergies in recent years, says Dr. Diane Ozog of Dr. Diane L. Ozog & Associates, an allergy and asthma specialist with offices in Naperville. Other factors include higher concentrations of airborne pollution, less ventilation in homes and offices, dietary considerations and more sedentary lifestyles.

“Depending on a person’s exposure pattern to the different allergens, this will result in the pattern of symptoms for that person,” says Ozog. “So a person who spends most of the time outdoors may be symptomatic in different ways than someone who is primarily indoors exposed to dust mites, cockroaches or furry pets.”

The likelihood of having or developing an allergy is also inherited to a significant degree. “If both parents have allergies, their children have about a 75% chance of being allergic,” says Dr. Stephen Kraseman of Drs. Girgis & Associates with offices in Hinsdale, La Grange and Oak Park. “That decreases to 30-50% when just one parent is allergic.”

“There is a very, very high level of complexity to the development of allergic disease,” cautions Dr. Brian Smart, an allergy, asthma and immunology physician at DuPage Medical Group with offices in Glen Ellyn, Lombard and Naperville. “ There are numerous genes and other risk factors involved, before allergies occur. It is useful to think in these terms: genetic factors create a predisposition to develop an allergy, then environmental exposures trigger the allergy to occur.”

The most common symptoms of airborn allergies include nasal congestion, sneezing, postnasal drip, rhinorrhea (drainage from the nose), itchy eyes, nose, and throat. While some allergies are little more than temporary annoyances, others are daily discomforts, and a few can be serious threats — a severe allergic reaction to venom, food, or medication can be potentially life-threatening.

While most allergies don’t really have a complete cure, they can be treated in a variety of ways to help manage and maintain a certain quality of life. “People who are not obtaining adequate relief from over the counter treatments or unable to tolerate these medications would be advised to seek professional help from an allergy specialist,” says Ozog.

Allergies 1

Treatment Measures for Allergies

“Allergy testing is usually the first step in determining the best treatment for a given individual,”says Kraseman. “This helps us understand the exact triggers for allergies and provides the right treatment options.”

When a patient seeks medical help for allergies, most doctors will require detailed medical history, a physical exam, and an allergy skin test to diagnose allergies. In some cases, based on the history and exam, additional tests might be needed. The results of the tests are analyzed and a specific allergy management plan is developed that is customized to the patient.

“There are three pillars for allergy management — environmental, medications, and allergy immunotherapy,” says Smart. Environmental control measures are always the first step to decrease exposure to the specific allergen involved. This includes avoiding outdoor activities when pollen and spore counts are elevated, encasing mattresses and pillows in vinyl or semipermeable covers, or washing all bedding regularly when dealing with dust mite allergies. These are generally guided by the results of the allergy test to determine the sensitivity level for various possible allergens.

The next step is to implement a medication plan based on the nature of the symptoms. Typical medications include oral, ocular, nasal antihistamines, nasal sprays, eye drops, decongestants, and leukotriene inhibitors.

Allergy immunotherapy or allergy shots usually include steroids. This form of treatment changes the immune system thereby making it possible to prevent the development of new allergies and asthma.

“Allergy immunotherapy is the single most effective management option for airborne allergy,” says Smart. “But the best use of the three pillars is different for everyone and hence requires careful evaluation and a thoughtful plan.”

According to Ozog, when started early in life, allergy shots have been shown to modify the natural course of allergic diseases by preventing new sensitizations to other allergens and reducing asthma.

New Forms of Allergy Treatments

As allergy research continues to evolve, new treatment options are becoming available. “Over the last few years, a new form of immunotherapy is available — sublingual (under the tongue) tablets for ragweed, grass, and dust mite allergies,” says Ozog. “In addition, there are several new biologic therapies for asthma, eczema and chronic rhinosinusitis that are administered by an injection and in some cases can be given at home.” This new at-home treatment method can sometimes be an alternative to allergy shots.

It is not completely known why some people develop new allergies or have existing allergies get better or worse with age. “After two years of age, the prevalence of allergic rhinitis gradually increases peaking in the early school years and then again in early adult years,” says Ozog. “It is uncommon to present for the first time in older adults unless there has been a significant change in exposure such as a new pet or a move to a different climate or environment.”

Neither is it clear why some individuals experience a life-threatening reaction to certain allergens while others have mild symptoms. “Allergy represents an abnormal response of one’s immune system, and certain people have a stronger abnormal response than others,” says Kraseman. “Awareness of one’s risk factors and using reasonable caution in avoiding known triggers will decrease the risk of adverse reactions.”

Untreated allergies can often lead to other secondary problems which can decrease the quality of life as patients deal with uncomfortable symptoms. For example, up to 50% of patients with asthma have allergic rhinitis. This triggers increased asthma problems when exposed to the allergen.

Eczema, sinusitis, ear infections, headaches, cough, allergic conjunctivitis, and sleep disorders are other common consequences of uncontrolled allergies.

The good news is that there are many options available to help minimize symptoms. Smart likens allergy care to a game of chess.

“A few simple rules can be learned in minutes, but mastery takes many years of training and experience,” says Smart. “The good news is that board-certified allergist and immunologists have exactly this kind of training and experience.

“Most people, even with using every available tool, do not feel perfect every day,” continues Smart,” but it is reasonable to hope and expect, with thorough care and consistently following a plan, allergy symptoms should be manageable and should not keep someone from participating fully in important parts of life, like work, school and outdoor activities.

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