One of the marvels of the human body is that it can defend itself against harmful invaders such as viruses or bacteria. But sometimes the defenses are too aggressive, and harmless substances such as food, drugs or pollen are mistakenly identified as dangerous. These triggers are called "allergens." The immune system then rallies a defensive response, launching a host of complex chemicals to attack and destroy the supposed enemy. In the process, some unpleasant and, in extreme cases, life-threatening symptoms may be experienced by the allergy-prone individual. These allergic reactions may occur anywhere in the body, but usually happen in the skin, eyes, lining of the stomach, nose, sinuses, throat and lungs - places where the immune system normally fights off invaders that are inhaled, swallowed or come in contact with the skin.
There are hundreds of ordinary substances that can trigger allergic reactions. Among the most common are plant pollens, molds, household dust (dust mites), animal dander, foods, medicines, feathers and insect stings. These triggers are called "allergens." An allergic reaction may occur anywhere in the body, but usually appears in the skin, eyes, lining of the stomach, nose, sinuses, throat and lungs - places where special immune system cells are stationed to fight off invaders that are inhaled, swallowed or come in contact with the skin.
Asthma and allergies can affect anyone, regardless of age, gender, race or socioeconomic factors. While it is true that asthma and allergies develop more commonly in children, they can occur for the first time at any age or, in some cases, recur after many years of remission. Although the exact genetic factors are not yet understood, allergies and asthma can run in families. Factors such as hormones, stress, smoke, perfume or other environmental irritants may also play a role.
While an estimated 40 - 50 million Americans have allergies, only 1 - 2% of all adults are allergic to foods or food additives. Food allergies are more common in children. The most common food allergies are to milk, peanuts, soy, eggs, and wheat. Pollen and animal dander allergies The pollens from trees, grasses and weeds are a major source of allergies, along with animal dander. Allergic Rhinitis, also known as "hay fever" is a term that describes the symptoms produced by nasal irritation or inflammation due to contact with allergens. Symptoms include runny nose, itching, sneezing and stuffy nose due to blockage or congestion. These symptoms are the nose's natural response to inflammation and irritation. Diagnostic testing can be done to identify which pollens or animals are causing your symptoms, and your allergist can develop a treatment plan for your individual condition. Stinging insect allergies Most people are not allergic to insect stings and should know the difference between an allergic reaction and a normal reaction. More than 500,000 people enter hospital emergency rooms every year suffering from insect stings. A severe allergic reaction known as anaphylaxis occurs in 0.5% - 5% of the U.S. population as a result of insect stings. At least 40 deaths per year result from insect sting anaphylaxis. Simple testing can be done to determine if you are allergic to insect stings, and excellent treatment is available.
Asthma is a chronic lung disease in which the lining of the airways become inflamed and swollen and muscle spasms restrict the flow of air to the lungs. It is a relatively common condition and the incidence of the disease has grown in recent years. Currently, it is estimated that 12 million Americans - including more than four million children - have asthma.
If you experience difficulty breathing, a tight feeling in the chest, coughing, and wheezing, you may suffer from asthma. Sometimes a chronic cough is the only symptom, and many of these cases go undiagnosed. The symptoms of asthma are most frequently noted at night and in the morning, but an asthma episode can happen at any time. Symptoms can range from mild discomfort to life-threatening attacks which require immediate emergency treatment.
Although the exact cause of asthma is still being studied, it is known to be a combination of inflammation of the lung combined with narrowing of the lung passages activated by the body's immune system. There are a number of factors that are known to trigger an asthma episode including: Exposure to Allergens Substances that cause an allergic reaction, including pollen, dust, mold, feathers, animal dander, and some foods can trigger an asthma attack in some individuals.
First, our asthma specialist will determine the severity of your asthma through breathing tests (spirometry or "PFT"), and will possibly recommend allergy testing to see if allergens are causing your asthma to become worse. All of our testing and treatment is based on scientifically proven research. After testing, the doctor will work with you to develop a plan tailored to your individual symptoms. The doctor may prescribe medications to keep your asthma under control or alleviate acute symptoms. We will have you attend an asthma education session with our certified asthma educator. This will allow you to become more informed and involved in your own treatment. This essential part of our evaluation has definitively reduced urgent medical center and emergency room visits for our patients. Our goal is to prevent asthma attacks before they start. With proper diagnosis and treatment by an asthma specialist, most people with asthma can pursue normal vigorous lifestyles and expect to:
An allergist is a doctor who is an expert in the diagnosis and treatment of allergic diseases and conditions such as:
An allergist is a doctor who is an expert in the diagnosis and treatment of allergic diseases and conditions such as:
Some useful guidelines include Your allergies are causing secondary symptoms such as chronic sinus infections, nasal congestion or difficulty breathing. You experience hay fever or other allergy symptoms several months out of the year. Antihistamines and other over-the-counter medications do not control your allergy symptoms, or create unacceptable side effects, such as drowsiness. Your asthma or allergies are interfering with your ability to carry on day-to-day activities. Your asthma or allergies decrease the quality of your life. You are experiencing warning signs of asthma such as:
Evaluation Our allergist will first review your symptoms, how often they occur, and what triggers them. The evaluation will include:
The mechanism for inherited allergies is not yet well understood. We do know that the stronger the family history of allergy, the more likely it will be that other family members will be allergic.
Allergies or asthma, especially in children, may eventually become more easily controlled, or may even seem to be "outgrown." This may take years, however, so that treatment may be necessary for prolonged periods. Asthma may occur in childhood, improve, but recur later in adulthood.
Skin testing is performed to detect whether a person reacts to an allergen by introducing the allergen to the skin of the back or arm. If the person is allergic to the specific allergen, a small wheal and flare (hive) will occur at the skin test site. Most skin testing is done to test for allergies to environmental allergens such as pollens or animal dander. Skin testing for food allergies is usually not done until after the individual has already had blood tests for food allergies.
In this office, two methods are generally used. A majority of tests are done by "prick" method. Drops of the skin test material are applied in rows across the back as tiny scratches are made through each drop, pressing the allergen into the skin. Results are usually read in 10 to 20 minutes. Additionally, some "intradermal" tests may be done after negative or indeterminate skin prick test results. These involve a small injection into the superficial layers of the skin of the arm. "Patch" tests are used to identify materials causing skin reactions on contact. A small amount of the suspect material is placed on a patch and the patch is taped on the skin and left for 48 hours before being read.
No, the tests usually do not hurt. People who are allergic to one or more of the allergens may experience itching at the site of the test. After the test, we will put a cream on the test site to help with the itching. Some people may have a delayed reaction to the tests, which consists of redness or a small swelling at the site. For most people, taking an antihistamine after the testing will alleviate the symptoms.
In general, skin test results correlate very well with clinical symptoms. As is true in all of medicine, however, there are some patients who do not follow the rule, and linking your physical examination with your medical history is, therefore, a very important part of allergy evaluation.
Medications containing antihistamines can suppress skin test reactions. Antihistamines are present in many cold remedies, allergy medicines, and motion sickness pills. Antihistamines must be stopped five days prior to skin testing. Some antidepressants also have antihistamine activity and may interfere with skin tests. If you cannot go without these medications, or question whether or not your particular medication should be stopped, check with our office.
This treatment involves periodic injections with tiny amounts of the allergen to which you are allergic. A tolerance to the allergen is gradually built up so that you can be exposed to the allergen without developing the same degree of allergic symptoms. Allergy injections may be prescribed for stinging insects, pollens, mites, molds and animal dander. Food allergy cannot be safely treated with allergy immunotherapy at this time.
This varies with the allergy being treated and how your body responds to the immunotherapy. In general, patients require injections at regular intervals for three to five years.
Allergy injections contain small amounts of the purified substances (allergens) to which the particular patients is allergic. Allergy injections may be prescribed for stinging insects, pollens, mites, molds and animal danders. Food allergy cannot be safely treated with allergy immunotherapy at this time.
Since the shots contain materials to which the patient is allergic, it is possible to produce allergic symptoms from the injections. Many patients experience short-term itching or swelling at the injection site. Taking an antihistamine on the day of the injection can minimize this reaction. Rarely, the patient may experience hives, trouble breathing, or a generalized allergic reaction. A reaction is more common if the injection is given when a patient is having active asthma symptoms. Always report any breathing difficulties before receiving allergy immunotherapy. Allergy injections also should not be given if a patient is ill or has a fever. Patients who are taking a beta blocker should not be on immunotherapy.
You must remain in our office for 20 minutes after receiving an allergy injection. This is necessary so that if you have a severe reaction it can be treated promptly.
This varies with the allergy being treated and the response of the patient. In general, patients require injections at regular intervals for three to five years. This will vary with the allergies being treated, and the response of the patient.
Development of tolerance is a slow process. At the start, we recommend having injections two times a week to build up tolerance. Allergy injections must be given at least 48 hours apart. Once the desired maintenance dose is achieved, you can cut back to shots every 14 to 21 days. Immunotherapy with venoms for stinging insect allergy follows a slightly different schedule. Keeping to the schedule of injections is very important. If injections are given irregularly, control of symptoms may be reduced or delayed, and risk of allergic reactions to the injections is increased.
With Offices in Bozeman and Butte, we can help.
Anyone with allergies and asthma should be able to feel good, be active all day and sleep well at night. You don’t need to accept less. An allergist can help you find relief and reclaim and maintain a vital lifestyle.
Q: Do People Outgrow their Allergies?
A: Allergies or asthma, especially in children, may eventually become more easily controlled, or may even seem to be “outgrown.” This may take years, however, so that treatment may be necessary for prolonged periods. Asthma may occur in childhood, improve, but recur later in adulthood.