ALLERGIES

45 million Americans suffer from allergies. Allergy symptoms occur when the body’s immune system begins to respond to a substance as though it were a dangerous invader (called an antigen).The body sends out defenders called antibodies to the site and chemical mediators, such as histamine, into the bloodstream. This is what causes our allergy symptoms. Common symptoms are itching eyes, sneezing, nasal stuffiness, or a drippy nose. Some people have drainage down the back of their throats, hoarseness, or cough. Skin irritation, hives, and asthma are other symptoms that can be related to allergies. Sometimes, allergies can contribute to chronic sinus problems as swollen membranes in the nose block sinus drainage pathways.

Pollen allergies (also called hay fever) are common causes when patients have seasonal problems. In the early spring, tree pollens, such as Juniper and Cottonwood, can cause allergy symptoms. In late May and June, grasses are the culprit. Then, after a brief full in July, weed pollens (such as ragweed, sage, and tumbleweed) may cause fall symptoms.

Perennial allergens are substances that may affect us all year long.These include pet dander, foods, and molds. Our ENT physicians are highly qualified to diagnose, test, and treat allergic disease. After a careful history and exam, if allergy is suspected, we will have you meet with our allergy nurse who will review all your medications and schedule you for an allergy test. These tests help identify which particular allergens trigger your symptoms.

Once the testing has been completed, we will develop a customized treatment plan for you. There are three basic, accepted approaches to allergy care: avoidance of offending allergens, medications that treat symptoms, and immunotherapy or desensitization to allergies with shots or drops. Our doctors will help guide you in making these choices.

Here are some suggestions for controlling your environment:

• Use a HEPA air purifier in your bedroom to help clean the air you breathe while sleeping.
• Keep windows closed during heavy pollen season.
• Wear a pollen mask when mowing grass.
• Rinsing the nose or eyes helps wash pollen away.
• Keep pets out of the bedroom and limit your exposure.
• Rid your home of indoor plants and other sources of mold.

Though medicines help, they will often be needed long term and only treat the symptoms.

• Antihistamines, both over-the-counter and prescription, help relieve sneezing, drippy noses.
• Decongestants can help with nasal congestion.
• Nasal steroid sprays can decrease many allergy nasal symptoms.
• Eye drops can help relieve itchy, red, or watery eyes

This is the only treatment method that can offer lasting relief or cure from allergies. Allergy injections or shots are designed to desensitize you to those substances to which you are allergic. Sterile extracts are prepared from allergy-producing substances such as pollens, mold spores, and animal dander. These biological substances are injected in increasingly stronger doses on a regular schedule (usually once per week) until your maximum dose has been achieved. This formula is custom made for each individual based on their test results and the level of sensitivity. We give allergy injections Monday through Thursday from 7:30 AM to 5:00 PM and no appointment is necessary, making it convenient for patients to just stop in.

Allergy drops (also sublingual immunotherapy) work like allergy shots, slowly desensitizing you to your allergies. They are delivered under the tongue in a drop form that can be taken at home. Allergy drops can safely and effectively treat a broad range of allergies, including pollen, dander, and molds. Drops are taken every day and are placed under the tongue. They can be taken when patients are traveling. They are very safe and have a slight sweet taste. The drops have proven to be a great alternative for patients who cannot come in every week for injections. Medical insurance does not currently cover the cost of drops, but they are reasonable in price.

Inflammation of the nasal mucous membrane is called rhinitis. The symptoms include sneezing, runny, and/or itchy nose caused by irritation and congestion in the nose. There are two types: allergic rhinitis and non-allergic rhinitis.

Allergic Rhinitis: This condition occurs when the body’s immune system over-responds to specific, non-infectious particles such as plant pollens, molds, dust mites, animal hair, industrial chemicals (including tobacco smoke), foods, medicines, and insect venom. During an allergic attack, antibodies, primarily immunoglobin E (IgE), attach to mast cells (cells that release histamine) in the lungs, skin, and mucous membranes. Once IgE connects with the mast cells, a number of chemicals are released. One of the chemicals, histamine, opens the blood vessels and causes skin redness and swollen membranes. When this occurs in the nose, sneezing and congestion are the result.

Seasonal allergic rhinitis or hayfever occurs in late summer or spring. Hypersensitivity to ragweed, not hay, is the primary cause of seasonal allergic rhinitis in 75 percent of all Americans who suffer from this seasonal disorder. People with sensitivity to tree pollen have symptoms in late March or early April; an allergic reaction to mold spores occurs in October and November as a consequence of falling leaves.

Perennial allergic rhinitis occurs year-round and can result from sensitivity to pet hair, mold on wallpaper, houseplants, carpeting, and upholstery. Some studies suggest that air pollution such as automobile engine emissions can aggravate allergic rhinitis. Although bacteria is not the cause of allergic rhinitis, one medical study found a significant number of the bacteria Staphylococcus Aureus in the nasal passages of patients with year-round allergic rhinitis, concluding that the allergic condition may lead to higher bacterial levels, thereby creating a condition that worsens the allergies.

Patients who suffer from recurring bouts of allergic rhinitis should observe their symptoms on a continuous basis. If facial pain or a greenish-yellow nasal discharge occurs, a qualified ear, nose, and throat specialist can provide appropriate sinusitis treatment.

Non-Allergic Rhinitis: This form of rhinitis does not depend on the presence of IgE and is not due to an allergic reaction. The symptoms can be triggered by cigarette smoke and other pollutants as well as strong odors, alcoholic beverages, and cold. Other causes may include blockages in the nose, a deviated septum, infections, and over-use of medications such as decongestants.

Rhinosinusitis: Clarifying The Relationship Between The Sinuses And Rhinitis Recent studies by otolaryngologist–head and neck surgeons have better defined the association between rhinitis and sinusitis. They have concluded that sinusitis is often preceded by rhinitis and rarely occurs without concurrent rhinitis. The symptoms, nasal obstruction, discharge, and loss of smell, occur in both disorders. Most importantly, computed tomography (CT scan) findings have established that the mucosal linings of the nose and sinuses are simultaneously involved in the common cold (previously, thought to affect only the nasal passages). Otolaryngologists, acknowledging the inter-relationship between the nasal and sinus passages, now refer to sinusitis as rhinosinusitis.

The catalyst relating the two disorders is thought to involve nasal sinus overflow obstruction, followed by bacterial colonization and infection leading to acute, recurrent, or chronic sinusitis. Likewise, chronic inflammation due to allergies can lead to obstruction and subsequent sinusitis.

Other medical research has supported the close relationship between allergic rhinitis and sinusitis. In a retrospective study on sinus abnormalities in 1,120 patients (from two to 87 years of age), thickening of the sinus mucosa was more commonly found in sinusitis patients during July, August, September, and December, months in which pollen, mold, and viral epidemics are prominent. A review of patients (four to 83 years of age) who had surgery to treat their chronic sinus conditions revealed that those with seasonal allergy and nasal polyps are more likely to experience a recurrence of their sinusitis.