ALLERGY THERAPY AT MANN EAR, NOSE & THROAT
Allergy Technician: Yokasta Castillo
Allergies affect approximately forty-five million Americans. Allergy symptoms appear when the body’s immune system begins to respond to an otherwise normal substance (called an antigen or allergen) as though it were a dangerous invader. An abnormal response by the immune system results in a release of chemical mediators, such as histamine, into the bloodstream. Those chemicals cause changes in the body, which produce various symptoms that are often annoying, and sometimes life-threatening.
Symptoms that may be caused by allergy are itching eyes, sneezing, nasal stuffiness, facial pressure, nasal congestion and drainage, and recurrent sinus infections. Other common head and neck complaints include hoarseness, ear problems and skin changes including eczema. Allergy, however, can affect virtually any part of the body.
Some allergy sufferers experience symptoms all year. Others find certain seasons bring on attacks. Allergy symptom control is most successful when multiple management approaches are used simultaneously. Minimizing exposure to allergens, managing symptoms with medications, and desensitization with injection immunotherapy (allergy shots) are all methods that can be useful in controlling allergic symptoms. The most exciting recent development is sublingual immunotherapy, or SLIT, where the desensitization occurs with simple drops placed under the tongue at home.
Anything can be an allergen. Pollens, food, mold, dust, feathers, animal dander, chemicals, and environmental pollutants commonly cause allergic reactions.
• Hay fever is caused by pollens. The most significant cause of hay fever in the United States is ragweed. It begins pollinating in late August and continues until the first frost. Late springtime pollens come from the grasses, i.e., timothy, Bermuda, Johnson, and some bluegrasses. Early springtime hay fever is most often caused by pollens of trees such as elm, maple, birch, poplar, beech, ash, oak, walnut, sycamore, hickory, and cottonwood.
• Certain allergens are present all year-round. These include molds, house dust, pet danders, foods, wool, various chemicals used around the house, and more. Symptoms from these are frequently worse in the winter when home ventilation is more self-contained.
Treatment and Prevention
A number of prescription and over-the-counter medications are useful in the treatment of allergy including antihistamine, nasal decongestant sprays, steroid sprays, and saline sprays. The further management of allergy also includes counseling in proper environmental control, including decreased carpeting, better filtering of indoor air, special vacuum cleaners, and avoidance of indoor pets.
At your initial visit, a complete head and neck exam will be performed to determine any other possible causes for your symptoms. If allergy seems to be a likely etiology, certain prescription medicines may be recommended, if they have not been tried already. Testing for allergies may be offered, and take the form of a blood test (RAST testing) or skin testing. Each has certain advantages in specific situations. The blood test will be scheduled at an outside laboratory, and is particularly useful if you are taking certain medications such as beta-blockers for high blood pressure (for a full list of medications that may and may not be taken prior to allergy testing, click here). A screening skin test may alternately be scheduled, and has the advantage of being needle-free! If testing is positive, specific allergens will be discussed, with emphasis on avoidance if possible.
Subcutaneous Immunotherapy (SQIT) or Sublingual Immunotherapy (SLIT)
If conservative measures such as avoidance and medicines have proven ineffective, immunotherapy may be discussed. Immunotherapy is a desensitization technique that has been proven effective in multiple studies, but does have certain potential risks including local and systemic reactions that can rarely be serious. A discussion of your specific situation will determine whether immunotherapy is right for you or your family member. The most common form of immunotherapy, called subcutaneous immunotherapy (SQIT), is usually given as a once weekly injection in the office. In general, anyone can be tested, but injection immunotherapy usually cannot be tolerated by young children. At Mann ENT, we also have many years of experience with sublingual immunotherapy, or SLIT, where the treatment is given as drops under the tongue, and this may be a suitable alternative in certain situations. SLIT is a newer, needle-free, clinically-proven, home allergy therapy that is preferable for children, frequent travellers, or for those that decline or cannot tolerate subcutaneous therapy.
Combining Immunotherapy with Procedures
Where appropriate, allergy therapy may be combined with procedures such as sinus surgery or Balloon Sinuplasty, which can be performed in an office setting, for maximal relief.