Allergies: How to Best Manage Them, What You Need to Know

“The greatest wealth is health.” — Unknown.

At least one out of every five Americans suffer from allergies. So, you’re not alone. But knowing that doesn’t really help the itchy eyes, the non-stop sneezing, the nasal congestion, and even wheezing. For those who suffer from allergies of any kind — food, seasonal, dog or cat — it can be a pretty miserable experience. Here’s what I think is important to know, and how I can help.

First, what are allergies? Allergies are your immune system on high alert. It is telling you something, as if it has gone into overdrive to make sure you get the message, often triggered by an allergen such as your cat’s dander, pollen, mold or a particular type of food. You can read more about what actually happens during an allergic reaction here, but suffice to say the rashes, runny nose, hives and watery eyes don’t lie. These are all pretty common symptoms, so don’t be alarmed.

What causes them? This is tough to say, but in general, your risk of developing an allergy starts in your genes. And while specific allergies are not inherited, a tendency toward having allergies in the first place is. Ask your parents if they had them, get a complete history.

How do we treat allergies? While there are lots of options with medication and lifestyle changes, I suggest starting with a physical exam to rule out any major issues. Allergy testing may be required to determine the best course of treatment.

  • Allergy Tests: Depending on your particular case, I may refer you to a board-certified allergist who specializes in diagnosing and treating allergies.  Or, we may want to start with an initial allergy blood test and/or skin test.
  • Allergy Journal: Keep an allergy symptom diary — if you can, track what you eat, or where you were and what you were doing when the symptoms began.
  • Try a Food Elimination Diet: If you are concerned that you have food allergies, we can give you a list of the most common foods you may need to remove from your diet. An elimination diet can help us pinpoint the suspect allergens — in the case of food, it could be nuts, milk, eggs, wheat or soy.

 Once we meet, we can discuss other treatment options that may include:

  • Allergy medications: These includes over-the-counter and prescription medications.  Antihistamines are often the first line of defense, following by nasal allergy sprays, steroid nasal sprays, eye drops, and allergy shots. All can be quite effective at alleviating symptoms, depending on your particular case.
  • Lifestyle and environmental changes: We may discuss ways to make your home  more allergy proof with dehumidifiers and HEPA filters, or how to control your outside environment from backyard to riding in the car. ( Things like wearing a protective mask for tasks like mowing the lawn, raking leaves, and even monitoring ‘pollen count’ so you know when it’s safe to be outside, etc. )

If you are interested, we can also discuss the latest natural allergy remedies.

But keep in mind, there are some allergies that are very dangerous:

The most severe allergic reaction is called anaphylaxis, a life-threatening reaction that requires immediate medical attention. In anaphylaxis, allergens cause a whole-body allergic reaction, and symptoms can progress rapidly  — within minutes. Head for the emergency room if you suspect anaphylaxis. Symptoms may include:

  • Hives and itching all over (not just in the exposed area)
  • Wheezing or shortness of breath
  • Hoarseness or tightness in the throat
  • Tingling in the hands, feet, lips, or scalp

More Details on Anaphylaxis from the American Academy of Pediatrics (AAP)

The AAP recommends that children who have had a previous episode of anaphylaxis be given epinephrine because anaphylaxis is likely to occur again. In some instances, self-injection of epinephrine should be prescribed for patients who are at an increased risk of anaphylaxis (e.g., patients with asthma) but who have not yet had an episode.

Physicians should always prescribe epinephrine if there is an emergency involving an individual at risk of anaphylaxis. A comprehensive management approach should be used for children at risk of anaphylaxis, and patients and their families should be shown how to use epinephrine auto-injectors. Physicians also should explain the warning signs and symptoms of anaphylaxis and instruct patients to call for emergency help if anaphylaxis occurs.

It is also important to instruct patients and their families to avoid allergens. If possible, a subspecialist should evaluate children at increased risk to confirm allergic triggers, educate the patient on how to avoid them, and provide specific preventive treatment.

To provide a safe and secure environment for children at risk of anaphylaxis, the AAP recommends that patients and their families construct emergency action plans and give them to other persons responsible for the child’s care at home as well as at school.

Be happy, stay healthy.

Dr. Christi Cheng

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