William Penn Life, 2004 (39. évfolyam, 1-12. szám)
2004-06-01 / 6. szám
HealthPage temporary. "Maybe you walk into somebody's house, they have three cats and suddenly your eyes itch, or your nose itches or your nose runs or you start to wheeze," Dr. Metcalfe says. "Pretty clearly, that's an allergy. The exposure to something that triggers these allergic reactions-and that's reproducible-is often the first sign to people they have an allergy." But it's not always easy to tell if you have allergies. Dr. Metcalfe says, "Let's say that somebody's sitting around and it's, say, February, and they say, 'Gee I think I'm getting a cold.' But maybe they're developing a tree allergy, because the tree pollen may be coming out in February or March in their area. Well, sometimes it's pretty hard for someone to determine whether it's a cold or a transient seasonal allergy." Your doctor can help you sort out whether you have allergies, but it's difficult for him or her to make a diagnosis without your help. You can play an important role by keeping track of when and where you get symptoms. "The history of your symptoms is usually much stronger evidence than simply looking," Dr. Plaut says. "It's often the duration of symptoms; people do not have colds that last more than two weeks." Look at your local pollen and mold counts and see if high numbers match up with when you get your symptoms. Peak seasons for pollens and molds differ depending on where you live, but many local newspapers, TV and radio stations now track levels of molds and pollens daily. The National Allergy Bureau of the American Academy of Allergy, Asthma and Immunology, which reports current pollen and mold spore levels to the media, maintains a web site you can check yourself at www.aaaai.org/nab/ As a general guide, tree pollen allergies strike in late winter to early spring, grass allergies can strike from spring through summer, and ragweed typically strikes in the fall. Ultimately, your doctor may send you to an allergy specialist, or allergist, for blood or skin tests to see if your body is making IgE against particular allergens. But keep in mind that even these tests can't be used alone for a diagnosis. That's because IgE antibodies are necessary for an allergy to develop, but they're not the whole story. "The basic abnormality in allergic diseases is that people make IgE antibodies to specific allergens, and if they didn't make those IgE antibodies they wouldn't be allergic," Dr. Plaut explains. "But that's not to say that everybody who makes IgE antibody has major symptoms." Prevention and Treatment If you do have allergic rhinitis, you and your doctor have many options. The first, and most obvious, is to avoid the allergens you react to. This is not as simple as it might seem. Some people think that they can just move to a place where the offending pollen doesn't grow. This drastic measure may provide temporary relief, but people who have an allergy to one thing tend to develop allergies to others as well, and may soon find themselves in the same situation. There are some simple things you can do. Sunny, dry, windy days can be especially troublesome for people with pollen allergies, so try to stay indoors on those days with the windows closed and the air conditioner on. Some people take vacations at the height of the expected pollination period and choose a location where they won't get much exposure; the seashore, for example, is a good Health Links To learn more about allergies and what you can do to help diagnose, prevent and treat your allergies, log onto the following websites: O The National Institute of Allergy and Infectious Diseases www.niaid.nih.gov O The National Institute of Environmental Health Sciences www.niehs.nih.gov place for many people with pollen allergies. There are also ways to avoid exposure to indoor dust mites, molds and other common allergens that cause allergic rhinitis. No matter what your allergy, your doctor should be able to provide guidance for you. If avoidance doesn't work for you, allergy symptoms can often be controlled with medications. Antihistamines are usually the first line of defense. An antihistamine counters the effects of histamine, which is one of the chemicals released by mast cells and basophils that cause allergy symptoms. Along with an antihistamine, your doctor might recommend oral or nasal decongestants to reduce congestion and swelling of the nasal passages. "If antihistamines are not judged to be sufficient," Dr. Metcalfe says, "then the next line of therapy is almost always a steroid nasal spray to decrease inflammation." Topical nasal steroids reduce mucus secretion and nasal swelling. NIAID says that the combination of antihistamines and nasal steroids is a very effective way to treat allergic rhinitis, especially in people with moderate or severe allergic rhinitis. Another option is cromolyn sodium, a nasal spray which inhibits the release of chemicals like histamine from mast cells. But cromolyn sodium takes several days to begin working, so to be effective it has to be started before the allergic reaction begins. For many, this is simply not practical. Dr. Metcalfe says, "The other thing is, if you have strong allergies, it tends to break through cromolyn." For these reasons, cromolyn sodium has largely been replaced by nasal steroids, but it may still prove useful for many allergy sufferers. Lastly, immunotherapy, or a series of allergy shots, is an option if you and your doctor know which allergens are causing you trouble. The therapy involves several injections of increasing amounts of the allergens to which you are sensitive. This is a long process that many people are not willing to go through, but it can bring a significant reduction in symptoms and the need for medication. |ffpy William Pen Life, June 2004 7
