What is an Allergy?
Allergy is often an inherited condition in which the immune system reacts to something that is either inhaled, touched or eaten that does not affect most other people.
Studies have shown that a person has a 50% chance of becoming allergic if one of their parents has allergies and an 80% chance if both parents are affected. Approximately 20% of the United States population has one or more types of allergies.
The immune system, in response to an allergy, reacts to this foreign protein as if it were an “enemy invader “(like bacteria or a virus). In response, the body produces antibodies to ward off the infection and other diseases. It does this by sending specific defenders called antibodies to the entry site. The battle between allergen and antibody results in a release of chemical mediators, one of them being histamine, into the bloodstream. These chemical mediators cause symptoms in the body that often adversely affect a person’s work, play, rest and overall quality of life. In fact, allergy symptoms account for more visits to the doctor’s office than any other single disease and are the leading cause of school absences and missed days of work.
What are the symptoms of Ear, Nose and Throat Allergies?
People often state that they do not have allergies because they compare their symptoms to the typical symptoms of hay fever such as sneezing, runny nose, nasal stuffiness and itchy/watery eyes. However, allergies can also cause symptoms such as these:
- Chronic sinus problems
- Excess nasal and throat drainage (post nasal drip)
- Head/sinus congestion
- Perception of frequent “colds” more than 3-5 per year lasting longer than 10 days
- Nasal/sinus polyps
- Recurrent, unexplained nose bleeds
- Hoarse voice, sore throat
- Enlarged tonsils/adenoids
- Itchy mouth/throat
- Eczema (skin allergies)
- Recurrent ear infections
- Fluctuating hearing loss
- Chronic fatigue
- Dark circles under eyes
- Chronic cough
- Crease across bridge of nose caused by allergic salute
- Gastrointestinal upset: diarrhea, constipation, stomach bloating
These symptoms can range from minor to severe. Allergies may be seasonal (occurring only during certain seasons such as spring) or perineal (meaning they occur all year long).
Can an Allergy be outgrown?
When people typically talk about outgrowing an allergy they are usually referring to a food allergy. In early childhood it is common to have an immature gastrointestinal tract which leads to leaky gut syndrome. This syndrome can cause adverse reactions such as allergies. However, when the lining of their intestinal tract matures their syndrome clears and so does their related allergy symptoms.
Most allergies cannot be outgrown, however, the way their symptoms present may change. For example, a baby may develop colic, recurrent ear infections, or have eczema, but as it grows older, it may develop different allergic symptoms such as hay fever, fluid behind eardrum or asthma.
How are Allergies diagnosed?
After a thorough patient history and physical examination the doctor may make a presumptive diagnosis of allergy and order additional testing. Tests may include CT scan to ensure that the sinuses are functioning properly and to rule out any anatomical abnormalities such as a deviated septum. Diagnosis of allergy is typically done by skin testing using the newest technology available. Blood testing can also be ordered, but is not as conclusive.
Intradermal skin testing is the most definitive way to test for allergies as it measures sensitivities to substances across multiple dilutions. Whereas, a skin prick/skin scratch test only measures an allergy at one level. In the latter case, you are either allergic or not. However, due to the antigenic load several minor or moderate allergies can cause an increase in allergic symptoms. For instance, consider your immune system as a bucket. When exposure to allergens occurs, the bucket begins to fill. If too much exposure occurs, the bucket overflows, causing adverse symptoms. In addition, stress, fatigue, poor nutrition, illness and other factors will add to the overflow. If all offending allergens were removed from the environment, then symptoms would disappear. Since this is impossible, the next approach would be to remove as much of the allergen as possible.
ENT Associates in Hillsboro Oregon tests for the Pacific Northwest’s most prevalent allergies such as pollen (trees, weeds and grass), molds, insects, animals and epidermals.
Who is qualified to diagnose and treat inhalant allergies?
Since allergies affect many areas of the head and neck, an otolaryngologist (Ears, Nose and Throat) specialist is the ideal choice to diagnose and treat allergies. Treatment is individualized for each patient.
What are the common ways to treat allergies?
As with any other treatment or procedure we start with least invasive to most. Treatment is individualized for each patient but may include:
- Environmental control
- Medication therapy
Environmental control involves practicing avoidance of substances to which you are allergic. Tips for controlling your allergen exposure will be discussed with your physician or nurse, but may include:
- Wearing a pollen mask when mowing or doing household chores (most drug stores sell them).
- Changing air filters monthly in heating and air conditioning systems and/or installation of an air purification system or a HEPA filter.
- Keep windows and doors closed during heavy pollen seasons. Visit pollen.com to check local levels.
- Rid your home of indoor plants, fish tanks and other sources of mildew.
- Replace feather pillows, down comforters, woolen blankets with cotton or synthetic materials.
- Enclose mattress, box spring and pillows in dust mite covers.
- Consider a humidifier in the winter. Dry, indoor heat aggravates many allergic people. Be sure to clean humidifier regularly.
- Change your shower routine. Ensure you shower each night before you go to bed, or you may be sleeping with your allergens.
- Wash sheets weekly in hot water and change pillow cases often.
- Observe general good health practices; exercise daily (not during heavy pollen times), stop smoking, avoid air pollutants and eat a balanced diet.
When environmental controls are not enough and living in a clean room or a plastic bubble is not an option, it may be time to add medication therapy to your daily allergy relief routine. Examples of typical medication therapy includes: antihistamines (Zyrtec, Allegra, Claritin, and Benadryl), nasal decongestant sprays, steroid sprays (Flonase, Nasonex) and saline nasal/sinus sprays/rinses. The treatments employed by your otolaryngologist (Ears, Nose and Throat) physician will depend on which materials you are allergic to and the degree of your sensitivity. The only proven cure available for allergies is immunotherapy.
Immunotherapy is most commonly referred to as Allergy shots or Sublingual Drops. Allergy shots are designed to desensitize you to substances which you are allergic. Immunotherapy program involves repeated injections of a sterile mixture that contains those substances identified as the causes of your allergies. Sublingual Drops are the same mixture of allergens, however, the drops are administered under your tongue.
After several months of weekly injections of increasingly stronger doses, you will reach a maintenance dose and continue to receive that dose at regular intervals. The size of doses and length of intervals between doses depends greatly on your response to the injections. The goal with allergy shots is to provide complete symptom relief, however, is not a guarantee.
An ongoing program of avoidance, medication, immunotherapy, or a combination of these methods, under direct supervision of your doctor is the best approach to controlling your allergies, allowing you to live more comfortably in your existing surroundings.
Will increasing my exposure to allergens do the same thing as immunotherapy?
No, increasing your exposure to allergens will not change the way in which your immune system reacts to these foreign proteins. The immune system is responsible for determining self from non self. From not self, your immune system determines if the protein is safe or unsafe (such as a virus or bacteria). In order for your immune system to change the way in which it reacts, it needs a substantial amount of protein. Simply put, there is not enough pollen or mold spores in an entire season to cure your allergies and increasing your exposure to the outdoors may lead to additional allergies. Each injection of immunotherapy contains more than a person would be exposed to in an entire season.
What sets our allergy practice apart from other allergy clinics?
Hillsboro ENT Associates is proud to offer 4 Board Certified Ear, Nose and Throat Specialists: Dr. Gregg Suits, Dr. James Caro, Dr. Steven Gabel and Dr. J.K. Thiringer. We offer in house allergy testing, treatment, education and management in a comfortable setting. Feel free to relax in our recliner while receiving your allergy test. We also offer Netflix’s and Pandora for your enjoyment.
In addition to our board certified physicians, we staff an allergy nurse with allergies. Who can better know how you feel than someone suffering a similar condition? Cassi Monroe, Allergy Nurse, is well versed in inhalant allergies, contact allergies and food allergies. She loves sharing her knowledge with her patients and helping them take back their lives. Allergies do not have to decrease your overall quality of life. Start taking back your life today!
If your physician deems immunotherapy an appropriate choice for treatment of your inhalant allergies, we will compound your prescription in house to better ensure the safety and timeliness of its preparation. We also offer convenient scheduling for our immunotherapy patients to ensure they get the most desired timeslot.
Have questions about what treatments are right for you?
We are just a phone call away and offer personalized consultations with one of our four board certified Ears, Nose and Throat physicians.
Call ENT Associates in Hillsboro Oregon today at 503.648.8971
Did cavemen have Allergies?
Remember that episode of “The Flintstone’s” when they could not stop sneezing? Or the pollinating flowers that brought the sleestaks to their knees in “Land of the Lost”? No? Me neither. But that does not mean that ancient man did not suffer from allergies. Although modern life is much different, what makes us think we are so different from Cavemen? Just because the first recorded allergies were not until sometime between 3640 and 3300BC when King Menses of Egypt supposedly died after a wasp sting does not mean cavemen did not suffer from allergies….it simply means they may not have had the same words to diagnose and describe allergy symptoms as we do today. Practicing medicine means we are always coming up with innovative ways to treat disorders and new research to prove or disprove previous theories.
Shen Nong of ancient China is considered to be the Father of Chinese Herbal Medicine. According to legend, he was the first to taste Ephedra which was used to treat asthma-like symptoms five thousand years ago. Ephedra promoted vasoconstriction, reversed congestion, inhibited the production of mucus and relieved bronchospasms. Ephedra then took hold of Greece and spread through their ancient civilization like a wild fire. Ephedra has since been used to treat many ailments including obesity and is even used in some diet pills.
Hippocrates, the “Father of Medicine” (460-377BC), described panting and noted that such persons become hunch-backed and cough before adolescence and die. Hippocrates is most likely describing what we call asthma today. He is also believed to be one of the earliest physicians to understand the link between respiratory diseases and the environment.
Ancient America (AD 1600) even recorded the use of a combination of plants or ceremonial customs to treat respiratory ailments. Following Columbus’ arrival in the New World, herbal remedies including balsam were used to treat coughs and balsam still remains in some cough medicines to this day. And with imports also went exports to Europe which included tobacco. Tobacco was used in experiments to treat asthma by European doctors. Physicians hypothesized that tobacco’s stimulant properties could help open constricted airways. Of course we know today that the exact opposite is true with tobacco smoke which causes constriction of blood vessels and less oxygen carrying capabilities of red blood cells.
So if tobacco smoke was once thought to treat asthma, how can we be so sure that cavemen did not suffer from allergies? It stands to reason that although environments and lifestyles change, humanity has always and probably always will have to deal with allergic reactions in one way or another.
Basic steps for saline nasal sinus irrigation:
- Draw the irrigation liquid into the irrigation device of your choice. Many pharmacies carry a variety of types. (We recommend using distilled water or water that has been boiled and allowed to cool.)
- Tilt your head down over the sink or bathtub, and rotate left.
- Squeeze a few ounces (your doctor can tell you how much) of liquid into your right (top) nostril. As you breathe normally through your mouth, the liquid should flow out your left nostril in a few seconds. Throughout the process, adjust your head if needed so the liquid doesn’t go into your throat or ears.
- Repeat the process with the opposite side.
- Blow your nose gently to help keep liquid out of your ears.
Check with your doctor before trying nasal irrigation. Each patient’s sinus symptoms are unique, so they require a unique treatment program.
Have questions about what treatments are right for you?
Call ENT Associates in Hillsboro Oregon today at 503.648.8971