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| Dr. Thomas Troost |
One Word for Fall: Gesundheit!
Get more insight into causes, treatment,
and prevention of seasonal allergies
Seasonal Allergies
| This month’s Ask the Doc is brought to you by Thomas Troost, MD. Dr. Troost, an honors graduate of Yale University, received his MD & PhD degrees from Georgetown University. He did a Microbiology fellowship at the Institute of Genetics in Moscow, Russia for one year. He completed his residency training in Otolaryngology - Head & Neck Surgery in 1988 from Georgetown University and is board certified in Otolaryngology and a Fellow in the American College of Surgeons. He was selected in 1999 as one of The Best Doctors in America, Washingtonian Magazine's Top Doctors and Who’s Who in Medicine. |
What is an allergy?
When many people think of allergies, they think of watering itchy eyes, sneezing, and a stuffy or runny nose. This most common allergic problem, called allergic rhinitis, is only one of many allergic reactions that a person can have. Arthritis, persistent sinus infections, rashes, chronic fatigue and even deafness can be caused by allergies to airborne particles, food, or chemicals.
Allergies are genetic and environmental conditions that begin in you immune system, which is designed to protect the body from harmful substances. When a person has allergies, the immune system mistakenly responds to normally harmless substances (like dust or certain foods) as though they were dangerous assailants. While many allergic reactions are mild, some sensitive people can have life threatening reactions.
More than 35 million Americans are estimated to suffer from allergies, and that figure grows yearly as medical science designs more and more sophisticated ways to determine what a patient may be allergic to. While it isn't clear yet why people suffer from allergies, the tendency to have them appears to run in families. Further, people with allergies towards any one substance generally have allergies to other substances.
An allergic person is born with the tendency toward allergy, and then becomes allergic through repeated exposure to an allergen in the environment or diet. Similarly, reactions to allergens can be outgrown over time.
What is an allergen?
An allergen is the normally harmless substance that your body "mistakes" for a harmful invader. Allergens can be found everywhere: in what you breathe, in what you eat, and in what you are exposed to. Allergies to airborne particles are called inhalant allergies. Reactions to things you eat are called food allergies or intolerances. Similarly, you can actually be allergic to chemicals--formaldehyde and phenol that are routinely used in products around our homes and offices.
What is hay fever?
Hay fever describes the symptoms of runny nose, itchy eyes and throat, uncontrollable sneezing and sometimes itching of the skin. It is not caused by hay, and does not produce fever. The correct name for the condition is seasonal allergic rhinitis.
Many seasonal "colds" are actually allergic rhinitis and will not respond to antibiotics. Seasonal allergic rhinitis happens when pollens and/or particles of plant or animal dander, mold spores, etc., come into contact with the lining of the nose, eyes, or throat. The body's immune system recognizes their presence and starts a reaction to prevent their invasion. In most people this is not a problem. However, in some patients the immune system is overactive and identifies normally harmless particles as dangerous, producing an excessive reaction that actually causes inflammation. This is known as allergy and the substances causing it are allergens. People are allergic to only certain substances, and the reaction does not usually appear until after several exposures to that substance.
What causes hay fever?
Hay fever is caused by pollens, the most significant in the United States is from ragweed. It begins pollinating in late August and continues until the first frost.
| Pollen Allergens | ||
| Late springtime pollens come from the grasses, i.e. timothy, orchard, red top, sweet vernal, 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, cypress, hickory, pecan, cottonwood, and alder. | Colorful or fragrant flowering plants rarely cause allergy because their pollens are too heavy to be airborne. |
Certain allergens are always present. These include house dust, household pet danders, foods, wool, various chemicals used around the house, and more. Symptoms from these are frequently worse in the fall and winter when the house is closed up. Mold spores cause at least as many allergy problems as pollens. Molds are present all year long, and grow outdoors and indoors. Dead leaves and farm areas are common sources for outdoor molds. Indoor plants, old books, bathrooms, and damp areas are common sources of indoor mold growth. Molds are also common in foods, such as cheese and fermented beverages.
Can allergies be serious?
Allergic patients show reduced resistance to respiratory infections, and more severe symptoms when infections occur. Allergies are rarely life threatening, but often cause lost work days, decreased work efficiency, poor school performance, and a negative effect on the enjoyment of life. Considering the millions spent in anti-allergy medications and the cost of lost work time, allergies cannot be considered a minor problem.
Why should I see a doctor?
The ENT specialist (otolaryngologist) will do a complete examination of your ears, nose, throat, head and neck. Careful evaluation of the sinuses will enable him or her to determine if infection or structural abnormality (deviated septum, polyps) are contributing to your symptoms.
Is there treatment available?
A number of medications are useful in the treatment of allergy including antihistamines, decongestants, cromolyn, and cortisone-type preparations. The medical management of allergy also includes counseling in proper environmental control. Based on a detailed history and thorough examination, your doctor may advise testing to determine the specific substances to which you are allergic. The methods employed by your otolaryngologists will indicate the materials to which you are allergic, and the degree of your sensitivity to them. The only "cure" available for inhalant allergy is the administration of injections that build up protective antibodies to specific allergens (seasonal pollens, molds, animal danders, dust, etc.). Your physician will oversee your progress throughout the course of treatment and care for any other nasal and sinus disorders that may contribute to your symptoms.
Prevention Tips
For more information on coping with seasonal allergies, please visit the Washington ENT Group (www.washingtonent.com) at the Suburban Outpatient Medical Center (www.suburbanhostpital.org).