Welcome to the first installment of the ABC's of Medical Conditions.
In this series, I will provide some basic information on common health conditions and diseases to help you better understand the condition as well as how to prevent and treat it. Raising awareness is key to helping you understand your body and how to be sensitive to the needs and conditions of other people.
Say hello to the letter A and the condition of allergies. While allergies are a very common condition, I did not know much about them until about 5 years ago when my family started developing them. This is now a condition that holds a lot of personal relevance for me and I think it's important for people to have a basic understanding of allergies.
What is it?
Allergies are when your immune system reacts to an otherwise benign substance and produces a physical response. You can be allergic to virtually anything. Many people have environmental allergies which can include indoor allergies (dust, mold, smoke, pet dander) and outdoor allergies (trees, weeds, grasses). Others are allergic to various insects (bees, ants), latex, or medications (penicillin, sulfa drugs). Another category of allergen that is becoming increasingly more common is food allergies. Any food is a potential allergen but the most common are shellfish, fish, peanuts, tree nuts (cashew, pistachio, pecan, almond, walnut), wheat, milk, soy, and eggs.
How common is it?
According to the Asthma and Allergy Foundation, approximately 50 million Americans (1 in 5) suffer from an allergic disease, a number that has been increasing since the 1980's. It is also the 5th leading chronic disease in Americans, and 3rd in American children.
Signs and Symptoms
For many allergy sufferers, a runny nose, cough, sneezing, and itchy/watery eyes are the chief complaints. These are common symptoms of seasonal allergies such as trees and grasses. Others suffer from skin reactions like hives or itchy or red patches. These are the symptoms that you probably associate with allergies. However, there are many other potential symptoms that are often overlooked, which is how I went undiagnosed for many years. After doing research, I realized that there were many less common symptoms associated with allergies.
Some people develop headaches, problems with balance, a foggy headed feeling, nausea, vomiting, and upset stomach. Many allergic reactions happen immediately but sometimes it can take up to a couple of days to feel the physical reaction, making it incredibly difficult to pinpoint the trigger.
With food allergies, some of the aforementioned unusual symptoms can also play a role. For example, an upset stomach can occur 2-3 days after eating the trigger food. However, many food allergies provide an instantaneous reaction. Many allergy sufferers develop hives around the mouth, a scratchy throat, nausea and vomiting, and diarrhea.
Some severe reactions (both from foods or from other triggers) can cause a potentially life-threatening situation called anaphylaxis. In anaphylaxis, the throat swells causing the person to not be able to breathe. Anaphylactic reactions usually come on suddenly but can be delayed several hours. The only way to stop an anaphylactic reaction is to administer epinephrine. If you experience an anaphylactic reaction, you should administer epinephrine if you have it and call 911. It is important to seek immediate medical attention.
Prevention
There is no way to prevent allergies. If one or both of your parents have allergies, you are more likely to develop them. Although many people develop allergies as children, others do not experience allergy onset until adulthood.
Treatment
Treatment depends on the type and severity of allergies. Seasonal and environmental allergies can typically be controlled using allergy medications such as antihistamines. Avoidance is key to reducing all types of allergic reactions. For outdoor allergies, it is recommended that you stay inside during peak seasons of your allergic triggers. For indoor allergies such as dust mites, it is helpful to use hypoallergenic pillows and mattress covers and wash linens weekly in hot water. Some doctors will recommend immunotherapy such as allergy shots or oral immunotherapy. Both of these approaches slowly build up the amount of the trigger over the course of several years to help your body learn to adapt to it.
For food allergies, avoidance is the most critical and effective treatment. Learning to read package labels and avoiding foods that contain your allergens (or are potentially cross-contaminated, depending on the severity of the allergy) is important. For more severe allergies, particularly those that often produce anaphylaxis such as nuts and shellfish, it is often recommended that you carry two doses of epinephrine with you at all times and self-administer the medication at the first sign of a systemic reaction.
When should I see a doctor?
If you suspect you may have allergies, discuss your concerns with your primary care physician or schedule an appointment with an allergist. Depending on the doctor and what you are being tested for, there are several different types of allergy testing, each with their own benefits and drawbacks. Unfortunately, the field of allergy and immunology is still developing and there are still a lot of unknowns. Allergy testing is not a perfect science and just because you test negative does not mean you are negative (and vice versa).
The most common types of allergy testing include blood tests, scratch tests, and patch tests. A blood test measures the allergen-specific IgE via a simple blood draw. The scratch test includes small pricks in the skin to see whether or not your body produces a histamine reaction. The scratch test is typically performed on the arm or back. The patch test is where certain foods are taped to your back and monitored for 3 days to determine delayed reactions.
Scratch Test
What questions should I ask my doctor?
Ask your doctor her opinion as to which test may most accurately determine your allergies. Before seeing your doctor, do your best detective work and keep a journal of all food (including those few bites of your kid's leftovers!), all soaps/lotions, medications, laundry detergent, etc. Take note of what rooms or places cause an increase in symptoms.
If you have any positive results, discuss with your doctor what your allergy treatment plan will be. If your symptoms do not improve after establishing a treatment plan, follow-up with your doctor.
Where can I learn more?
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