Allergy is a condition characterised by a
level of sensitivity greater than normal to a specific substance or
group of substances. These substances, called allergens, trigger a
response in susceptible individuals. They can enter the body through
various routes like inhalation, ingestion, injection, and external
skin contact. They react with antibodies in a susceptible person,
causing the release of histamine (a chemical mediator in allergic
reactions) and other chemical substances that cause various symptoms.
This creates a chain response known as the allergic response.
What is the cause?
Allergic reactions may be caused by many factors. These
include the most common allergy 'triggers' like pollen grains, dust,
moulds and foodstuffs. Other triggers include animal proteins from
hair, and fur and substances that cause skin allergic reactions such
as certain oils found in plants, drugs, cosmetics, chemicals etc. The
allergies can be classified as seasonal allergies and perennial
allergies.
Seasonal allergies
Seasonal allergies occur during certain seasons of the year. They
are caused by inhaling microscopic particles in the air and
substances like pollen released by plants, grasses and weeds. This
can lead to a sustained allergic response.
Perennial allergies
Perennial allergies occur throughout the year. They occur due to
mould, fungi and dust found indoors. Perennial allergies can be
caused by fur from cats and dogs and other pets.
An exaggerated response to specific food allergens
is termed food allergy or hypersensitivity and such foods include
milk, eggs, chocolate, nuts, corn, pork, prawns and beef. Histamine
and its related substances are responsible for mediating the allergic
response and causing the characteristic symptoms of
allergy.
What are the symptoms?
Breathing problems and skin irritations are the common
allergic responses. Sneezing, running nose, watery eyes, wheezing,
skin redness, and skin itching and rashes are common symptoms.
Allergic rhinitis is a term that is used to describe a thin, watery
trickle from the nose accompanied by sneezing, as in common colds.
Severe allergies can cause anaphylactic shock, a life threatening
reaction to some allergens where there may be a sudden and dramatic
drop in blood pressure. Anaphylactic shock may also cause closure of
air passages and result in death. Anaphylactic reactions may be caused
by bee stings, drugs like penicillin and also some types of food
substances. When an individual's allergies are triggered, there is
swelling of the nasal linings, which results in sinus blockage and
infection.
How is the diagnosis made?
A family history of allergy and
allergy-related diseases is important in the assessment of allergies.
Reactions occurring with regularity at certain times each year may be
due to seasonal allergies, while those that manifest throughout the
year are perennial. If the symptoms improve with anti-allergy drugs,
then an allergic component to the problems is believed to be present.
There are also a variety of tests that help in the diagnosis of
allergies.
n-Vivo testing- The basic principle in this method is to
demonstrate an actual allergic reaction in the patient by using micro
doses of the suspected allergen.
In-Vitro testing- It is based on identifying the antibody
proteins (chemicals produced in the body due to an immune response)
produced by the individual during an allergic reaction.
Nasal smear testing- In this a sample of nasal secretions is
collected and analysed in a laboratory. Eosinophils (a type of cell
present in the body) are produced during an allergic reaction, and
these are observed under a microscope in the nasal specimens obtained.
What is the treatment?
Since the allergic reaction is due to
histamine and its related substances that trigger the full-blown
allergic reaction, drugs called antihistamines are used to treat
allergies. They block the activity of histamine and relieve symptoms.
Their most common side effect is drowsiness. Some antihistamines are
non-sedating, and do not cause drowsiness. Antihistamines in the form
of nasal sprays work relatively rapidly once sprayed into the nose.
Antihistaminic sprays avoid some of the unpleasant side effects of
oral antihistamines. Steroids are the most potent drugs for allergies.
They help by decreasing the inflammation seen in the allergic
reaction. Prolonged use of steroids can have serious adverse effects,
so they should be taken on a limited, short-term basis to provide
relief. Steroid sprays are relatively safer than oral steroids. If
environmental controls and medications have failed to provide adequate
relief, allergy shots (allergen immunotherapy or desensitization) can
be used.
What is the prevention?
The best way to avoid symptoms of allergy
is prevention. This means avoiding exposure to agents that trigger the
allergic response. Being aware of common allergens like pollen, dust,
fur, drugs, specific foods etc, and avoiding them is absolutely
essential in preventing an allergic reaction. Patients, who have
suffered from an anaphylactic reaction in the past, should carry an
injectable shot of a drug called epinephrine that can be administered
in an emergency. Prompt treatment of severe allergic reactions,
especially anaphylactic reactions, is essential.
Symptoms
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