By Martha Smith FNP-BC
Finally, it’s spring! The grass is green, flowers are blooming, and unfortunately, you can’t stop sneezing. You are not alone, however, since 20 percent of us suffer from allergies. Allergies occur when our immune system responds abnormally to common, usually harmless substances called allergens in the environment, such as pollen, animal dander, or mold.
To have an allergic reaction a person must first be exposed to the allergen. After inhalation, swallowing, touching or being injected with an allergen, the body produces a specific antibody called IgE to bind this allergen. These antibodies attach to a specialized blood cell in the body called a mast cell. These mast cells are located in the airways and the intestines making these regions more susceptible to exposure to allergens. When these allergens bind to the IgE that are attached to the mast cell, a variety of chemicals are released from the mast cell. One of the main chemicals is histamine, which causes most of the allergic reaction symptoms.
Allergy symptoms and treatment
Symptoms of allergies depend on the part of the body that the allergen touches. Common symptoms of inhaled or contact allergies include itchy and watery eyes, itchy and runny nose, sneezing, skin rashes (including hives), and feeling ill or tired. People who suffer from year-round allergic rhinitis usually are allergic to indoor allergens, such as dust mites, mold or animal dander. Grass, weeds and tree pollen usually cause seasonal allergies. Some people have a combination of these allergic reactions. Eating foods that you are allergic to can cause vomiting, diarrhea and stomach cramps. On the other hand, an allergic reaction from a bee sting or other insect sting can cause redness, swelling and pain to the affected skin. In general, allergic reactions can range from mild symptoms, such as just feeling a little ill, to severe life-threatening symptoms such as an anaphylactic reaction. Anaphylaxis occurs when the allergic reaction affects the whole body. Symptoms of anaphylaxis include itching, hives, shortness of breath, wheezing, tightness of the throat, tingling in the hands, lips, scalp or feet, abdominal pain, and nausea, vomiting and diarrhea. This is a medical emergency; seek medical attention at the first sign of an anaphylactic reaction.
The best way to treat allergies is to avoid the allergen. This is very important for those allergic to certain foods or drugs. For seasonal allergies, you can track pollen counts in your area on the Internet or using smart phone applications that are available. Limit the time you are outside during the afternoon when pollen counts are at their peak. Wear a dust mask when mowing grass in order to minimize exposure. Protect your eyes from pollen by wearing large sunglasses. Pollen can cling to our clothes and skin so if you are having severe symptoms, change your clothes after outdoor activities and consider showering. To treat nasal symptoms, gently irrigating nasal passages with saline can remove allergens from the nasal mucosa. You can purchase 0.9 percent saline at the local pharmacy for nasal irrigation or make your own. Add 1/4 to 1/2 teaspoon of non-iodized table salt and a pinch of baking soda to 1 cup of water to make a solution that is similar to normal body fluids and is non-irritating for nasal irrigation. It is very important to use a fresh mixture daily because bacteria can grow in this solution and cause infection.
For indoor allergens, use high efficiency particulate air (HEPA) filters to trap allergens in central heating and air conditioner filters. Carpet is a haven for allergens; consider replacing it with tile or hardwood flooring, both of which are easier to keep clean. Replace older pillows and mattresses, and then cover the new ones in allergen-proof covers. Bathe and brush your pets regularly. Because they can bring in allergens, wipe their paws and fur before bringing them inside your home. If taking all of these steps to reduce your exposure to allergens does not help, there are several medications available to prevent allergies and ease mild allergy symptoms. Consult with your health care provider for recommendations based on your specific symptoms and overall health.
One of the first medications your health care provider may recommend is an antihistamine, such as Benadryl, Zyrtec, Tavist or Claritin. These work by blocking histamine in the immune process. Many of these medications cause drowsiness, especially some of the older drugs like Benadryl. Do not take these while driving or working with heavy equipment. Some of the newer generation drugs like Allegra and Clarinex have fewer side effects but all antihistamines can cause drowsiness, dry mouth, dizziness, blurred vision and confusion. Although most of these are over the counter, use caution while taking any of these medications and consult your health care provider prior to taking any of them since they can interact with other medications and make some medical conditions worse.
Antihistamines help with sneezing and itching, but sometimes a decongestant is needed to shrink swollen nasal tissues and blood vessels. Decongestants can come in pill form, like Sudafed PE, or a nasal spray like Afrin. Nasal sprays should never be used for more than three days to prevent rebound congestion, which can actually cause your nose to become more stopped up. Like antihistamines, decongestants can cause dangerous side effects and should not be used if you have certain medical conditions such as a heart condition, glaucoma, high blood pressure, etc. Always consult your health care provider before taking any over-the-counter drugs.
Your health care provide may prescribe corticosteroids to treat inflammation due to allergies such as a steroid nasal spray to treat swollen nasal passages, steroid creams for allergic reactions of the skin, or a steroid eye drop to treat itchy inflamed eyes. Severe allergies may be treated with steroid pills or injections for a short period of time.
Newer medications called leukotriene inhibitors, such as Singulair and Accolate actually block the substances that trigger the allergy cascade. Your health care provider may prescribe these to treat allergies and asthma.
If the allergen cannot be avoided and symptoms cannot be controlled, your health care provider may recommend allergy shots to build your immunity to the specific allergen or allergens that you are allergic to. This involves injecting the allergen, whether it is pollen, mold, pet dander, bee venom, dust mites, etc., into your arm on a routine basis to de-sensitize your body to this allergen.
Heredity and environmental exposure are thought to play a role in the development of allergies. Interestingly, there is evidence that infants raised on farms tend to have fewer allergies than those growing up in more “sterile” environments. So exposure to certain allergens, such as animal dander and dust mites, in the first year of life may actually lessen the chance of certain allergies. Breastfeeding exclusively for the first four to six months of life may also help prevent or reduce allergies. A specific allergy is not inherited but if your parents, especially your mother, have allergies you are likely to have them also.
Treating allergies and avoiding allergens that trigger a reaction are necessary once allergies have developed. Allergies can be just a minor nuisance or can disrupt your lifestyle. Taking steps to minimize your exposure to allergens may be all the treatment needed to avoid symptoms. If symptoms interfere with your lifestyle or persist, consult your health care professional to determine the best treatment for your allergies.
About Martha Smith
Martha Smith resides in Hazelhurst, Miss., a small community south of Jackson, and has been a member of the NBHA for 15 years, competing actively in Mississippi District 05. In 2006, she earned the Open 3D Mid-South National championship and has qualified for numerous NBHA World Shows. Smith now serves as adjunct faculty at the University of Southern Mississippi School of Nursing in the Family Nurse Practitioner program, teaching RNs how to become nurse practitioners.
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