10 frequently asked questions about allergies
published: Wednesday | June 23, 2004

By Dr. A.W. Lawrence, Contributor

Question 1: Are allergic illnesses common?

Answer: Very common ­ more than 50 per cent of the Jamaican population have allergic sinusitis and more than 20 per cent of our children and young people have mild, moderate or severe asthma.

Question 2: Does my body's immune (defensive) system need boosting to deal with my allergies?

Answer: No, the allergic person has an immune system that tends to overreact when allergy-producing agents (allergens) enter the body, for example, when sinusitis sufferers inhale small amounts of pollens, house dust mite or other allergens, they suffer from excessive sneezing, nasal itching and so on.

Question3: How do allergic illnesses manifest?

Answer: This is determined by the part of the body that comes in contact with the allergen:

The skin may show rashes and itch in some people following contact with jewellery, cosmetics and other agents.

The sinus lining (epithelium) may become inflamed and itch after exposure to inhaled pollens, dusts, mold (mildew) spores and so on. When the eyes are also involved with excessive itching and redness, this is something called 'hay fever'.

When the air passages (bronchi) in the lungs become involved (the lining or epithelium is similar to that found in the sinuses) then the allergic process (one of the main but not the only cause) results in asthma.

Gastrointestinal (food/drink) allergies may produce nausea, vomiting, diarrhoea, abdominal pains and other symptoms.

The allergic reaction is a complex one and many chemicals are released in the body when it is initiated. Areas of the body distant from direct contact with the allergen(s) may also show signs, for example, wheals and swelling of the skin with itching ('ptomaine poisoning') associated with food allergies.

Question 4: What is the cure for allergies?

Answer: The allergic tendency in an individual is permanent. While allergic symptoms may be prevented from affecting the person for months or years, the potential remains so there is no permanent cure for allergy. However, preventing and reducing the severity of allergic illnesses provides marked relief, a more normal lifestyle and significant savings in medications costs.

Question 5: How are allergies treated?

Answer: Ideally, the allergen(s) should be identified and avoided. Complete avoidance is possible in food allergies. Inhaled allergens need further measures for control as it is difficult to totally avoid inhaling pollens, dusts and so on.

Question 6: How is this done?

Answer: The allergist (doctor specialising in treating allergic diseases) determines the relevant allergens by:

Obtaining from the patient a detailed history of the allergy-related illness.

A thorough physical examination and a few routine lab tests then serve to exclude other chronic illnesses.

Performing a special skin test then determines the relevant inhaled allergens causing hay fever, sinusitis, asthma. Food allergens causing wheals or urticaria may also be detected by skin testing.

Question 7: What is a skin test? Is it safe?

Answer: Properly performed, a skin test by the scratch method is a quick, safe, easy, and accurate way of determining the allergens listed under answers to question 6.

Question 8: Do I have to live with my sinusitis or asthma?

Answer: No. Remember, the potential for allergies is permanent, but prevention and reduction of symptom severity is possible for most patients. Nowadays, measures to avoid identified allergens, effective preventive medications and specific allergen immunotherapy can prevent or significantly reduce allergic conjunctivitis, sinorhinitis and asthmas for months and years.

Question 9: What is specific allergen immunotherapy?

Answer: People suffering from hay fever, sinorhinitis and/or asthma get much relief from allergen avoidance and medications. Specific allergen immunotherapy, where indicated, can actually change the course of these illnesses in preventing and minimising recurring attacks. After skin testing has identified and confirmed the relevant allergens, a vaccine containing these same allergens is prepared on prescription (in the U.S.A.) specific to that particular person. Small injections of this vaccine in the person's arm 'immunises' the person against the particular allergens.

The injections are each a small volume (0.01 ml) and are given just beneath the skin (subcutaneously) once monthly for two to three months, then two monthly then three monthly as maintenance for a total of two years. At the end of the two years when the injections are discontinued, the majority of patients so treated and who continue to avoid excessive allergen exposure remain essentially well for the next 10-15 years at least. Additional medication needs are either not necessary or are greatly reduced.

Question 10: Then, can my allergy symptoms be safely and efficiently treated?

Answer: Yes. Much research and the study of allergy problems over the last several years make possible the safe, effective and specific treatment measures available today.

Dr. A. W. Lawrence is a Consultant Paediatrician and Allergist; email: yourhealth@gleanerjm.com.