Approximately 15% of the U.S. population suffers from some type of significant allergy. The purpose of this information is to explain what allergy is, what symptoms may occur and how allergies are diagnosed and treated in this office. An allergy is an abnormal reaction or increased sensitivity to certain substances. The allergic individual produces symptoms when exposed to these substances which are harmless to nonallergic people. The main reason for this is that allergic people make a special type of antibody called Immunoglobin E(IgE) which can react with environmental substances in a harmful way. These substances are called allergens. The reaction between allergens and IgE antibodies causes release of substances such as histamine which produce the allergic symptoms in the skin, nose, eyes and in the chest, etc. In the nose, histamine causes blood vessels to swell and begin leaking fluid. The result is a runny nose, congestion and difficulty in breathing. These symptoms are frequently called “hay fever” although they do not involve fever and represent allergic responses to many substances, not just hay. The most common allergens are pollens, animal danders, house dust, house dust mites, molds, some drugs and many foods, especially fish, eggs, milk and nuts. Bee and wasp stings may cause allergic reactions with fatal results in rare cases. Additionally, feathers, wool, dyes, cosmetics and perfumes may act as allergens.

 

WHO BECOMES ALLERGIC?
Anyone can develop an allergy, but the probability is increased if one or both parents suffer from some kind of allergic condition. The presence of another allergic

individual in the family is the strongest factor for predicting allergy in a child. However, it must be noted that even when both parents are affected, a child may not be.

DIAGNOSIS
It is essential for successful treatment that the allergens responsible for the symptoms are accurately identified. There are different ways to arrive at a diagnosis. The case history is extremely important in all allergy investigations. Based on what the patient tells about his symptoms, the doctor decides what tests should be carried out.

CASE HISTORY
The case history should form the basis for all allergy investigations. In order to give the doctor an idea of the mechanisms and allergens causing the trouble, the

doctor will question the patient or ask him to fill in a questionnaire. It is important to know when and how the symptoms develop. Also important is the relationship
to seasons, damp weather, physical activity and certain foods, etc. A knowledge of personal habits such as smoking, occupation, hobbies, etc. will be necessary

and some information about the home can be important, i.e. whether there are pets or fitted carpets in the house or if cleaning aggravates symptoms. A favorite cologne or perfume can be the cause of allergic conjunctivitis, while a soap may be the cause of chronic eczema.

LABORATORY TESTS
IgE can play an important role in allergic rhinitis, allergic asthma and some forms of eczema. Detecting and accurately measuring the amount of IgE therefore can be of great importance when diagnosing allergies.We have found skin testing to be more sensitive then blood testing. One method of skin testing we do is called Skin Endpoint Titration (S.E.T.). During S.E.T. testing a controlled amount of allergen is injected between the layers of skin in the upper arm making a small flea-bite-sized bubble. These “bubbles” are measured after ten minutes. The series of injections are continued every ten minutes until the endpoint or sensitivity level is found. Skin prick is another form of skin testing using the inner forearm. Allergens are pressed onto the skin and read after twenty minutes. A combination of both of these methods can also be done.

TREATMENT
There is no cure for any allergy, although in some instances, it is possible to reduce a person’s allergic sensitivity to the point that it is no longer such a bother. The treatment is avoidance of the allergen – something that can range from simple lifestyle changes to unavoidable exposures. For example, if a person is allergic to feathers, it is easy to discard any pillows, clothing or furniture containing feathers. A person known to be allergic to pollens, molds or some foods, may find avoidance more difficult. For patients who are unable to avoid certain allergens, who cannot tolerate allergy medication or whose allergic problems are severe, a series of injections called immunotherapy or desensitization may be required. This therapy consists of weekly injections which contain increasing amounts of the substance to which the person is allergic. Eventually, the patient’s body reaches a maintenance level of immunity. By giving injections containing small amounts of the antigen to which the person is sensitive, an antibody is formed. The antibody acts with the antigen, and if there is enough antibody, the symptoms should be greatly decreased. We have found that when an individual has allergic nasal and sinus problems with ragweed, trees, grasses and other pollens, the results of injection therapy are consistently good. Dust and mold preparations may not be quite as effective. Extracts to foods are not used by this office as they are frequently not reliable. A special problem are those people allergic to animal dander. Injection therapy for people sensitive to dogs, cats, horses, etc. is usually reserved for people who absolutely cannot avoid animals. Its effect is much less predictable than the above mentioned allergens. Injections may be given safely to pregnant patients with approval from an obstetrician. The form of injection therapy preferred here is the perennial method. This means that the injections are year round and not just during the season that a person expects to have symptoms. Our experience is that this is the best way to control allergies. A patient can usually expect to have some relief of symptoms within 2 to 3 months. Since improvement is so gradual it may take up to a year to notice. Ultimately, our goal is to reach a maintenance level of dosage which is given every 3 to 4 weeks. Once a maintenance dosage has been reached, the therapy should be continued for approximately 3-5 years.

 

 

Colchester

9-5:00 Friday

8-5:00 Monday & Tuesday
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Willimantic

8:30 -5:00 Monday & Thursday
8:00 -5:00 Tuesday
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Injections and Testing by Appointment Only