Allergies: Symptoms, Diagnosis & Treatment

An allergy occurs when your body’s immune system sees a certain substance as harmful. It reacts by causing an allergic reaction.

Substances that cause allergic reactions are allergens.

There are many types of allergies. Some allergies are seasonal and others are year-round. Some allergies may be life-long.

It is important to work with your health care provider to create a plan to manage your allergy. Avoiding your allergens is the best way to prevent an allergic reaction.

Classic Allergic Reactions

These reactions occur like other types of allergic conditions such as asthma or hay fever. What is different is that the drug gains access to the whole body rather than just the respiratory tract. Thus, it produces an allergic reaction throughout the body. The classical symptoms of this type of reaction are:

#1 – Skin reactions

The most common form of this is hives.

#2 – Generalized Allergic Reactions

This kind of reaction can involve many body systems. This is a serious allergic reaction called anaphylaxis (anna-fih-LACK-sis). Hives are usually present. But, the symptoms also may include:

• wheezing (a whistling, squeaky sound when you breathe)
• shortness of breath
• throat and mouth swelling
• nausea
• vomiting
• diarrhea
• cramping abdominal pain
• fall in blood pressure
• fainting

Other Immunologic Type Responses

There are other ways (that are not a classic allergic reaction) the immune system may react to a drug. For example, antibodies to certain drugs can destroy red blood cells. This destruction of red blood cells can cause anemia. The most common type of immune drug reactions are skin rashes (other than hives).

Allergy Treatment

Good allergy treatment is based on your medical history, the results of your allergy tests and how severe your symptoms are. It can include three treatment types:

1. Avoiding allergens
2. Medicine options
3. Immunotherapy (allergens given as a shot or placed under the tongue)

How Do I Avoid Allergens?

The best way to prevent symptoms and limit your need for allergy medicine is to avoid your allergens as much as possible. This includes removing the source of allergens from your home and other places you spend time. You can also reduce your symptoms to airborne allergens by washing out your nose daily. You can do this by using a nasal saline rinse using a squeeze bottle or a Neti pot.

What Medicines Can I Take for Allergies?

Some people don’t take allergy medicines because they don’t think their symptoms are serious. They may say, “It’s only my allergies.” This can result in painful problems such as sinus or ear infections. Don’t take the risk. There are many safe prescription and over-the-counter medicines to relieve allergy symptoms. Here is a short list of allergy medicines:

Nasal corticosteroids are nose sprays

• Nasal corticosteroids reduce swelling. Swelling causes a stuffy, runny and itchy nose. They are the most effective medicines for nasal allergies.

Antihistamines block histamine, a trigger of allergic swelling

• They can calm sneezing, itching, runny nose and hives. They come in pills, liquids, melting tablets or nose sprays. These treat seasonal and indoor allergies.

Mast cell stabilizers keep your body from releasing histamine

• This can help with itchy, watery eyes or an itchy, runny nose. They are available as eye drops or nose sprays.

Decongestants reduce stuffiness by shrinking swollen membranes in the nose

• Be careful! Using these sprays more than three days in a row may cause the swelling and stuffiness in your nose to get worse. This can happen even after you stop using the medicine. This reaction is a rebound reaction.

Corticosteroid creams or ointments relieve itchiness and stop the spread of rashes

• See your doctor if your rash does not go away after using this cream for a week.

Oral corticosteroids may be prescribed to reduce swelling and stop severe allergic reactions

• These medicines can cause serious side effects. Expect your doctor to carefully monitor you while taking it. Oral corticosteroids are not the same as anabolic steroids used illegally by some athletes to build muscles.

Epinephrine (ep-uh-NEF-rin) comes in a pre-measured and self-injectable device

• It is the most important medicine to give during a life-threatening anaphylaxis (severe allergic reaction). To work, you must get an epinephrine shot within minutes of the first sign of serious allergic reaction. It treats life-threatening allergic reactions to food, stinging insects, latex and medications.

What Immunotherapy Treatments Are Available?

Immunotherapy is a treatment option for some allergy patients. There are two common types of immunotherapy:

• Allergy shots
• Sublingual immunotherapy (SLIT)

Allergy shots involve giving injections of allergens in an increasing dose over time. The person becomes progressively less sensitive to that allergen. Allergy shots can work well for some people with allergies to pollen, pets, dust, bees or other stinging insects, as well as asthma. Allergy shots do not usually work well for allergies to food, medicines, feathers, or for hives or eczema.

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About Patrick Donahue, MD

Dr. Patrick Donahue is the Medical Director for WakeMed Physician Practices – Urgent Care.