All About Allergies

by BTM

Mon, 25 March 2019

All About Allergies

Dr Bhramara Madduri, consultant paediatrician at the Royal Bahrain Hospital sheds some light on allergies and how they can be tackled.

An allergy, in simple medical terms, is the body’s reaction to any substance (called an allergen), by producing antibodies to it. Exposure to the allergen initiates a chain of responses that manifest in different organs as an allergic reaction. In short, the person is said to be hypersensitive to the allergen.

Allergies can involve the skin, respiratory tract, digestive system, eyes, joints and, rarely, other organs. Based on the time it takes to manifest and how the reaction is initiated, there are four types of reactions. They can be mild, to moderate and severe. The most dramatic type is anaphylaxis, which presents as a medical emergency, with immediate swelling of the lips and vocal chords and difficulty in breathing that may be life threatening. Therefore, it is important to identify and treat all kinds of allergies. 

Common allergens are food (cow’s milk protein, eggs, nuts, especially peanuts, seafood, and chemical additives), inhaled allergens (house dust, plant pollen, dander from pets and dust mites), and medicines. 
Age of onset:

One can develop allergies from as early as the first month of life. There have been cases where a pregnant mother is intolerant to a certain food, but can resume eating it after giving birth. However, her exclusively breastfed newborn can develop a reaction to this particular food.

Who gets it?
Usually there is a family history, but allergies can occur out of the blue at any time. For instance, one may have always eaten eggs, but one fine day, an aversion to them can develop.

Allergies can have a wide range of symptoms affecting various body parts:
Skin: urticaria, eczema, and pruritus
Respiratory tract: excessive sneezing, persistent and recurrent cough, asthma, ear colds, recurrent sinusitis, prolonged nasal blocks.
Eyes: watery, itchy and red eyes with or without mucoid discharge  
Digestive system: oral ulcers, colic, constipation, blood in stool, vomiting 
Joints: pain and swelling

When to Seek Help
When symptoms are recurrent, and affect the quality of life, one must consult with a doctor. As the risk of anaphylaxis looms large, any allergy ideally needs medical attention.

How Is It Diagnosed?
Usually a thorough history of how symptoms began and the triggers can indicate and point to the diagnosis. At times, using a trial and error approach, one can identify the suspect allergen /allergens. The doctor may prescribe certain blood tests in addition to specific diagnostic tests like the RAST test, skin prick tests and food intolerance tests, which can identify allergens with greater accuracy. These tests have a limitation, in that they are not all-inclusive. A person may be allergic to a substance not included in the list of allergens these tests detect.

How is an Allergy Treated?
Based on the site involved, most mild to moderate allergies are treated with antihistamines and topical steroids; more severe allergies need oral/injectable steroids. The most severe form, anaphylaxis, needs immediate emergency care. Patients at risk of anaphylaxis are given an Epipen, which is a self-injectable lifesaving drug. Ideally, those with a risk of anaphylaxis should wear a medical bracelet indicating the allergens and severity. 
The best form of treating allergies is to totally avoid the allergens. But it is easier said than done, as some allergies can be challenging to treat.

Preventing Allergies
Breastfeeding babies exclusively for the first four-six months is research-proven to prevent allergies, especially asthma and eczema. Contrary to the earlier belief that delaying the introduction of allergenic food would prevent allergies, recent evidence suggests that when such foods are introduced at between four and six months, there is less chance of an allergy developing. However, more studies are needed to reconfirm this. In addition, your baby’s doctor may suggest a special hypoallergenic infant formula if there is a strong family history of allergies, which can effectively prevent allergies.

Eating healthy, natural foods, regular exercise, and practicing good hygiene are other general measures to prevent allergies.

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