Allergies & Asthma

Allergy Info
Asthma Info

Allergy Info

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Well Recognized Allergens

Foods:

sesame seed, peanuts, tree nuts, fish, shellfish, eggs, milk, wheat, and soy.

Inhalant Allergens:

house dust mites; mold spores; cat and dog dander, cockroaches, trees, ragweed, weeds, and grass pollen.

Contact Allergens:

poison oak, poison ivy nickel (found in jewelry), latex, and cosmetic ingredients, all of which can cause allergic reactions that occur mainly in the skin.

Drugs:

penicillin, sulfa, aspirin and ibuprofen

Insect Venoms:

honeybee, wasp, yellow jacket and hornet

Allergy v.s. Intolerance

Intolerance is an unpleasant reaction to a substance that can produce similar symptoms of an allergy but does not involve an immune mechanism. For example, milk lactose intolerance can cause extreme bloating and diarrhea can be very uncomfortable but does not progress to anaphylaxis like an allergy to milk protein can. Smoke, perfumes, and irritants which can trigger severe asthma attacks are also intolerances as opposed to being mediated by an allergic mechanism.

Allergy Testing

Food allergies, inhalant allergies, and insect venom allergies can be diagnosed by skin testing. Additionally, a blood test that detects the specific IgE allergy antibody may be useful. The skin tests are felt to be more sensitive and the results are available in the office within 15-30 minutes. The only drug which has a standardized skin test available is penicillin. Contact allergens are determined by patch testing which requires allergens to be taped on the back and then read at 48 hours and again at 72 hours. Patch testing is available for multiple substances and can be customized according to the exposure history.

allergy treatment

Allergy Treatment

The first line of therapy for allergies is an avoidance of your allergen triggers. We can make recommendations regarding environmental controls. However, often medications are also required. Allergy and asthma medications can be taken prior to allergen exposure, seasonally, or on a daily basis. In addition to environmental control measures, medications, allergy immunotherapy (allergy shots) can be very effective to reduce symptoms and to reduce medication use. Food allergies are treated with avoidance, patient education, a Food Allergy Action Plan, which the physician will write up for you and availability of epinephrine.

Asthma Info

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What Is Asthma?

Asthma is a chronic lung disease that makes breathing difficult. The lining of the bronchial tubes or airways becomes inflamed and swollen causing the airways to narrow. Additionally, muscles surrounding the bronchial tubes can tighten up causing the airway to narrow further. Thick mucus is also produced which adds to airway narrowing and makes it hard to move air in and out of the lungs. Bronchial Asthma is diagnosed through history, physical exam and pulmonary function testing. Allergy testing may also be beneficial to identify allergen triggers for asthma.

Asthma Symptoms

If you or someone you know has any of these symptoms, the diagnosis could be asthma:

Coughing
Wheezing or whistling when you breathe
Chest tightness
Shortness of breath
Excess mucus

In addition, these symptoms or conditions are sometimes associated with asthma:

Stuffy or runny nose (rhinitis or hay fever)
Sinusitis
Nasal polyps
Eczema (atrophic dermatitis)
Gastro esophageal reflux

Patterns

These symptoms could follow any pattern:

Seasonal or year-round
Sudden attacks or gradual worsening
Any duration and frequency
Nighttime vs. Daytime symptoms
Only at certain places, such as work, home, or school

Triggers

Asthma can happen any time in your life. Symptoms may be triggered by:

Viral respiratory infections
Exposure to pollen, mold, house-dust mite, cockroach, and animal dander, urine, and saliva
Exposure to workplace chemicals or allergens
Environmental change resulting from moving or vacation
Exposure to tobacco smoke, perfumes, hairsprays, air pollutants, vapors, gases, and aerosols
Emotional expressions such as fear, anger, frustration, crying, and laughing
Medications such as aspirin, beta-blockers, food additives, and preservatives
Changes in weather, air pressure, humidity, and cold air
Exercise
Menstrual period, pregnancy, obesity, acid reflux, obstructive sleep apnea or thyroid disease
Cold drinks

Asthma Can Be Controlled

While asthma cannot be cured, it may be managed to improve the quality of life and symptoms. Treatment involves fast-acting bronchodilators or “quick-relief medications” for acute symptoms. If symptoms are frequent or more severe, daily long-term controllers or prevention medications may be needed to decrease ongoing airway inflammation and thus minimize symptoms. Improvement in symptoms can take weeks or months, but we will evaluate your progress and adjust your medications accordingly. We will provide an Asthma Action Plan that will direct your medication use. Once you have achieved good control of symptoms, continuing to follow your Asthma Action Plan will help you maintain this control.

RECOVERY
PREVENTION
EARLY INTERVENTION
CRISIS

Patients who suffer from severe asthma and do not reach complete control of their symptoms with traditional asthma treatments may be a candidate for receiving a biologic. Biologic drugs have been shown to decrease the rate of asthma flare-ups and improve quality of life for severe asthmatics. Xolair, Nucala, Dupixent, Cinquair and Fasenra are the five biologics approved by the FDA in the treatment of severe asthma. A blood test will help your physician determine which biologic would be the most effective for you and how often you would receive the treatment.