ALLERGY, ALLERGEN, ANTIGEN-ANTIBODY COMPLEXES

Allergic disease of the ear, nose, and throat areas presents itself in many ways. The most common allergic symptoms are congestion, runny nose, postnasal drip, watery eyes, and itching of the eyes or throat. Ear infections and sinus infections are often aggravated by allergies. Less commonly, hives, headaches, and Menière's disease can be caused or aggravated by allergies. People who cannot breathe through their noses adequately because of allergies do not sleep well, either. That can cause or aggravate sleep apnea which increases the risk of heart attacks in folks over 50, causing death in some.

Simple allergic reactions involve an allergen (Ragweed, dust mite, cat, etc) finding an antibody in the nose, mouth, or throat and creating antigen-antibody complexes, triggering the immediate release of histamine which causes congestion, itching, etc. Less common allergic reactions involve blood compliment or fixed tissue reactions, which are often delayed in onset, prolonged in duration, and involve parts of the body other than the nose, throat, and lungs. Mild allergic reactions are usually treated symptomatically with antihistamines or nasal sprays and don't require identifying the offending allergens. As allergic reactions get worse and interfere more with daily life, the need to identify the offending allergens becomes greater and treatment becomes more prolonged, more complicated, and more specific. Allergy testing is usually done either as a skin test or a blood test (RAST). Skin testing involves placement of a small amount of allergen in the skin of the arm, creating small wheals (bumps). These wheals are then observed for 10 minutes and the change in size and color is recorded. Inhaled allergens cause acute reactions that go away within a few hours with the exception of molds, which can create acute and/or delayed reactions. Delayed mold reactions, usually dark red bumps that occur 24-72 hours after the skin test was placed, are often important. Notify your allergist if you note delayed reactions to skin tests that were placed one or more days earlier.When you are scheduled for skin testing: Wear a short sleeved shirt. Make sure you have been off all drugs that might interfere with skin testing for an adequate period of time. This includes antihistamines, many antidepressants, and certain anti-acid stomach medications. Ask about your current medications when scheduling your appointment for skin testing. Check with the doctor who put you on antidepressants before stopping antidepressant medications! Make sure toe doctor know if you are on a beta blocker for any reason. Skin testing is not usually done on someone on a beta blocker.

Allergic disease of the head and neck presents itself in many ways. The most common allergic symptoms are congestion, runny nose, postnasal drip, watery eyes, and itching of the eyes or throat. Ear infections and sinus infections are often aggravated by allergies. Less commonly, hives, headaches, and Menière's disease can be caused or aggravated by allergies. People who cannot breathe through their noses adequately because of allergies do not sleep well, either. That can cause or aggravate sleep apnea which significantly increases the risk of heart attacks in folks over 50, causing death in some. Simple allergic reactions involve an allergen (Ragweed, dust mite, cat, etc) finding an antibody in the nose, mouth, or throat and creating antigen-antibody complexes, triggering the immediate release of histamine which causes congestion, itching, etc. Less common allergic reactions involve blood compliment or fixed tissue reactions. The latter create symptoms which are often delayed in onset, prolonged in duration, and involve parts of the body other than the head and chest. Mild allergic reactions are usually treated symptomatically with antihistamines or nasal sprays and don’t require identifying the offending allergens. As allergic reactions get worse and interfere more with daily life, the need to identify the offending allergens becomes greater and treatment becomes more prolonged, more complicated, and more specific.

Allergy testing is usually done either as a skin test or a blood test (RAST). Skin testing involves placement of a small amount of allergen in the skin of the arm, creating small wheals (bumps). These wheals are then observed for 10 minutes and the change in size and color is recorded. Inhaled allergens cause acute reactions that go away within a few hours with the exception of molds, which can create acute and/or delayed reactions. Delayed mold reactions, usually dark red bumps that occur 24-72 hours after the skin test was placed, are usually important. Notify your allergist if you note delayed reactions to skin tests that were placed one or more days earlier. RAST testing determines the amount of immunoglobulin E present in the blood for specific antigens. It is less invasive than skin tests, it doesn’t require the patient to be off medications, and it does not involve much of the patient’s time. Not all allergens, especially molds, can be tested accurately using RAST, so it cannot totally replace skin testing. If you are scheduled for skin testing: Wear a short sleeved shirt. Make sure you have been off all drugs that might interfere with skin testing for an adequate period of time. This includes antihistamines, many antidepressants, and certain anti-acid stomach medications. Ask about your current medications when scheduling your appointment for skin testing. Check with the doctor who put you on antidepressants before stopping those medications!