Peanut Allergies—What Every Parent Should Know

Peanut allergies have become one of the fastest growing health concerns among schools everywhere, considering the number of new cases reported in young children each year.

The peanut butter and jelly sandwich, once considered a lunchbox staple is finding its way less and less into “nut-free” lunchrooms across the nation as school districts move to restrict peanuts and other peanut products from the classroom.

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What sets peanut allergies apart from many other food allergies is the potential severity of the allergic reaction. Peanut proteins are commonly associated with “anaphylaxis”, a dangerous, life-threatening condition that requires immediate medical treatment.

Symptoms—Both Mild and Severe

Peanut allergy symptoms generally occur within minutes of ingesting peanuts, (or products containing peanuts) and may include:

• Hives or small spots/large welts, itchy skin
• Tingling or itching in or around the mouth or throat
• Nausea, diarrhea, stomach cramps, vomiting
• A congested or runny nose
• Wheezing/shortness of breath
• Anaphylaxis (less common), a life-threatening condition that affects many bodily functions, restricts breathing and can cause the body to completely shutdown

What Causes Peanut Allergies?

When the body’s immune system mistakes peanut proteins for harmful foreign invaders it mounts an immune system response to protect itself. This results in an allergic reaction. Contact with peanuts either directly or indirectly can cause powerful chemicals to be released into the bloodstream.

Exposure may occur through:

• Direct contact: Ingesting peanuts or foods/food products containing peanuts is the most common cause of exposure. Skin contact with peanuts may also cause an allergic reaction to occur.

• Cross contact: This results when foods are exposed to peanuts during processing, handling, or preparation.

• Inhalation: It is possible to trigger an allergic response by inhaling peanut dust from peanut products, such as peanut flour, or from aerosol sprays like peanut oil/spray.

Management and Treatment

• Prevention and avoidance are the keys to successful management of peanut allergies.

• Inadvertent exposure to peanuts may require the need for emergency medical treatment.

• Some who suffer from peanut allergies carry an epinephrine auto injector. This can counteract the possible severe effects of anaphylaxis, which can be life threatening if not treated.

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Misconceptions Surrounding Peanuts and Peanut Allergies

• A peanut is not actually a tree nut, but a legume. Legumes are part of the same family as soybeans, peas and lentils.

• Research at the National Institutes of Health reveals that roughly 20 percent of those with peanut allergies do eventually outgrow it.

Types of Food Allergies – Your Body’s Overreaction to the Foods You Eat

According to the Centers for disease Control and Prevention, food allergies impact more than 50 million Americans including some 4-6 percent of children and 4 percent of adults. These occur when the body’s own immune system, designed to protect itself from foreign invaders triggers an overactive response to allergens causing a myriad of symptoms.

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Common Food Allergies

While any food or food substance can cause an allergic reaction, the majority of food allergies stem from one or more of the following:

  • Eggs
  • Milk
  • Peanuts
  • Tree nuts
  • Fish
  • Shellfish
  • Wheat
  • Soy

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Symptoms Associated With Food Allergies

Allergy symptoms can range from mild discomfort to the more severe, life threatening condition, anaphylaxis that can impair breathing and shut the body down completely.

Allergic reactions may affect the skin, gastrointestinal tract, cardiovascular system, or respiratory tract.

These may include:

  • Stomach cramps/vomiting/diarrhea
  • Hives
  • Shortness of breath
  • Wheezing
  • Cough
  • Circulatory collapse/shock
  • Hoarse throat/difficulty swallowing
  • Swollen tongue, impairing the ability to breathe or talk
  • Weak pulse
  • Blue or pale color skin
  • Feeling faint or dizzy
  • Anaphylaxis—a serious physical reaction that can be life threatening, causing the body to go into shock

Delayed Allergic Reactions

While the majority of allergic symptoms present within two hours of ingesting a known allergen, reactions often occur within minutes. Rarely however, an allergic reaction can occur four to six hours later, as in cases of a skin allergy such as eczema developed by some children.

A severe gastrointestinal allergic reaction known as (FPIES), or food protein-induced enterocolitis syndrome can occur up to six hours after consuming milk, soy or certain grain products. It is mostly common among young infants after ingesting these foods for the first time, (or being weaned) and results in repetitive vomiting which can lead to dehydration.

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Managing Food Allergies

Avoidance and Cross-reactive Allergens

The majority of food allergies can be managed by simply avoiding food triggers and the environments these foods are prepared in. Much of the time allergies run in families and can be inherited, though not always. It is impossible to predict whether children of allergy sufferers, or siblings will develop sensitivity to certain foods.

Some food substances may also be “cross-reactive” meaning that allergies to specific foods may also crossover to general food groups. This happens with shellfish for example, when persons are allergic to shrimp, but also react to crab and lobster, or with peanut allergies and other tree nut reactions such as pecans, cashews, and walnuts.

In most cases however, once properly identified, food allergies can be managed fairly well through product and environmental awareness and avoidance.

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Allergy Testing – The Basics

Allergy Testing

Your body’s immune system works around the clock to defend itself against foreign invaders it has inhaled, ingested, or come into contact with.
It does this by producing antibodies known as, Immunoglobulin E, or (IgE). These travel through the body to cells, releasing chemicals, which cause individual allergic reactions.

These may include a multitude of symptoms including sneezing, itching, runny nose, hives—even the life-threatening reaction known as, “anaphylaxis” which can completely shut the body’s respiratory system down, among other functions.

Identifying Triggers—Allergy Testing

Physicians and medical practitioners combine a patient’s medical history and thorough physical examination with comprehensive allergy testing to determine specific allergy triggers.

Not every person who experiences an allergic reaction will need to undergo allergy testing however. Some people are already aware of a mild adverse reaction that involves one or two types of foods or substances and can control allergy symptoms by avoiding these foods/substances.

When To Call The Doctor

Certain symptoms if severe enough, or persistent may warrant allergy testing.

These include:

• Respiratory Symptoms- itchy, sticky eyes, nose or scratchy throat; nasal congestion, runny nose, congestion in the lungs, coughing, sneezing or wheezing
• Skin-related Symptoms- itchiness, hives, eczema, or rash
• Abdominal Symptoms- stomach upset, vomiting, cramping, gas, bloating, or diarrhea after consuming certain foods
• Insect sting reactions severe enough to cause respiratory problems or other major symptoms
• Anaphylaxis- a potentially life-threatening allergic reaction affecting several functions of the body

Common Allergy Tests Performed

An allergist or immunologist will generally perform one or more tests to identify specific allergens for patients. These will be evaluated along with the medical history.

IgE Skin Tests: The most common type of testing for allergies is the IgE Skin test, also known as the, “prick” test. This allows for a small amount of a specific allergen to be inserted under the skin. Once an allergic reaction occurs, a raised bump, (much like a mosquito bite) presents.

Challenge Tests: These are generally performed when food or medication allergies are suspected and involve inhaling or ingesting a small amount of the substance.

IgE Blood Tests: These may be performed when skin tests are not safe or viable for patients, because of skin conditions or certain medications, which may interfere with results.

Protections and Precautions

The American Academy of Allergy, Asthma & Immunology (AAAAI) does not support the following tests, (test methodologies):

Drug store/supermarket allergy screening
Home test/screening
Applied kinesiology
Cytoxicity
Rinkel skin titration method
Provocative neutralization testing
(IgG) testing for food allergy
Sublingual provocation

Sources: http://www.aaaai.org/conditions-and-treatments/library/at-a-glance/allergy-testing.aspx

Seasonal Allergies—All Year Long

While most people naturally associate springtime with seasonal allergies when many trees, plants and grasses release pollens into the environment, each of the four seasons can actually trigger allergy symptoms in sufferers.

Because allergies are the body’s overactive immune response to what it perceives as foreign “invaders”, allergens come in many forms at all different times of the year.

Some of these may include:

Trees
Grasses
Pollens
Mold
Smoke
Insect bites and stings
Chlorine
Candy and celebratory food ingredients
Pine trees and wreaths

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Allergies for All Seasons

Fall—

From August to November Ragweed releases pollen into the air causing itchy swollen eyes, runny nose, scratchy throat and sinus congestion for many who are allergic. Prevalent mainly in the Midwest and on the East coast, Ragweed does grow everywhere in the United States and becomes airborne the most throughout mid-September.

Other fall weeds that promote allergies include:

Burning bush
Cocklebur
Lamb’s-quarters
Pigweed
Sagebrush and Mugwort
Tumbleweed and Russian thistle

Winter—

From December through March, indoor allergies affect millions of people, triggering a multitude of symptoms. (Milder winter temperatures can also bring about early pollination of some plants and grasses).

Indoor allergens include:

Dust mites
Mold
Pet dander
Fireplace smoke
Pine trees (holiday trees)
Wreaths
Holiday candy ingredients

Spring—

One of the biggest allergens in springtime is pollen. April through June, these tiny grains are released into the atmosphere by trees, grasses, and weeds in order to fertilize other plants. When persons who are allergic ingest these tiny particles, the body’s immune system goes into overdrive.

The following trees, grasses and weeds are common offenders:

Trees

Alder
Ash
Aspen
Beech
Box elder
Cedar
Cottonwood
Cypress
Elm
Hickory
Juniper
Maple
Mulberry
Oak
Olive
Palm
Pine
Poplar
Sycamore
Willow

Grasses and weeds

Bermuda
Fescue
Johnson
June
Orchard
Perennial rye
Redtop
Saltgrass
Sweet vernal
Timothy

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Summer—

Warmer days, higher humidity and, outdoor activities leave allergy sufferers vulnerable to a host of common triggers present in summertime environments June, July, and August. Many of these are natural plants, grasses, and pests while others are common manmade substances.

Insect bites and stings
Mold
Chlorine
Smoke (campfires)
Seasonal fruit
Sunscreen
Poison ivy

Weeds:

Ragweed
Cockleweed
Pigweed
Russian thistle
Sagebrush
Tumbleweed

Grasses:

Bermuda
Blue grasses
Orchard
Red Top
Sweet vernal
Timothy grass
Johnson grass
Rye grass

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Although many allergens are present in each of the four seasons, certain plants and trees, as well as pollen counts vary by region throughout the country.

Post Nasal Drip, Septal Deformities, and Natural Treatment for Allergy Sufferers

Most of us never notice the one to two quarts of mucus, produced daily by glands in the nose and throat, necessary to moisten and clean the nasal membranes, humidify the air, clear foreign matter that is inhaled and fight infection.  This is because the majority of it is swallowed unconsciously within the course of the day.  Sometimes however, a clogged, or dripping sensation from the back of the throat referred to as, “post-nasal drip” occurs causing mild irritation and discomfort.

What Causes Post-Nasal Drip? —Treatment Options

Abnormal Secretions—Excessively thick mucus secretions, or increasingly thin secretions can contribute to post-nasal drip.  Thick secretions may result from dryness due to overheated buildings in the winter, sinus infections, or nasal allergies.  These can be from foods such as dairy products.  Sometimes thin secretions can become thick and turn green or yellow because of bacterial infection in the sinus area.

Thin mucus secretions may contribute to post nasal drip as well. These can be due to certain spicy foods, pregnancy, cold temperatures, hormonal changes, allergies, or bright lights.  Some medications, such as oral contraception, or blood pressure medication may cause increased secretions in the sinus passages as well.

Swallowing—Sometimes muscles in the throat, mouth and esophagus fail to interact properly causing secretions to overflow into the larynx and breathing passages.  This can cause hoarseness, coughing, and throat clearing.

The following factors may contribute to difficulty swallowing:

  • Age—Muscles often lose coordination as we get older and lose strength.  This can make it difficult for secretions to easily pass into the stomach.
  • Sleep—Secretions gather since swallowing occurs less frequently.  Coughing and throat clearing is often necessary when waking.
  • Stress—Spasms may occur when throat muscles tighten making it feel like a lump in the throat.  Throat clearing can actually irritate soft tissue at this point, as it often produces little or no mucus.
  • Swelling or growths—These, (when obstructing the food pathways) can prevent the smooth passage of mucus secretions.
  • GERD (gastroesophageal reflux disease)— Causes the contents of the stomach to back up, spilling acid into the throat or esophagus. 

Effects on the Throat

  • Sore, irritated throat
  • Swollen tonsils, throat tissue
  • General discomfort, (lump-like feeling) in throat

Treatment for Post-Nasal Drip-Allergy Remedies

A physician must conduct a detailed ear, nose, and throat examination.  If necessary, x-rays, endoscopic procedures and laboratory tests may be conducted.

Treatment Options Based on Causes

Bacterial Infection—Antibiotics for short-term sinusitis.  Surgery for chronic conditions to open blocked passages.

Remedies for Allergies—Prevention and avoidance of known allergen.  Relief through antihistamines, decongestants, steroids, and allergy shots, (these may be sedating or non-sedating and come in the form of pills, liquids, sprays, or injectables.)

GERD—Elevating the head of the bed, eliminating caffeine and alcohol from the diet, and avoiding food or drink, two to three hours before bedtime.  Certain over-the-counter and prescription medications are available to help treat GERD as well.

General Measures—Drink more water, avoid caffeine and diuretics.  There are some mucus thinning agents available.  Using a nasal douche or neti pot may help drain the sinus passages as well.

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The Neti Pot—Home Remedies for Allergies 

Although the practice of “saline irrigation” for allergy relief and the sinuses has been around for many years, there has been a resurgence of interest in the convention with the introduction of the “neti pot”, a teapot like container used to flush a saltwater solution through the nose and sinus cavities.  By leaning over the sink and pouring the saline solution into one nostril, the neti pot helps rinse away mucus and other irritants in the sinus cavity and nasal passages. 

Finding homeopathic remedies and “natural allergy medicine” solutions is important for many people, especially during times of high pollen such as during the spring and fall seasons.   

Historic Use of the Neti Pot

Many people with sinus allergies develop a chronic condition known as, “rhinosinusitis”.  This involves inflammation and sometimes infection of the sinus passages and cavities.  Many centuries ago Ayurvedic Indian medicinal practices utilized saltwater to flush the nasal cavities of ancient peoples to remove foreign debris, pollen, and excess mucus.  Practitioners of homeopathic allergy relief would irrigate the nasal cavities up to four times per day by delivering saltwater into one nostril and allowing it to readily drain out of the other.

Natural Allergy Relief-How it Helps

  • Reduces nasal congestion
  • Reduces headaches caused by sinus congestion
  • May decrease dependence on antibiotics that fight sinus infection
  • May decrease dependence on corticosteroid sprays used for nasal inflammation due to allergies
  • Considered safe and well tolerated

Safety Concerns

  • Should not be used for infants.
  • Physician should be consulted regarding regular use.
  • In certain cases, may actually create conditions for sinus infections.
  • May remove critical lining of mucus membranes necessary in sinus passages with overuse.
  • Sterile water must be used due to a parasitic amoeba, known as, “naegleria fowleri”, that has been linked to several deaths in neti pot users.

Natural Cure for Allergies—How the Neti Pot Works

A neti pot is a vessel that resembles a smaller version of Aladdin’s lamp.  When warm sterile saltwater is placed in the pot, the user tilts their head to one side and places the spout in the nostril that is elevated.  They then allow this to drain through the nasal cavities and through the other nostril.  Nasal irrigation should never be attempted using non-sterile water or seawater due to issues with contamination.   

Kosher salt is safe for use and prevents the discomfort of a burning sensation associated with a non-isotonic solution.

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The Deviated Septum—Symptoms, Causes, and Treatment

A deviated septum can wreak havoc in the lives of both allergy and non-allergy sufferers, depending on the significance of the blockage created by the condition.

When the thin wall (nasal septum) between the nostrils is displaced to one side, this causes one nasal passage to be smaller than the other.  This can be significant, blocking one side of the nose and reducing the flow of air to the lungs.  Crusting or bleeding may occur as well, due to the effect of dry air flowing through the nose.  Obstruction of the nasal passages can happen also because of swollen tissues in the lining in the nose.

Symptoms

Many people live their entire lives without ever realizing they have septal deformities.  Some structural abnormalities do however cause troubling symptoms.

These may include:

Obstruction of the nostrils:  This may cause difficulty breathing, especially when allergies, a cold, or upper respiratory infection is present, which can already cause swelling or narrowing of nasal passages.

Nosebleeds:  The drying of the nasal septum may increase the risk for nosebleeds.

Facial pain:  One-sided facial pain may be caused by a deviated septum.

Noisy breathing while sleeping:  Infants and young children may breath loudly if intranasal tissues are swollen or if they have a deviated septum.

Over awareness of the nasal cycle:  Becoming overly aware of the cycle of obstruction from one nostril to the other may indicate a deviated septum.

Preference for sleeping on a particular side:  A strong preference for sleeping on one side, as opposed to another may indicate that breathing is impaired due to a narrow nasal passage.

Causes of a Deviated Septum

A birth condition caused during fetal development

Injury:  Injury during childbirth may cause a deviated septum in infants.  Accidents may occur in children and adults that cause trauma to the nasal structure.

Aging:  The normal aging process can exacerbate an already existing condition with the septum.

Acute Rhinosinosinusitus:  This can make a deviated septum worse because of swollen nasal tissues that will further narrow nasal passages and cause obstruction.

Treatment

Treatment of nasal obstruction may include medications to reduce the swelling, or adhesive strips that may help open the nasal passages. To completely correct a deviated septum however, surgery is necessary.

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Allergies and the Histamine Connection

HOW IT ALL WORKS

Certain substances cause our body’s immune system to overreact and produce histamine as a response to proteins found in foods, insect venom, or airborne allergens.  Normally these agents are inhaled or absorbed through the skin.  The body’s immune system creates antibodies to attack the foreign substance by releasing chemical histamines in the body.

WHAT CAN HAPPEN

When too much histamine is released into the body, several allergy symptoms may occur.  These include skin irritations, such as rashes, hives or eczema.  The eyes are also affected and may become watery, inflamed, irritated or scratchy.  Nasal passages can become swollen, and airways congested with runny nose and sneezing.  Too much histamine in the airways may bring about allergy-induced asthma as well.  This can lead to shortness of breath, coughing and wheezing.

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The Antihistamine Solution

Antihistamines are used to treat allergy symptoms and come in pill form, liquids, tablets, and capsules.

Antihistamines treat:

  • Skin rashes and hives
  • Runny nose, sneezing, congestion, or itching
  • Nasal passage swelling
  • Runny, itchy eyes

Treatment for an Allergic Reaction

The body releases chemicals known as, “histamines” as a response to contact with allergens such as pet dander, pollen, ragweed or dust mites, for example.  This causes the swelling, itching or stuffiness that accompany an allergic reaction.  Antihistamines work to either reduce the level of histamine released in the body, or block it altogether to lessen allergy symptoms.

Allergy treatments may include medications such as steroids, allergy shots, or antihistamines.

These may be either prescribed by a physician or purchased OTC (over-the-counter).

Antihistamines: These are used to treat allergy symptoms and generally fall into two categories, sedating and non-sedating.  Older antihistamines fall into the first category.  These medications relieve allergy symptoms, but cause drowsiness, and several other side effects such as dry mouth.  Non-sedating antihistamines, often considered a newer class of medications do not cause as much drowsiness.

All antihistamines work to lessen or prevent the amount of histamine that causes an allergic reaction in the body such as, swelling, itching, tearing, and breathing issues and secretions.

Antihistamines come in pill form as creams, nasal sprays, lotions, nose drops, and eye drops.

Other allergy drugs may include:

Corticosteroids: These work to reduce inflammation and include creams, ointments, nasal sprays, and tablets.

Mast cell stabilizers: These must be taken regularly to prevent allergic reactions.  Some inhalers such as (Cromolyn Sodium) may be used for the prevention of asthma.   

Leukotriene inhibitors: These drugs target specific leukotriene receptors in the body to reduce allergic symptoms.

Nasal anticholinergics: These medications work to reduce nasal discharge only.

Decongestants: These drugs constrict blood vessels in the nose, which help limit the secretions that come from the inner lining.  They are available in nasal sprays, liquids, and pills.

Immunomodulators: These help to relieve skin allergies and are topical.

Auto injectable epinephrine: This drug application is used to treat anaphylaxis, a severe allergic response to food, insect venom, or other substances.

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UrticariaThe Management and Treatment of Hives

Hives, also known as, “urticaria” will affect about 20 percent of people in their lifetime.  Several different substances, causing an allergic reaction that creates itchy patches of skin that become swollen red welts, trigger this skin condition.  Certain activities may exacerbate hives such as, stress, alcohol, or exercise.

Symptoms

The symptoms of hives are itchy, raised, red or skin-colored bumps.  “Blanching” also occurs when the center of a red hive is pressed and it turns white. 

Triggers

Common triggers include:

  • Food Allergies (Food allergy rash)—Peanuts, eggs, nuts, shellfish
  • Medications—Antibiotics, Ibuprofen, aspirin
  • Insect venom—Bee sting allergy
  • Physical stimuli—Sun, heat, cold
  • Latex allergy
  • Blood transfusions
  • Infections—viral or bacterial
  • Pet dander
  • Plants—pollen, certain plants such as poison ivy, poison oak

Allergist Prescribed/OTC Medication

Treatment for hives includes both low-sedating and non-sedating antihistamines available by prescription or over-the-counter.  These may be taken along with anti-itch creams or salves, or cold compresses to reduce the swelling from hives.  Severe urticaria may require a temporary steroid such as Prednisone, a corticosteroid medication, or an immune modulator to reduce more severe symptoms.  In cases where the tongue or lips swell, or breathing is affected, a physician may prescribe an Epinephrine injector to be kept on hand in case of anaphylaxis, a potentially fatal severe allergic response.

It is important to identify, avoid, and eliminate triggers if possible including:

  • A food allergy or foods that may cause an allergic response
  • Scratching or rubbing
  • Harsh soaps
  • Pressure from tight-fitting clothing
  • Temperature, including cold air or water
  • Excessive sun exposure
  • Specific medications

Chronic Hives—Not Forever

Chronic hives may occur if urticarial symptoms exist for more than six weeks.  If no known cause can be found for the condition, it is said to be, “idiopathic”, or “unknown”.  Many of these cases can be linked to immune disorders, however.  Chronic hives may also be associated with other medical conditions, such as cancer, thyroid disease, or other hormonal disorders.  In general, even chronic hives disappear over time, however.

Anaphylactic ShockA Life-threatening Condition

This potentially fatal condition occurs as a severe allergic response toward a particular substance.  When this happens, the body can quickly shut down.   Breathing becomes labored, and blood pressure drops rapidly.  Thinking becomes unclear as the brain becomes starved for oxygen.  Cell-fluids in the throat can cause it to swell shut and death can occur within three to four minutes of exposure to a specific allergen. 

Anaphylaxis is a severe reaction to a food allergy such as peanuts or seafood.  It can also occur in persons allergic to bee stings or other insect venom. This is a life-threatening condition that needs emergency medical treatment to prevent anaphylactic shock.  It is important to note that the body may not react to initial exposure, but may produce a large amount of histamine upon subsequent episodes of exposure to specific allergens.

General symptoms of anaphylaxis may develop within seconds or minutes and include:

  • Pain in the abdomen
  • Abnormal breathing sounds
  • Anxiety
  • Tightness in the chest
  • Cough
  • Diarrhea
  • Breathing difficulties
  • Swallowing difficulties
  • Light-headedness, dizziness
  • Hives, itching
  • Nasal congestion
  • Nausea, vomiting
  • Heart palpitations
  • Skin redness
  • Slurred speech
  • Swelling in the eyes, face, or tongue
  • Unconsciousness
  • Wheezing

Emergency Medical Care

At this time, an injection of the hormone, epinephrine, (which is naturally produced in the adrenal glands) is the only treatment for anaphylactic shock.  This works to open the airways by constricting the blood vessels in the body.  Unfortunately however, the effects of an injection only last about 10-20 minutes and the drug must be administered before, or at the onset of symptoms.  It is critical to get help immediately upon exposure to a known allergic substance that could lead to anaphylaxis.

http://1.usa.gov/U2D9ot

Allergies or Sinus Infection? —Similar Symptoms

According to the Centers for Disease Control, the recent number of adults diagnosed with sinusitis in the United States is about 28.5 million.  That’s roughly, 12.1% of the adult population, and at least some of these cases can be attributed to allergies alone.

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Bacterial Causes of Sinus Infection

Seasonal allergies affect many of us in different ways, especially in the area of the sinuses and the sinus passages.  Pollen from trees, plants, and grasses often causes stuffy noses, runny eyes and achy heads.  Sometimes, however this can lead to a more serious condition known as, “sinusitis”, or swelling and inflammation of the sinuses, (the air cavities surrounding the nasal passages). This may prevent normal drainage of the mucus the body creates to protect the lungs from foreign invaders such as dust and debris.

As mucus collects in the nasal passages bacteria begins to grow.  This may cause infection of the surrounding tissue that can spread through the sinus cavities.

While allergy symptoms may appear similar to that of a sinus infection, a physician must diagnose this through a physical examination, an x-ray of the sinuses, or a specific test for bacteria of nasal discharge.

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Sinusitis and Sinus Infection—Acute and Chronic

Symptoms of sinus infection may range from discharge that is thick and yellow, or green in color that runs from the nose, or down the back of the throat.  The nasal passages will generally also be obstructed, causing congestion.  There may be swelling in the face, around the nose, cheeks, eyes, or forehead, and it may be more difficult to taste or smell.

There are two types of sinusitis, which include, acute sinusitis, and chronic sinusitis.  (Sinusitis can be caused by infection or allergy irritation). 

Acute sinusitis:  This is the temporary inflammation of the sinuses where mucous membranes in the nose, sinuses, or throat become inflamed due to allergies.  The swelling caused by allergies blocks mucus from draining, causing pressure to build in the sinus area.

Chronic sinusitis:  If symptoms persist for more than 12 weeks, or if persons experience more than three sinus infections in one year, then sinusitis is considered chronic.  Over 50 percent of people with moderate to severe asthma have chronic sinusitis.

Sinus Infection Treatment—Getting Allergy Relief

A sinus infection may be treated in a variety of ways depending upon the severity of the infection. 

Unblocking the Nasal Passages:

This is the initial first step that is needed to treat a sinus infection.  Without proper drainage, the bacterial infection will remain in the nasal cavity causing further inflammation and damage to the tissues.  A physician may flush sinus passages or advise the patient to inhale steam, or sleep with a vaporizer to loosen phlegm. 

Options in Allergy Medicine

Nasal steroids:

Sprays containing steroids can be used to decrease inflammation of the nasal lining. 

Antibiotics:

Physicians prescribe a course of antibiotics to fight infection in the sinus cavities.

Oral steroids:

These may be prescribed for chronic sinusitis, but are powerful with significant side effects.  Generally they are only prescribed when other medications have failed. 

Nasal steroids: 

Sprays are helpful for many people to decrease inflammation, but can often lead to damage of the nasal lining.

Surgery: 

Some patients with chronic sinusitis that have not responded to antibiotics or other medications may be candidates for functional endoscopic sinus surgery (FESS), or a “balloon sinuplasty” to help clear sinus pathways and allow for normal drainage of mucous.

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Can Allergies Cause Headaches?The Truth About Whether Sinus Allergies Can Lead To a Sinus Headache

Sometimes allergies or hay fever can lead to sinus pressure and headaches in the front of the head or around the eyes.  A physician must diagnose true sinus headaches since they may also be confused with migraine pain because of their location.  Sinus pressure caused by blocked or inflamed sinus passages may press on the nerves surrounding the ocular area and head causing severe headaches for some allergy sufferers. 

If an infection occurs due to bacteria from mucus build up, the sinus passages will remain swollen and inflamed causing pressure and possible headache pain to persist. 

Allergy Headache—The Sinus Pressure and Pain Connection

It is important to note that many people who “self diagnose” their headache as a sinus headache really suffer from migraine pain.  (Research finds there is a link between migraines and allergies). 

There are four pairs of paranasal sinuses contained in the skull that help the voice resonate and make the skull lighter.  Within this area, severe headache pain may occur in connection with allergies, sinusitis and sinus infection.  Physicians use specific criteria to diagnose true sinusitis (rhinosinusitis) headaches.

These include:

  • A headache must be present in the front of the head with additional pain in the ears, face, or teeth.  There must also be clinical evidence of either acute or chronic rhinosinusitis.  (A nasal endoscopy, CT, or MRI could provide this, as well as some type of nasal or sinus culture performed by a physician).
  • A headache must be present at the same time as rhinosinusitis symptoms.
  • Within a period of seven days of successful treatment, (or reduced symptoms) of acute or chronic rhinosinusitus, the headache and/or facial pain disappears.

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Allergies—Our Overactive Immune System

Over 50 million Americans suffer from chronic allergies each year. Caused by an overreaction of the body’s own immune system, symptoms may range from sneezing, coughing or mild skin irritation to more serious conditions such as allergy induced asthma or life threatening anaphylytic shock. While the Centers for Disease Control report that allergies are the 6th leading cause of chronic illness in the nation, and that over $18 billion is spent annually for treatment, some persons may be at higher risk than others for allergy related illnesses.

Persons at risk include:

Infants who have already developed cow’s milk allergies
Small children who have asthma or food allergies
Anyone who has developed an allergic reaction to an insect bite or bee sting
Any person with a preexisting allergic condition
Anyone with close family members with allergies including hay fever, skin allergies, food allergies, or allergies to insect stings

So, what are allergies and why do we get them?

Normally, the body’s own immune system produces antibodies to protect itself from substances that cause illness or infection. In the case of allergies however, the body mistakenly identifies allergens as harmful agents, triggering the immune system to release chemicals such as, histamine that produces allergy symptoms. These can irritate and inflame the skin, clog sinuses and airways, and negatively affect the digestive system.

Allergies may be relatively minor, causing only minimal discomfort, but can also escalate to a serious condition known as, “anaphylaxis”, requiring emergency medical treatment.

While the majority of allergies cannot be cured, most can be treated to relieve symptoms.

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Food Allergies and Seasonal Allergies—Among the Most Common

Many people suffer allergic reactions to certain foods, and plant and tree pollens during specific times of the year.

Food Allergens: peanuts, tree nuts, wheat, soy, fish, shellfish, eggs, milk

*Peanut Allergy—An allergy to peanuts can be especially serious since it can cause anaphylaxis.

Airborne Allergens: pollen, animal dander, dust mites, mold

Insect Stings: bee stings, wasp stings, hornet stings, yellow jacket stings, and fire ant stings

Materials Allergies: Latex is a common substance that may promote an immune system response. Proteins found in latex rubber, used in gloves, condoms and other products cause contact skin allergies for some people.

Drug Allergies: These can affect the skin or other tissue or organs
of the body. This includes Penicillin or Penicillin derivatives.

Allergic Reactions—Signs and Symptoms

These vary depending on the substance and the area of the body affected. This includes the digestive system, nasal passages and skin.

Seasonal allergy symptoms/airborne allergies: sneezing, runny nose, stuffy nose, red, swollen eyes, watery eyes, itching on the roof of the mouth

Food allergy symptoms/food allergies: swelling of the lips, tongue, throat, face, mouth, hives, anaphylaxis

Insect sting allergies: swelling at the sting site,
hives or itching covering the body, wheezing, coughing, chest tightness, shortness of breath, anaphylaxis

Drug allergies: hives, itchy skin, skin rash, swelling in the face, wheezing, anaphylaxis

Atopic dermatitis—a skin allergy also known as “eczema” that may cause skin to become red, peel or flake

Medical conditions associated with allergies include asthma, conjunctivitis, eczema, dermatitis and sinusitis, hives and hay fever.

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Anaphylaxis—Life Threatening Consequences

Anaphylaxis is a life threatening condition caused by a severe allergic response requiring emergency medical assistance. Some foods and insect stings can cause anaphylaxis, causing the body to go into anaphylactic shock.

Signs of anaphylaxis include:

Tingling/Palms/Hands/Feet/Lips
Tight chest
Seizures
Cardiac arrhythmia
Shock
Face Flushing
Loss of consciousness
Loss of blood pressure
Shortness of breath/ragged breathing
Skin rash
Lightheadedness/dizziness
Weak/rapid, pulse
Upset stomach/nausea/vomiting

Risks and Concerns

An allergy may increase your risk of:
Anaphylaxis
Asthma
Atopic dermatitis (eczema)
Sinusitis
Infections of the ears or lungs
Fungal complications of your sinuses or your lungs
Bronchopulmonary aspergillosis, (a hypersensitivity response to the fungus Aspergillus if you’re allergic to mold)

Can Allergies Be Prevented?

Once the body develops an allergic reaction to a certain substance there is generally no way to prevent that allergen from reacting with the body again. Eliminating a particular substance from a person’s environment or controlling the amount of exposure a person has to an allergen is the general protocol surrounding treatment for allergies. This can be done by avoiding particular foods that trigger allergic responses, installing air filtration systems that filter out pet dander, dust mites, pollen, and dust particles, and taking medication to minimize the symptoms and effects of allergies.

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Multiple Allergy Treatments—Many Forms

Allergies may be treated by prescription medications, or over the counter products. These are available in the form of pills, liquids, nasal sprays, inhalers, eye drops, skin creams and injections.

Antihistamines—Antihistamines block histamine, a symptom-causing chemical released by your immune system during an allergic reaction.

Pills and liquids—Oral antihistamine to ease symptoms

Nasal sprays— Relieves sneezing, runny nose, sinus congestion, postnasal drip

Eye drops—Antihistamine for itchy, red, swollen eyes

Decongestants— Offers immediate relief from sinus and nasal congestion.

Pills and liquids—Oral decongestants

Nasal sprays and drops—For short applications

Corticosteroids—Corticosteroids relieve symptoms by suppressing allergy-related inflammation. Most of these medications require a prescription.

Nasal sprays—Prevention and relief of stuffiness

Inhalers—Daily use for asthma prevention

Skin creams—For relief of itching, scaling, redness, swelling, or irritation

Immunotherapy—Gradual increased exposure to allergens to build tolerance

Allergy Shots as Treatment

Regularly scheduled allergy injections can also be taken to either prevent the symptoms of an allergy from occurring or to lessen the severity of the symptoms.

Emergency epinephrine shots—self administered shots to treat anaphylaxis

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Multiple Chemical Sensitivity

“ABSTRACT.  Consensus criteria for the definition of multiple chemical sensitivity (MCS) were first identified in a 1989 multidisciplinary survey of 89 clinicians and researchers with extensive experience in, but widely differing views of, MCS.  A decade later, their top 5 consensus criteria (i.e., defining MCS as[1] a chronic condition [2] with symptoms that recur reproducibly [3] in response to low levels of exposure [4] to multiple unrelated chemicals and [5] improve or resolve when incitants are removed) are still unrefuted in published literature.)  Along with a 6th criterion that we now propose adding (i.e., requiring that symptoms occur in multiple organ systems), these criteria are all commonly encompassed by research definitions of MCS.  Nonetheless, their standardized use in clinical settings is still lacking, long overdue, and greatly needed–especially in light of government studies in the United State, United Kingdom, and Canada that revealed 2-4 times as many cases of chemical sensitivity among Gulf War veterans than undeployed controls.  In addition, state health department surveys of civilians in New Mexico and California showed that 2-6%, respectively already had been diagnosed with MCS and that 16% of the civilians reported an “unusual sensitivity” to common everyday chemicals.  Given this high prevalence, as well as the 1994 consensus of the American Lung Association, American Medical Association, U.S. Environmental Protection Agency, and the U.S. Consumer Product Safety Commission that “complaints [of MCS] should not be dismissed as psychogenic, and a thorough workup is essential,” we recommend that MCS be formally diagnosed–in addition to any other disorders that may be present–in all cases in which the 6 aforementioned consensus criteria are met and no single other organic disorder (e.g., mastocytosis) can account for all the signs and symptoms associated with chemical exposure.  The millions of civilians and tens of thousands of Gulf War veterans who suffer form chemical sensitivity should not be kept waiting any longer for a standardized diagnosis while medical research continues to investigate the etiology of their signs and symptoms.”

 

*”archives of Environmental Health”, May/June 1999 [Vol. 54 (No. 3)]