Surviving Allergy Season With Mr Turlough Farnan, ENT Consultant
27th, Apr 2023
Spring brings warmer temperatures, longer days and blossoming flowers! However, it also brings seasonal allergies which can be uncomfortable and irritating if not treated. To help get you through allergy season, our ENT Specialist Mr Turlough Farnan tells us about common symptoms and triggers, ways to cope when allergies arise and red flags to keep an eye on.
What is an allergy, can it develop at any age and is it genetic?
An allergy is an abnormal immune response to a typically harmless substance called an allergen. Common allergens include pollen, pet dander, dust mites, insect venom, and certain foods. When a person with an allergy comes into contact with an allergen, their immune system overreacts and produces antibodies called Immunoglobulin E (IgE), which cause various symptoms such as sneezing, itching, runny nose, hives, and even life-threatening anaphylaxis in severe cases.
Yes, allergies can develop at any age. While many people develop allergies during childhood or adolescence, it is possible to develop new allergies as an adult or even in older age. Allergies can also change over time, with symptoms becoming more or less severe, or even disappearing completely.
Allergies have a genetic component, but they are not solely determined by genetics. Research has shown that there is a higher risk of developing allergies if one or both parents have allergies, asthma, or eczema. However, environmental factors, such as exposure to allergens, hygiene, and infections, also play a role in the development of allergies. This means that while genetics can increase the likelihood of developing allergies, they are not the sole determinant, and not everyone with a family history of allergies will develop them.
What are the 3 most common allergies?
Allergic reactions can be caused by sensitivity to foods, inhalants, or substances that contact the skin. From an ENT perspective we deal mainly with inhaled airborne allergies. The most common allergies vary depending on the population and geographical location, however, three of the most prevalent airborne allergies worldwide are pollen, pets, and house dust mites.
Pollen allergies are triggered by pollen from trees, grasses, and weeds. These allergies are seasonal, with symptoms typically occurring during specific times of the year when pollen levels are high. Grass pollen is the most common type of pollen in the UK. It is released into the air from May to September. Tree pollen levels are highest between March and May, while weeds are commonest between June and September.
Pet allergies are usually caused by proteins found in a pet's skin cells, urine, or saliva. Cats and dogs are the most common sources of pet allergens, but other animals, such as birds and rodents, can also cause allergies.
Dust mites are microscopic creatures found in household dust. They feed on dead skin cells and other organic materials, and their waste products can trigger allergic reactions.
What things are most likely to trigger allergies and what symptoms do they present?
The trigger for an allergic reaction is exposure to any of the allergens mentioned above in a hypersensitive person. What causes someone to become hypersensitive isn’t fully understood, but it may involve factors such as genetic susceptibility, or exposure to air pollution, tobacco smoke, or other environmental factors.
Whatever the trigger, patients can suffer from a range of symptoms, including nasal blockage, sneezing, runny nose, itchy eyes, and a cough. Sometimes there can be a genetic predisposition to develop hypersensitivity reactions. When there is a genetic link we refer to the condition as atopy. Atopic children are also at risk of developing eczema and asthma.
What is the best way to cope with allergies, and if they aren’t working, when should someone seek more help?
If allergen avoidance and simple treatments fail to control symptoms, then it is appropriate to seek the advice of a healthcare professional. Your pharmacist will be able to recommend over-the-counter medical treatments such as oral antihistamines and nasal steroid sprays. If symptoms persist in spite of these measures then it is reasonable to request an appointment with your GP, or a specialist.
As a specialist I can review a patient's history, examine inside the nose, and investigate the source of the allergy with a simple blood test. We can also offer some surgical treatments that can help to provide symptom control when medical treatments are not enough.
What are red flag symptoms of allergies, that may indicate something more?
The symptoms of allergic rhinitis include nasal blockage, runny nose, sneezing, itching, and watery eyes. It is important to remember that these symptoms rarely indicate the presence of a serious illness. In rare circumstances they may be associated with something more concerning, such as anaphylaxis, severe bacterial infections, or tumours. Each of these conditions will have its own set of trademark symptoms.
Symptoms of anaphylaxis usually come on within minutes of exposure to an allergen, but sometimes there can be a delay of a few hours. Along with nasal blockage there may also be wheezing, shortness of breath, and swelling of the face, lips, or tongue. There may also be more general symptoms such as rapid heart rate, headache, nausea, and a feeling of anxiety, or panic. Patients with these symptoms should seek immediate medical attention.
Severe bacterial sinus infections can progress over a period of hours or days. Warning signs include Intense or worsening facial pain, especially around the cheeks, forehead, and eyes. A high fever combined with nasal discharge could signal a more severe infection and changes in vision, such as blurriness, double vision, or reduced vision, may indicate a severe infection or other complications that require immediate evaluation.
Tumours of the nose and sinuses are uncommon, but when they occur, they usually only affect one side of the nose. If a patient is experiencing unilateral symptoms such as nasal blockage that is getting progressively worse, or gradually increasing facial pain or nose bleeds on one side then they should see a specialist for a full internal nasal examination.
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