Tag Archives: allergies

Chronic Sinusitis at a Glance

No273 13 Oct 2009 Sneezephoto © 2009 mcfarlandmo | more info (via: Wylio)Sinusitis makes you and almost 30 million people each year feel miserable. The combination of facial pressure, headache, fatigue, sneezing, runny nose, drainage of thick colorful mucus from the nose and severe nasal congestion contribute to the misery. It is often difficult to treat, in many people is very slow to improve, and recurs frequently.

The chronic recurring condition known as chronic sinusitis or rhinosinusitis is a bit of a puzzle. We do not really understand all the factors that promote the symptoms that make you so vulnerable to recurrence.

Although the causes are not understood, there are several theories and observations floating around. Clearly, this is a stubborn condition often slow to resolve.

  • Infections are a common component but not the only piece to the puzzle. Research suggests there is a certain amount of swelling and inflammation in the sinuses and nasal passages that cause the congestion blocking airways and connections between sinus cavities. Any time there is warm, moist, closed-off space in the human body, it predisposes to problems.
  • Many factors may stimulate the swelling and inflammation. Environmental allergies are common and probably an underrated contributor to the inflammatory response.
  • The presence of some kinds of bacteria without actually causing an infection may also irritate the immune system to produce inflammation.
  • Structural abnormalities to the septum or polyps, which also result from chronic inflammation, may serve to block nasal airways as well.
  • Other medical conditions can be part of the problem. This can range from simple allergies, acid reflux from the stomach reaching nasal passages while asleep, cystic fibrosis, or any chronic conditions that affect immune system response.

The importance of identifying chronic sinusitis and initiating management can help provide greater comfort and prevent serious complications.

Treatment should aggressively address infections when they are present.

  • Since so many clues point to the role of inflammation, nasal steroid sprays have become a cornerstone of management.
  • There are several non-sedating antihistamines available without prescriptions that are effective when allergies play a role.
  • Many people find benefit from daily use of saline irrigation done with an inexpensive neti pot or irrigation bottle. Regular use of simple saline spray also is very helpful to help open and provide added moisture to nasal airways.
  • Surgery should be left as a last resort for only extreme cases that have failed all other measures.

Over-the-counter decongestants should be avoided. Although they provide quick short-lived relief, they just as quickly become less effective and can actually stimulate rebound congestion. This means they become part of the problem rather than the solution.

Chronic sinusitis is undoubtedly a stubborn and all too common problem. Although we do not understand completely why, many treatment options are available. Consult your healthcare provider to tailor a regimen that suits your needs. Do not ignore it and keep suffering. There is help!

– Dr. Bruce Kaler

Advertisements

Food Allergies at a Glance

The topic of food allergies is murky and confusing. Many reactions reported as allergy to a food product are really mere intolerance, over-eating or other factors. True food allergies are thought to occur in 8 percent of children under age 5 and only 3 to 4 percent of adults. The frequency of allergies does not vary much around the world, while both genders are equally affected.

True food allergies can cause reactions that differ from mild digestive issues, rash, hives or difficulty breathing. Anaphylaxis is the most severe form of allergic reaction, with onset within 20 minutes of ingestion that progresses rapidly, resulting in hives, shortness of breath, rapid pulse and even death if not immediately treated. Although estimates of life-threatening reactions vary widely, it comprises only a small number of the overall allergic reactions to food. True food allergies usually occur within 2 hours or less after ingesting the food. Onset of swelling or tingling around the throat, lips, face or hives and itching are early signs. It can progress to dizziness, nausea, vomiting or difficulty breathing. Which symptoms and how rapidly it progresses may be different in one person to the next.

Food intolerance is only sensitivity to a food that is driven by a different physiologic mechanism that causes much milder symptoms and does not lead to more severe reactions. A good example of this is lactose intolerance, or sensitivity to milk and dairy products. Due to an enzyme deficiency, it often results in abdominal gas, discomfort, cramping and diarrhea. It is a lot more common and vastly different than a true food allergy.

FOOD by Wolfgang Wildnerphoto © 2011 Wolfgang Wildner | more info (via: Wylio)

The most common food allergies are eggs, milk, peanuts, tree nuts (i.e. walnuts, pecans) wheat, and shellfish (shrimp, lobster, crab, clams). Regular fish and chocolate are much less common allergens than anecdotes suggest.

Food intolerance can be confused with an allergy. Only a small amount of a food can trigger a severe allergic reaction. Food intolerance, food poisoning, stress, a virus, medications, food additives (preservatives, coloring) can all produce similar but milder symptoms, particularly intestinal problems. So it can be confusing at times to ascertain what the origin of the reaction may be.

A family history of food allergies, asthma or eczema increases the risk of true food allergies. Allergic individuals may cross react between certain allergens. Some of those sensitivities can extend between dissimilar items that may not be obvious. Consulting your healthcare provider, an exam and possible testing may be able to provide peace of mind, appropriate treatment and identify what to avoid in the future.

The most important aspect of managing food allergies is avoidance. Unfortunately there is no specific treatment. Antihistamines are still the first line of defense in both children and adults at the onset of a food allergy. If severe, prompt medical attention may be needed. Food allergies in children often change over time. The onset is most common in the first few years of life but can occur at any age. Allergies do get better in some children as they get older. Research shows there is no relationship between allergies and when new foods are introduced after 6 months of age.

Variation in personal experience seems to be the rule. Family and personal history of allergies are stronger predictors of future course. The severity of a past reaction cannot predict the severity of a future reaction.

When in doubt about food sensitivities or allergies, simply avoid it! Consult your healthcare provider to help with any confusion.

– Dr. Bruce Kaler

5 Steps to Survive Winter Allergies

Most of us associate allergies with spring and summer when things are in bloom. Even some of us who don’t have allergies seem affected by a vigorous bloom; however, folks who have spring allergies are also more prone to winter allergies. The human immune system’s sensitivity to different allergens is very individualized. But if one is prone to spring allergies then there is a greater chance that you may have problems in the winter even though the triggers are entirely different.

When the weather gets cooler, we close up the house and turn on the heat, making the perfect storm for allergy sufferers. Dust, mold, mildew and pet dander are the big winter culprits. The secret is these things are actually around all year long. In sensitive individuals, these factors may intensify allergies any time of year but really come into play in the cooler weather. Trying to minimize the amount of these allergens in your environment is helpful.

Even though you cannot truly be the master of your domain, you can improve the condition of your habitat by following these tips:

“Cats are magical. . .the more you pet them the longer you both live” ~photo © 2010 Nancy ~ | more info (via: Wylio)

1. Avoid known allergens: This means some regular house cleaning, probably weekly with a more vigorous attention to problem areas once per month. Keep pets out of the bedroom – this will make your sleeping area as a safe zone to keep down the amount of pet dander, dust and molds that animals also carry on them wherever they go. You spend a lot hours in your bedroom, so keep it as allergen-free as possible. Really sensitive individuals may consider showering more often to remove potential allergens from hair, skin and clothing.

2. Change your bedding weekly. Washing sheets, linens and towels helps keep the amount of dust, dust mites and mildew down to a minimum. Dust mites are microscopic organisms that exist everywhere. They thrive on dry skin cells that naturally slough off our bodies. Special bedding or mattress covers can be purchased that help contain this situation for individuals who need additional help. Allergy bedding and special mattress covers can be purchased at many department stores that handle regular bed linens.

3. Add moisture. The dry indoor air exacerbated by heating systems of any kind is irritating to airways and tends to make people with allergies even more vulnerable. Room humidifiers, liberal use of saline nasal spray, nasal irrigation systems, and simply staying well hydrated by drinking plenty of fluids can be very helpful.

4. Take allergy medicine regularly. If you suffer with allergies, you need to be proactive and take a preventive stance against your symptoms. Waiting until you feel bad is too late. It is much harder to gain control by that time. There are good non-sedating antihistamines that are available without prescription, very effective and still form the foundation of allergy control.

No273 13 Oct 2009 Sneezephoto © 2009 mcfarlandmo | more info (via: Wylio)

5. Consult your healthcare provider. If you still can’t gain control and a functional level of comfort with the above mentioned measures, there are additional prescription medications that can be effective. Discussing which choices are right for you and the severity of allergies would be time well spent.

Whatever you do, don’t give up. There is help. It is just a matter of identifying what your triggers are and how best to avoid them.

– Dr. Bruce Kaler