What are allergies? Allergy is an abnormal reaction of the individual to substances in the environment. The incidence of allergy is reaching epidemic proportion affecting up to 40% of the population. What’s in a name Allergy manifests in various forms and can affect different body systems concurrently. They are called by different names and treated by different specialists causing confusion to patients and doctors alike. • Allergy of the nose: Allergic Rhinitis/ Sinus • Allergy of the eyes: Allergic Conjunctivitis • Allergy of the lungs: Allergic Asthma • Allergy of the skin: Ezcema, dermatitis, contact dermatitis, hives, and urticaria • Allergy of the gut: Manifests as colic, bloating, diarrhoea • Middle Ear Fluid: Otitis Media • Non Specific Symptoms: Fatigue, hyperactivity, headaches, depression It is therefore critical in the treatment of allergy that the patient is managed in a holistic fashion rather than compartmentalisng the symptoms. Causes of Allergies This is predominantly caused by what we breathe: inhalant allergy; and what we consume: food allergy. Inhalant Allergy Inhalant allergy is well recognised. Dust mite, pollens (hay fever) and animal danders are all common contributors. Food Allergy Food Allergy presents in two forms:

The Immediate Allergy
This form presents no difficulty in diagnosis as a reaction like rash occurs immediately on food consumption such as peanut or shellfish allergy.

The Non-Immediate Allergy
The reaction appears much later and specialised tests become necessary for diagnosis. Symptoms caused by food allergy include eczema, chronic cough, nasal polyps, phlgem (in the absence of infection), chronic headaches, etc. Often the symptoms are non-specific and statistics have shown that typically the sufferer would have sought numerous medical opinions without relief.

How are allergies diagnosed? For allergies to be appropriately treated and controlled, it is important that the specific allergen(s) causing the allergic symptoms be identified. The first step is a detailed history and physical examination to confirm the symptoms of allergy. The methods of assessment include using skin tests and or blood tests. These tests will help determine the mode of treatment for the allergies. How are allergies treated? Treatments of allergy include avoidance, medication and immunotherapy.

1. Avoidance
In most instances, the cause of symptoms can be avoided or removed. For example, a particular food that causes the allergic reaction can be avoided, or a pet can be removed from the home or kept away from the sleeping area. Some causes of symptoms cannot be eliminated but exposure may be reduced.

2. Medication
Medication is frequently used to decrease or eliminate allergy symptoms. These include steroid nasal sprays, steroid tablets, creams and antihistamines. While they are effective in controlling symptoms, they do not provide a cure.

3. Immunotherapy (Desensitisation)
Immunotherapy is the only means of curing your allergies as endorsed by the World Health Organisation (WHO). The program allows for desensitisation against the substance you are allergic to. For example, if you are allergic to dust mite, then immunotherapy can prevent you from reacting to dust mite after an appropriate time of treatment. The immunotherapy benefits can last up to and beyond ten years. Both adults and children from the age of 3 can benefit from it. Immunotherapy will also help in reducing the development of new allergies. It has been used successfully for allergic rhinitis and asthma with excellent results.

In the past, immunotherapy was only available in injection form. Now an oral preparation called Sublingual ImmnoTherapy is available. Accurate diagnosis is essential for treatment. Trained allergist and ENT doctors with a subspecialisation in allergy provide this treatment.

Allergy in ENT
An otolaryngologist is a doctor who specialises in ear, nose and throat problems. Chronic nasal congestion and postnasal drip are commonly related to allergy. This may be further complicated by chronic sinus disease and middle ear disease. The otolaryngologist who specializes in allergy will be able to provide comprehensive diagnosis and treatment.

Allergy problems in Children
These are often neglected as the children do not complain or the allergy is not recognised. Allergy manifestations change as the child grows. The type of allergens that can affect the child also changes. For instance, babies are more troubled by gut problems and ezcema. The main cause is food related. As the child grows, the problems of rhinitis and asthma become more prevalent and the ezcema may subside. Environmental exposure to dust, pollens, pets and diet play a part in the change. There is now an increasing trend of allergy in children.

Allergic rhinitis when left untreated leads to increased risk of asthma. The child that has recurrent colds, flus, runny nose, sneezing, glue ears and ezcema should be evaluated for allergy. Successful management of the child’s allergy will lead to a better quality of life with less frequent concomitant medical problems.