Sneezing? Must be allergies. Eyes red? Must be allergies. Congested? Must be allergies. Ears popping?

Seems like the in rage diagnosis the last 10 years is allergies. While certainly allergies affect a broad range of people in a broad range of ways, we have to be careful to not run away with the rubber stamper. The management and treatment of allergies as they pertain to symptoms of nasal congestion, sinusitis, runny nose, ear pressure and fullness, eye irritation, and cough has a rational basis, but must include a thorough evaluation of both allergic and non-allergic problems that may be contributing to these symptoms. Furthermore, effective treatment of allergies requires an effective strategy to control symptoms.

Understanding how allergies work is the first step to any type of treatment. Allergies are simply your body's defense systems overreacting to something that is otherwise harmless. For instance, a floating pollen comes in contact with your nose, and your nose does everything in its ability to attack the pollen as if it were under attack from a bacteria or virus. The primary response involves chemical mediators working to increase blood flow to your nose to make your nose run, become congested, and increase your body's defense cells in the area. Your body will try to sneeze the pollen away as well as part of the defense. This is great for removing truly harmful things, but innocent things like pollens are ubiquitous in nature and do not require this response. Liken this to calling out the fire department for each time you turn on your stove. You would hate to be hosed down with water when nothing is wrong.

So why do we react to react this way, and why does this affect only certain people? To give a simple answer to a complex question, no two person's defense systems are the same, and no single person's defense system is perfect. It's just a matter of being exposed to something in your environment that exposes a programming error in your defense system. When you change your environment, such as getting a new pet or moving to a new area or home, you may encounter something new that exposes your weaknesses.

Treatment of allergies involves avoidance, medication and possible immunotherapy. But before that step commences, evaluation for common problems that mimick allergies or worsen them must be done. For instance, nasal passages are often narrowed by crooked bones or cartiledge internally. Tonsils and adenoids, particularly in children, often swell to the point they narrow the nasal passages. Both of these problems will make you congested with a runny nose chronically, but are better treated with surgery rather than lifelong medication. Irritants in the air such as cigarette smoke make create similar symptoms to allergies, but are not mediated by an overactivity of the body's defense system.

When the other reasonable causes of the problems have been evaluated, identifying the triggers for your allergies is the next step. Sometimes this is easy, i.e.- your new cat makes you feel sick when you are around her. Sometimes it's not so easy- you go to the park and feel ill, where you are surrounded by a variety of trees, grasses, pollens, etc. Even more complicated are problems that are year round such as dusts and food allergies. When allergies are suspected, the reasonable next step is allergy testing.

Allergy testing comes in a few different forms. Skin testing works great for inhalants such as pollens, trees, dusts, grasses, etc. A small puncture in the skin is used to introduce a portion the item being tested, and if you are positive, a reaction in the skin is detected there and measured. Blood testing (RAST) works great for those unable to tolerate skin testing such as young children or people with severe reactions. Dietary trials are the means to identify the non-obvious food allergies.

Once you have an idea of what you are allergic to, avoidance is the best treatment. Unfortunately, this is not always practical-i.e. you can get rid of your cat, but you can not avoid trees forever. Medications for allergies are plentiful and many are now available over the counter, but understanding how they can be used for your optimum benefit with minimum side effects is something you should discuss with your physician. In addition, certain medications are available only by prescription. If medications are not helping, the only way to "cure" allergies is to modify your body's immune responses in a process called immunotherapy. This can be done by very carefully receiving doses of the allergen in gradually increasing amounts, usually in a series of injections, through the physician's office.

If you are interested in learning more about what's troubling your nose, or suspect you have allergies, please contact our office at 858-674-1165, or visit our website at www.ranchoent.com. We offer comprehensive care including allergy evaluation and treatments, as well as medical and surgical treatment options to get you feeling better. I wish you the best of health.