Frequent Allergies: Is there any permanent cure?

Frequent Allergies: Is there any permanent cure?

An allergy occurs when the immune system reacts to a foreign substance. This could be seasonal pollen, a bee sting or even pet hair. Food allergies are also quite common in people. The severity of the allergies can vary from one individual to another. It could range from a minor irritation to even a potentially life threatening emergency in some individuals. If you are in Singapore, patients with allergies can visit The ENT Clinic, with its well trained and experienced ENT physicians who can address your condition.

How is an allergy caused?

An allergy is caused when a person’s immune system overreacts to substances which are generally harmless. When a person gets exposed to an allergen for the first time, it may not usually cause a reaction, however, with time the immune system can develop sensitivity to a particular allergen. As time goes on, the body recognises and remembers the allergen. This causes the body to build antibodies against it and this build-up is called sensitization. A person who has grass pollen allergy for instance would experience hay fever symptoms in April and May and the severity can increase when the pollen count rises.

What are the usual allergy symptoms?

A person who comes into contact with an allergen can cause the immune system to react leaving an inflamed skin, sinuses, airways or the digestive tract. The specific symptoms of the allergy will depend on the type of allergen. Based on the trigger, the following symptoms are observed.

Pollen: Watery, itchy eyes and nose together with a cough or congested nose.

Food: Itchiness in mouth, vomiting, swelling in the face, lips and throat, shortness of breath, a swollen tongue and tingling sensation in the mouth would be experienced. Children can have rectal bleeding and diarrhoea may occur in adults.

Insect bites: Hives on the skin, dizziness, itchiness and swelling, restlessness, shortness of breath and even a drop in blood pressure may be observed.

Medications: Skin rashes, itchy skin, wheezing and swelling in the face and lips may be observed.

What is an anaphylaxis reaction?

This is when an allergic reaction can become life threatening requiring a medical emergency. An anaphylaxis reaction can send a patient to go into a shock. Some of the symptoms include.

  • Light-headedness
  • Loss of consciousness
  • Decrease in blood pressure
  • Shortness of breath
  • A weak pulse.

When to see a doctor?

If you suspect that you have an allergy, and over the counter medications are not providing relief then it is good to have an ENT doctor evaluate you. In case of a severe allergic reaction seek emergency treatment immediately.

How is an allergy diagnosed?

To evaluate the allergy, the ENT doctor will ask a detailed set of questions to understand the signs and symptoms. In addition, the doctor will perform a physical examination and if needed perform a skin test by exposing the skin to small amounts of potential allergens. If the allergy is present, then a hive will develop at the test location. In addition, blood sampling to check the sensitivity levels for IgE level antibodies may be done if required.

What is the closest cure for an allergy?

Medications are quite effective in treating the allergic symptoms, but it is important to have an effective cure. Allergen immunotherapy is the best option at hand to cure an allergy. This helps to reduce the severity of the symptoms and the requirement of any allergy medications.

How is allergen immunotherapy performed?

This is when the allergen is administered in increasing doses over a period of time by an ENT physician. The administration of the allergen can happen as an injection, orally or sublingually. By doing this procedure, the immune system gets used to the allergen and switches off the allergy.  This helps to desensitize individuals to the allergy and the patients become immune to the allergens. This will help to tolerate the allergen and there will be few or no symptoms observed.

Although the benefits from immunotherapy are high, it is not a quick fix of treatment. One needs to be committed between 3 to 5 years for best results. It’s important to be cooperative with the doctor to minimise any side effects.

Allergen Immunotherapy for Environmentally Inhaled Allergens

If you have a child who has chronic allergic rhinitis or rhino-conjunctivitis which is caused by pollen or dust mite, immunotherapy may be a very effective treatment and it can benefit in controlling allergic asthma too. If the child has severe allergy symptoms and the allergen is difficult to avoid, then this treatment may be recommended by the ENT doctor. Through this process the children can be made to tolerate allergens with few or no symptoms. This is usually a successful treatment and there is less need for medications in future.

Usually, the treatment offered is subcutaneous immunotherapy and it is done through regular monthly injections which are given under the skin with a fine needle. It is generally well tolerated. Sublingual immunotherapy too can be done and this is when drops or tablets are taken daily to form effectiveness. The compliance with this method is lower when compared to subcutaneous immunotherapy.

What kind of side effects may be witnessed through subcutaneous injections?

Certain individuals can develop a localised swelling at the injection site. It can be treated with ice-packs or an oral histamine. If the swelling is very big, then the ENT doctor will use a smaller dose next time. Generally severe anaphylaxis reactions are not witnessed, but predicting is difficult. Therefore, the ENT doctor will advise you to remain in the ENT clinic for at least half an hour. It is also recommended not to exercise for at least 3 hours following the injection and to avoid any hypertension medications like beta blockers immediately.  Always remember to discuss with your ENT doctor about the medications you are on. In addition, the doctor may recommend taking an oral histamine prior to the injection to reduce any risks from side effects. Do keep your doctor informed if you experienced any side effects after the last injection and if you are taking any other medications currently or if you are pregnant.

Patients who are planning pregnancy or are pregnant are not recommended for allergen immunotherapy until they have given birth. If an individual gets pregnant while on maintenance doses then, the ENT specialist will decide if to continue the injection or not depending on the level of safety.

Allergen avoidance and medications doesn’t offer a permanent cure and therefore choice of immunotherapy after discussing with your ENT doctor would be a great step forward to prevent a recurring allergy. The ENT Clinic has the facilities to perform immunotherapy in both adult and pediatric patients. Conveniently located at Gleneagles hospital and Mt. Elizabeth Novena Center, this medical practice offers state of the art facilities in ENT for Singaporeans and visitors by leading otolaryngological specialists Dr Jeeve, Dr Annabelle and Dr Hobbs.