What you need to know about allergies.

What are allergies and how may they affect me?

Allergic diseases occur when the body makes an inappropriate, exaggerated response to seemingly innocent and common environmental or dietary substances, known as allergens. Other offenders (allergens) include insect stings, drugs, cosmetics, heavy metals and occupational substances.

Allergies are not infectious diseases however an allergic person may get more frequent infections. The commonest allergies occur when the body produces a type of antibody against these, causing inflammation (swelling, redness, itching, irritation and watery discharge) resulting in the following types of allergic diseases:

Rhinitis (nose allergies), sinusitis, ear and eye allergies

Asthma, allergic wheeze and night-time cough

Skin allergies, eczema, urticaria (hives) and angioedema (skin swellings)

Food allergies and gastrointestinal symptoms

Anaphylaxis (life threatening severe allergy)

Are allergies common in East Africa?

Allergies are among the most common chronic conditions worldwide. The prevalence of allergic diseases worldwide is rising dramatically in both developed and developing countries and higher in urban areas. They are reported to affect at least a third of our population as reported in international studies (ISAAC) of 1996 and 2001 conducted in 3 Rift Valley Schools on 13-14 year old children. The 2001 study revealed a significant increase over 1996 demanding urgent action as it reflects environmental/ dietary changes are a cause.

Can an allergy develop at any age? Who gets allergies?

Allergic reactions can develop at any age, no matter how old you are. Allergies can affect anyone, regardless of age, gender, race or socioeconomic status.

Is it true that allergies run in families?

There is a link to family history of allergies and allergic diseases. If neither parent is allergic, then the risk of their child being allergic is 12.5%. If one parent is allergic, the risk is 19.8%, but if both parents are allergic, then the risk rises to 42.9%. If both parents are allergic with the same allergic condition, then the risk for their child is 72.2%! A patient who has the tendency to be allergic is known as Atopic.

While we cannot change our genes, we can find out and manage the allergens that cause the allergic diseases!

What is the pattern of allergies? What is the 'Allergic March'?

Allergies can present in a variety of ways throughout one’s life, however certain characteristic allergies do tend to present at certain ages. In infancy, food allergies, digestive symptoms and eczema tend to predominate. In some cases, these may resolve with age or continue to adult life. Often, by age 5 years, children get nasal/ tonsil or adenoid problems and ear infections. Asthma or nocturnal cough may present by 3-5 years of age. Some children, those at higher risk of allergic diseases, can progress through the above pattern having features of one allergic disease and then subsequently developing the rest with age. This is called The Allergic March. Identifying these high risk children is important, in order to institute the correct measures to reduce or halt the progression of this Allergic March.

Some food allergies can resolve with time as new microscopic airborne allergen sensitivities develops so your doctor needs to review the food allergy to avoid unnecessary elimination of healthy, affordable foods once it can be tolerated. Adults can also develop food allergies.

Evidence has shown that for patients of all ages with untreated or poorly controlled rhinitis, there is a progression to allergic asthma and exercise induced wheezing. This occurs because the nose and lungs are one airway where allergic inflammation in one area can affect the other over time.

Is fever a regular sign of allergies?

Generally fever is not a sign of allergies but it appears when inflamed organs from allergies develops a secondary infection as in adenoids, tonsils, ears, sinuses or skin. Hence, repeated use of antibiotics can be avoided by dealing with the root cause – the allergies.

How are allergies diagnosed?

The doctor needs to take a very careful detailed history and examination of the patient’s disease and ask about the appropriate environment and diet of the patient to try and narrow down the offending suspects. Your doctor will ask for your medical history and medications used. Bring your medications with you.

Specific allergy testing is then required to identify which of the allergens have antibodies made against them. There are different types of allergy tests. The preferred, more reliable, accurate and interpretable test is the . The results are available immediately for interpretation by the specialist. It is very well tolerated, even in infants. are only offered for certain conditions.

Confirmation or exclusion of suspected food allergies will require a special short diet to be followed as guided by the doctor.

Special blood tests can also be performed; however these are only advised to be used under special circumstances directed by the allergist. The blood tests available routinely do not test for the relevant dietary and environmental allergens present in our tropical countries (as these were developed for use in temperate climates and western diets). Interpretation of the skin prick tests and laboratory tests requires specialist training and understanding about allergic diseases. The doctor then advises whether these offenders are genuinely responsible for the symptoms.

And once the allergy has been diagnosed, what happens next?

There are 3 steps to managing the allergic conditions once a formal diagnosis has been made.

  • Allergen avoidance measures are formulated by the doctor to help reduce symptoms and bring the need for medication down to a minimum
  • Medical therapy may still be required to manage symptoms if allergen avoidance is not fully possible or where the symptoms remain troublesome
  • Allergy shots (desensitization/immunotherapy) are offered to patients whose symptoms or allergies warrant this form of therapy For patients with life threatening allergies, the allergist will also prescribe and train you on how to use life saving treatment in case of emergencies.

How can allergies affect my/my child's health and quality of life?

In children, allergic diseases (even seemingly mild conditions like rhinitis) which are untreated or poorly controlled have been shown to affect growth and development, hearing, sleep, school performance, poor exercise tolerance, psychological wellbeing and self confidence. Young adults particularly feel self conscious of skin problems and suffer low self esteem.

Children often end up on prolonged, inappropriate diets by parents, alternative and untrained practitioners out of desperation leading to dietary deficiencies. These can be avoided by using the correct techniques to identify the foods genuinely responsible for the disease and then liberating the diet as much as possible. Also the allergist will make recommendations of dietary substitutions for your child to prevent nutritional deficiencies.

Adults can suffer the above as well as work absences, irritability, relationship and social difficulties.

The Allergy Clinic | Copyright 2019