And Other Things You Can Live With But Could Get Along Very Well Without - Allergies

Discomforts of various kinds are considered allergies when they are brought on by substances or conditions that ordinarily are harmless. Not too long ago, perturbed allergy sufferers would say things like:

“I can't use that soap because it gives me hives.”

“Smelling roses makes me sneeze.”

Nowadays, such complaints are commonly recognized as indications of allergies.

Symptoms

Allergic symptoms can range from itching eyes, running nose, coughing, difficulty in breathing, welts on the skin, nausea, cramps, and even going into a state of shock, depending upon the severity of the allergic individual's response. Almost any part or system of the body may be affected, and almost anything can pose an allergic threat to somebody.

Allergens

Substances that trigger an allergic reaction are called allergens . The system of an allergic individual reacts to such substances as if they were germs, producing antibodies whose job it is to neutralize the allergens. But the body's defense mechanism overreacts: in the process of fighting off the effects of the allergens, various chemicals, particularly histamines , are dumped indiscriminately into the bloodstream. It is the overabundance of these “good” chemicals that causes the discomforts associated with allergies.

Allergens are usually placed in the following categories:

1. • Those that affect the respiratory tract, or inhalants , such as pollens, dust, smoke, perfumes, and various airborne, malodorous chemicals. These bring on sneezing, coughing, and breathing impairment.
2. • Food substances that affect the digestive system, typically eggs, seafood, nuts, berries, chocolate, and pork. These may cause not only nausea and diarrhea but also hives and other skin rashes.
3. • Medicines and drugs, such as penicillin, or a particular serum used in inoculations.
4. • Agents that act on the skin and mucous membranes, such as insecticides, poison oak, and poison ivy, particular chemical dyes, cosmetics, soaps, metals, leathers, and furs.
5. • Environmental agents, such as sunlight or excessive cold.
6. • Microbes, such as particular bacteria, viruses, and parasites.

Treatment

In general, approaches to treatment for allergies fall into three categories: removing or avoiding as many allergens from the environment as possible; using creams, inhalers, pills, and other medications to control the symptoms; and undergoing immunotherapy (allergy shots) to reduce the allergic response. The type of treatment selected often depends on test findings that indicate what is causing the allergic reaction; the tests may produce such identification quickly or they may have to be continued for weeks or months before the allergen is finally tracked down.

As soon as the source of the allergen is identified, the obvious course is to avoid it, if possible. Avoidance may not, however, be possible. Few persons can avoid breathing pollen in the spring and fall. Giving up a house pet may be almost as difficult, but may be necessary as a health or comfort measure.

New medications that control the symptoms of allergies have been marketed in recent years. Newer antihistamines, for example, relieve allergic reactions but do not cause the drowsiness associated with earlier medications. Other medicines that have been used to treat allergies include adrenaline, ephedrine, and cortisone. Aerosol drugs may be used to attack specific symptoms. Some, for example, may be inhaled to treat the linings of the nose and throat.

In addition to histamines, other body chemicals are released during an allergy “attack.” Researchers have found that these chemicals include leukotrienes. Consequently, antileukotrienes have tested as medications.

Direct or specific immunotherapy constitutes the third approach to treatment of allergy. The shots are effective in reducing allergic responses. A person with a substance allergy receives increasing amounts of the substance over a period of years. For example, a person who is allergic to insect stings receives injections of the particular insect's venom.

A life-threatening allergic reaction calls for emergency treatment, usually with adrenalin. Physicians suggest that persons with very intense food allergies or who are allergic to insect stings should carry special kits that include an adrenalin-filled syringe. The allergy victims administer the medication to themselves in case anaphylaxis —an acute, life-threatening response (see “Allergic Shock” in Ch. 31, Medical Emergencies ).

Persons subject to severe, disabling allergy attacks by a known allergen should also carry a card describing both the allergen and the allergic reactions. Detailed information on the latest developments in allergy treatment is available from the Asthma and Allergy Foundation of America, 1125 15th St. NW, Suite 502, Washington, DC 20005. See also Ch. 24, Allergies and Hyper sensitivities .